SUMMARY:

• Over 5+ years of extensive and diversified experience in the Healthcare Industries.
• Excellent project management skills with an ability to understand the business domain, formulate business goals and ensuring that they are met.
• Experienced in gathering user requirements, analyzing them and translating them into business requirements.
• A highly efficient team player possessing excellent analytical, interpersonal, communication, documentation skills and a focused approach towards achieving target goals.
• Familiar with current industry standards, such as HIPAA, SOX, Title 21 CFR Part 11, 21 CFR Part 820, ISO, and Capability Maturity Model (CMM).
• Experienced in Healthcare Systems (ITS, QNXT), Health insurance plans - Indemnity plans, Managed Care plans(HMO, PPO & POS), Government Sponsored Programs (Medicare, Medigap, Medicaid, FEP & SHBP) & Consumer Driven Health plans(CDHP). Medicare Part A, B, C, D and Medicaid systems.
• Comprehensive understanding of HIPAA Standards (4010 & 5010) and Compliance issues, Medicare, Medicaid, ICD9, ICD10 and Claims adjudication process.
• Knowledge of HIPAA compliance and Healthcare systems. Experience providing primary analysis for business processes running on the EDI (Electronic Data Interchange) standard.
• Exposure to HIPAA Compliance requirements and HL 7 standards.
• Knowledge on Facet applications.
• Extensive knowledge of concepts like Gap Analysis, Risk Analysis, Impact Analysis.
• Working knowledge of SDLC.
• Skilled in the analysis of business requirements for software applications from functional and project management perspectives.
• Interacting with stakeholders, gathering requirements, rating them and assigning priorities to each of them.
• Elicitation techniques like interviewing, questionnaires, brainstorming, focus groups, prototyping.
• Exposure to data validation and data correction methodologies.
• Excellent presentation and communication skills combined with a proficiency in problem abstraction, business modeling, interpersonal, leadership skills, and ability to work in a cross functional team.
• Experience in creating and transforming business requirements into software requirement specification (SRS)
• Professional experience in business and data analysis.
• Working knowledge on processes running on the EDI (Electronic Data Interchange) standard.
• Sound knowledge in Object-Oriented analysis and design.
• Knowledge in Java related technologies such as J2EE, Servlets, JDBC, JMS.
• Basic knowledge of frameworks like Struts, Spring, Hibernate, and JPA.
• Knowledge in Ruby on Rails (Ruby Shell).
• Knowledge of developing GUI based application using Swings and Java Applets.
• Knowledge on different IDEs such as Eclipse and deployment using Application Servers Apache Tomcat.
• Knowledge in RDMB such as Oracle, MySQL and IBM DB2 databases.
• Good understanding of Business workflow, Business logic and Business methods for further implementation of user requirement in a distributed application environment

TECHNICAL SKILLS:

Project Methodologies: Waterfall, Agile/Scrum, RAD, RUP

Languages: Java, ASP.Net, Visual C#, SQL, XML

Business Analysis Skills: Business Process Analysis & Design, Requirement Gathering, User Case Modeling, JAD Sessions, Gap Analysis, and Impact Analysis

Requirement/Documents Tools: Rational Requisite Pro, Toad, Clear Quest, Clear Case.

Project Management Rools: Microsoft Project, Microsoft Office

Documentation: Data Mapping Document, Data Dictionary, User Specification Document, Process Documents

Database: SQL Server, Microsoft Access, Oracle

PROFESSIONAL EXPERIENCE:

Confidential, Richmond VA

Business Analyst

Responsibilities:

