- Technical Business Analyst with over 9 years of experience in Healthcare, Life and Financial applications
- In depth knowledge of HIPAA (4010, 5010), ICD (9, 10), HL7, EDI (file formats like 837 I/P/D, 835 270/271, 276/277), Managed Care, Claims and Medicare business areas
- Hands on Experience in implementations for various domain areas in Property & Casualty Insurance.
- Extensive design experience in creating UML diagrams such as Use Cases, Activity Diagrams and Sequence Diagrams using MS Visio and Rational Rose
- Adept at creating and transforming business requirements into functional requirements and designing business models using UML diagrams- Use Case Sequence and Activity Diagrams Data-Flow Diagrams & Data Modeling.
- Good conceptual understanding of Data Warehousing. Proven experience in complete project life cycle - Design, Development, Maintenance and Documentation of Enterprise Data Warehouse, Data Marts, and Operational Data Stores (ODS)
- Proficient with web technologies such as HTML, XML, Web Services, Ektron and Alfresco
- Comprehensive knowledge of SDLC with experience in black box, regression, integration, UAT, load and performance testing
- Expertise in implementing systems Development in Agile (Scrum), RUP & Waterfall Methodologies
- Excellent communication and presentation skills with experience in development, implementation and integration of strategies within a team oriented environment
Applications: Healthcare, P&C and Auto LOBs, Finance, EDI Enrolment, Enterprise Data Warehouse, ICD Conversion , Billing & Payment
Health Care Subject Areas: Claims, Enrolment, HIPAA, ICD 9/ICD 10, HL7, Medicare, EDI ( 837 I/P/D, 270/271, 276/277, 835)
Methodologies: SCRUM, RUP, Waterfall
Data Modeling: Use Cases, Sequence Diagrams, Activity Diagrams, Data Flow Diagrams, ER Diagrams
Phases: All Phases of SDLC
Tools & Standards: MS Visio, Rational Rose
- Oracle, SQL Server, Access
- TOAD, MySQL
- HTML, XML, WebServices
- Ektron, Alfresco
- SharePoint, Lotus Notes
- HP Quality Center
- Mercury Test Director
- HP QTP, Mantis
- UML, Visio
- SQL, JSP, C++
- IBM RAD 7
- UNIX, Windows
- SWOT, PEST and SAR analysis
Client: Confidential, NJ
Position: Lead Scrum Business Analyst
Project 1: Enterprise Data Warehouse
The project scope is to successfully implement EDW (Incremental data load) for which EHR Transaction System is primary source and there after integrate many other sources like Physicians System and Drug Database into EDW. Additional requirements for Reporting were laid out for the existing reports.
- Interact with business users for better understanding of individual subject areas and modified specifications to reflect accurate user needs
- Gathered user requirements by interviewing focus groups and brainstorming with SMEs, Business users and Product owners. Created targeted questionnaires for SMEs to refine requirements and translated into business rules
- Used AGILE methodology and worked in short SPRINTS to achieve goals.
- Participated in SCRUMS and discussed the open issues and statues.
- Participated in Agile Planning Sessions and as sumed the Product Owner role for the agile initiative.
- Developed the Epics and Themes for the Scrum Project
- Devised and prioritized the Product Backlog by conducting requirement churning sessions with various Business / Product Teams.
- Created and explained the User Stories to the Scrum Team and helped them design the Tasks.
- Designed acceptance criteria for validating the output of each Sprint.
- Reviewed Team Velocity on a frequent basis and advised Scrum Master at various stages.
- Participated in Sprint Planning and Sprint review meetings for Finalizing the Sprint Backlogs and Verifying the sprint outputs respectively
- Cre a ted Release Tracking Document in orde r to trac k the ne ce ssa r y c h a n g e s .
- P a rticipa ted in Business Demonstrations and Decisions for the Release of the Sprint Output to Production.
- Worked Extensively with EHR Drug data and formats forms received from various Vendors & Partners in validating the Data in Stage Environments, Test running the formats and conducting issue analysis.
- Worked with drug databases like RX Norm & FDB for data validation and created Data mapping and ETL process requirements for loading data into the EDW.
- Worked with SME’s in resolving Drug Mapping issues and resolving errors and exceptions.