• Conduct review meetings with development, QA and data team to discuss business requirements.
• Collect, evaluate, and report data to support the analysts assigned to them in order to manage inventory flow effectively.
• Analyze inventory records to ensure the forecast for monthly usage is up to par and update the forecast on situations where the forecast is over or under corrected.
• Interpret results of overall inventory to ensure that customer fill-rate at each event distribution center about 98%.
• Analyze user requirements, attend change request meetings to document changes and implement procedures.
• Test data integrity and data validation to improve the work of the coordinators who uses such data.
• Present manual and showcase new procedure to inventory coordinators to ensure all requirements are met.
• Audit inter-company transfer purchase orders to ensure inventory does not come out of warehouse locations in conversion process.
• Review all Non-stock items to determine what level of buy-multiple category of item they need to be to ensure the correct amount of items are purchased on a monthly bases.
• Interview suppliers to understand their business with PSS and to ensure the same business principles are met during and after conversion.
• Review daily readiness reports to determine any discrepancies and fix them if applicable or forward to appropriate analyst for further review.
• Work with database development team to improve on Access database functions to shorten time spent on purchase order follow ups.
• Extract data from databases for review and manipulation
• Run reports using Excel and to compare and verify data.

Environment: Rational Requisite Pro, UML, MS Visio, MS Project, MS Office - PowerPoint and Excel, MySQL

Confidential, Richmond VA

Business Analyst

Responsibilities:

• Helped to communicate business priorities to the organization to effect business solutions.
• Utilized Agile Methodology to configure and develop process, standards and procedures.
• Conducted JAD sessions workflow diagrams, UML diagrams, process models, activity diagrams, use cases, for incorporating design changes in the order creation/ management system.
• Worked as a liaison between the business and technical side to convey the business needs to the system architects.
• Collaborated and provided critical thought and best practice discipline in the planning, design, development, and deployment of new applications and enhancements to existing applications.
• Act as a liaison between business stakeholders and the IT team to ensure requirements are accurately captured and fully understood by involved parties.
• Prepared the Business requirement Document (BRD) and functional requirement document (FRD) for the enhancement of the existing services.
• Analysis and Design of existing transaction sets, and modification of these transaction sets to ensure HIPAA compliance.
• Good exposure to Clinical systems /EMR/EHR/Practice Management.
• Attended daily SCRUM and guided QA and Developer regarding the defects, Technical Specification Documents and Mapping Documents.
• Worked closely with business users and IT team in War room to solve the issues in time.
• Assisted with/facilitated mapping of “to-be” processes and worked on the gaps of “As-is” to “To-be” processes.
• Proficient in using UML for Business Process Modeling, Use Cases, Activity Diagrams, Sequence Diagrams, Data Flow Diagrams, Collaboration Diagrams, Class Diagrams and document them using Rational Rose for UML Modeling.

Environment: MS Office, MS Visio, UML, MS Project 2000, Oracle, UNIX, Windows

Confidential, Confidential MD

Business Analyst

Responsibilities:

• Responsible for gaining a good understanding of user needs and accurately representing them in a well-documented software functional specifications document.
• Gathered Business Requirements, interacted with the users, designers and developers, project manager and QA team to get a better understanding of the business processes.
• Created workflows adhering to Business Process Model and Notation (BPMN).
• Helped in defining the ETL process with data quality requirement definition and testing.
• Worked with HIPAA X12 electronic transaction standards version 5010 with EDI 834 transaction set for benefit enrollment.
• Involved in Enterprise Data Warehousing to store and retrieve data regarding EDI transactions 837P which helped giving accurate information regarding the and claim process.
• Involved in Claims Adjudication Process for 837P and validate data with facets.
• Created Business Process documentation.
• Developed Use Cases and created UML Diagrams including Use Case Diagrams and Activity Diagrams using MS Visio.
• Used IBM BPM for process design and monitoring with focus on workflow and productivity.
• Managed requirement changes and their associations with other requirements for traceability.
• Involved in drawing data flow diagrams and process flow diagrams using MS Visio for the Claim Adjudication module.
• Involved in generating Test Plans and Test Scenarios as per business requirements and conducted Manual and Automated testing at various phases of the project development.
• Wrote test plans and prepared test data as per application specifications.
• Participated in the bug review meetings, updated requirement document as per business user feedback and approved changes in the functionality of the application.
• Involved in User Acceptance Testing and coordinated with the development team in documenting End User Manual.

Environment: BEA Aqualogic, WebSphere, UNIX, MS-Project, Visio, Rational Rose, clear case, Requisite Pro