- Work closely with team leads in process of standardizing job parameters, job flows, audit process and rollback strategies that hold major attention for the successful implementation of EDW Incremental
- Developed UI models for Reports with new system and documented report frequencies and Subscription requirements.
- Provided inputs for Database Testing and Report Testing to the QA Teams.
- Address production, UAT issues, proper action was taken accordingly based on priority and requirement
Sr. BA / Product Owner
Confidential is a point-of-care information retrieval application that automatically generates and sends queries to electronic health information resources (e-resources) using patient data extracted from the electronic medical record and context information that is captured from the interaction between a clinical user and a clinical information system (e.g., user characteristics, patient demographics, task being performed by the user). Confidential – WebServices was implemented to receive and respond to the Physician-Print Service requests and the Patient Portal Service requests using the HL7 Confidential standards.
- Gathered requirements through a series of interview sessions and group meetings with the identified users and developers to design, build and release the Public facing Website.
- Conducted Joint Application Development (JAD) sessions with stakeholders throughout the Project to resolve open issues.
- Performed HL7 standards analysis and documented the enhancements to meet the end state requirements.
- Produced Visuals for the application using Azure tool and created Use Cases, State diagrams, Sequence Diagrams and Activity Diagrams.
- Developed EPIC’s from the Themes and Documented the Product Backlog for the release.
- Presented and Detailed Product Backlog Items to the Scrum Team in the Sprint Planning Sessions and assisted them in arriving at the Story Points for the User Stories.
- Reviewed user Stories and Acceptance Criteria with the team
- Assisted the Scrum Master in Creating and Managing the Release Planning Documents in the Version One and Share Point Repository.
- Assisted Scrum master in Developing the Task Sheet and Burn down Charts.
- Facilitated Demo’s of the software output of each Sprint and assisted Business in making Decisions on the release during the Sprint Review Meetings.
- Conducted requirements Churns between Sprints to update the product backlog.
- Conducted Analytics and Assessments to derive the Team Velocity based on the various Sprint Outputs.
- Designed HL7 mapping and UI document for the Website.
- Created UI mock ups and PoC’s for the Public facing user interface and the adverse event Reporting form.
- Extensively analyzed XML’s and documented business rules and Validations for XML documents.
- Worked closely with the Scrum Dev architects and Content Engineers for Design and Development of Confidential WebServices.
- Worked with Scrum QA team to go over the various test scenarios for different types XML Elements and Data Fields in the WebServices.
- Created the UAT document and conducted the UAT testing and Smoke Testing for the Release.
Confidential - Charlotte, NC
Sr. Business Analyst
Confidential is a leading financial services organization with $453 billion in combined assets under management. The firm is a leader in helping those in the academic, medical, cultural, and governmental and research fields plan for and live in retirement. The ultimate goal of this project is to develop a data mart and reporting back end to support the sales reporting needs of the executive and financial management community. A systematic process shall be in place for the Business to reconcile data in Data Mart with the GL for the data warehouse transactional information ensuring a very high level of data integrity at the policy level for each admin system. The data mart will be housed in the distributed environment thereby relieving the CPU demand on the mainframe. The reporting back end will provide the required daily, weekly, monthly, and MBR sales reports as well as security based ad-hoc presentation layer to allow reporting based on pre–formulated variables.
- Worked with the core team to gather business requirement from multiple stakeholders, accounting, operations and management groups - and reconciled conflicts by conducting Joint Application Development (JAD) sessions based on the project scope.
- Assisted Project Manager in driving Field Business Intelligence solution strategy, integrating multiple disparate processes, and addressing short and long term organizational needs
- Analyzed BI problems/gaps and recommend the appropriate BI or Reporting solutions for the Sales organization
- Analyzing data and metrics needs across all facets of the business; ensuring that all key performance indicators are identified and measured, supported by continued stability and reliability of Reporting tools to tell the business story through the numbers
- Updated existing reporting infrastructure to align with new reporting platform, OBIEE
- Performed GAP analysis involving the current state and proposed state.
- Working with the Data Analyst and data owners in validating the source data, reconciliation of the data and gathering input for the technical specification document.
- Created Requirement Specifications document for OBIEE reports as per the business requirement.
- Worked closely with the architects, database administrators and technical team during Data Mapping and Data Integration.
- Collaborated with the QA team to develop the test strategy, test conditions and test case scripts to be used in testing based on business requirements, technical specifications and/or product knowledge.
- Played a key role in the user acceptance testing (UAT), and implementation of system.
- Extensively used SQL scripts/queries for data verification and Validation at the backend.
- Created User Training Documentation and conducted demos.
Business Analyst / UAT SpecialistCigna major service lines include workers compensation claims administration and healthcare management services, property and casualty claims management, class action services and risk management information services. As a Business Analyst in Cigna I was involved in development of claim management data warehouse to assist claim professionals to analyze and administer the claims in an efficient manner. The operational data came from multiple sources and was then loaded into claim management data warehouse.
- Helped in defining Change Management Process for Release Management Team.
- Mapped process flow, assess as-is process through user interviews, data collection and analysis, design and evaluation of to-be process solutions.
- Prepared Business Process Models that included modeling of all the activities of business from conceptual to procedural level. Reviewed EDI companion guides for all payers to ensure compliance, edit integrity and maintain up-to-date list of payer contacts.
- Assisted the QA team in designing the Test Plan and Test Cases for User Acceptance testing.
- Designed and developed Use Cases using UML and Business Process Modeling.
- Consulted with healthcare insurance company to develop conversion specifications for other insurance Coordination of Benefits (including Medicare).
- Developed data conversion programs for membership, claims, and benefit accumulator data - converted thirteen corporate acquisitions. Developed data field mappings. Provided programming and support for claims processing functions and auto-adjudication.
- Validated the following: 837 (Health Care Claims or Encounters), 835 (Health Care Claims payment/ Remittance) & 834 (Enrollment/Dis-enrollment to a health plan)
- Identified gaps in the business process.
- Performed Data mapping, logical data modeling, created class diagrams and ER diagrams and used SQL queries to filter data
- Assisted process owners in process training and implementation.
- Streamlined the Restatement Financial Data Warehouse access review Process.
- Planned and defined system requirements to Wire Frame with Use Case, Use Case Scenario and Use Case Narrative using the UML (Unified Modeling Language) methodologies.
- Coordinating with the development team to set up test environment for issue escalation and issue resolution process for SIT and UAT testing to enable smooth operation
- Established RUP (Rational Unified Process) methodology and provided assistance in developing Use cases and project plans.
- Involved in reviewing test plans and test cases and ensuring test cases reflect user needs. Also responsible for conducting user training and user acceptance testing to ensure and verify system is designed according to user needs.
Confidential, Alpharetta, GA
Business Analyst Jr.
The project was to upgrade the Functionality of the Provider Desktop module for the EHR (Electronic Health Record System) with the objective to improve productivity and patient care. It serves as a central dashboard for providers to access crucial information such as Patient appointments, Clinical results, Messages, Electronic lab orders and Patient encounter notes anytime anywhere. The project was implemented securing patient privacy and health information conforming to HIPAA standards and guidelines.
- Upgrades to Provider Desktop module for the EHR (Electronic Health Record System)
- Objective to improve productivity and Patient care
Enhancements to Screens:
- Patient appointments
- Clinical results
- Electronic lab orders
- Patient encounter notes anytime anywhere
- Interacted closely with the Business users (Physicians) along with the administration and management to gather business requirements and analyze the functionalities to be incorporated into the system
- Participated in JAD sessions / conducted interviews for analyzing business requirements and reviewing them with business and technical teams
- Identified all necessary Business and System Use Cases from requirements, created UML diagrams, including Use Case Diagrams, Activity Diagrams and Data Flow Diagrams using MS Visio.
- Attended demo sessions to understand existing system functionalities
- Arranged interviews with all the stakeholders to review and understand the gathered business requirements
- Developed UID Documents, FRD and other SDLC Artifacts
- Coordinated with system architects and developers to convert business requirements into system requirements
- Conducted Demos and walkthroughs for Confirming Business requirements
- Developed UAT strategy, UAT Plan and facilitated UAT
- Verified and validated all build or release related issues and resolved them through discussion with business analysts with users’ approval.
- Conducted Smoke tests in Production and Documented Lessons Learnt during the Project.