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Lead Business Analyst Resume



  • Over 8 years of Business Analysis experience, actualized through a persistent drive for excellence and continuous Improvement.
  • Experience in Financial, Insurance and Health Care domains.
  • Strong experience in various Software developments Life cycle (SDLC) Data warehouse concepts and Business Intelligence Applications.
  • Hands on experience in Waterfall, Prototyping and Agile (scrum) methodologies with a thorough understanding of Object Oriented Analysis and Design (OOA&D) concepts.
  • Hands on experience with EDI file formats such as 837 (Healthcare Claims), 835 (Healthcare Claims payment/Remittance), 270/271 (Eligibility request/Response), 834 (Enrollment/Dis - enrollment to health plan) Part B and Part A of Medicare health claims.
  • Profound Knowledge of business process in Facets, HIPPA, Claim processing, ICD-9, ICD-10 and experience with supporting strategic planning and goal setting in relation with technology.
  • Knowledge of health care services and regulatory environments including HIPAA, Medicaid/Medicare and EDI.
  • Knowledge of ICD 9 and ICD 10, along with various HIPAA 4010/5010 formats.
  • Extensive design experience in creating UML diagrams such as Use Cases, Activity Diagrams and Sequence Diagrams using MS Visio and Rational Rose.
  • Worked on Data migration, Facets enrollment configuration, version upgrades, Reports implementation, letters,
  • Inbound/outbound interfaces and Facets extensions.
  • Worked on Setting up Provider groups and IPA’s in Facets with practical knowledge of Facet configuration principles and activities, including the Facets data Model.
  • Worked on Facets pre-pricing of claims and integration with benefits and providers in Facets.
  • Good conceptual understanding of Data Warehousing.
  • Experience in a complete Project life cycle - Design, Development, Maintenance and Documentation of Enterprise Data Warehouse, Data Marts and Operational Data Stores (ODS)
  • Experience in creating Data mapping specifications and converting the business Requirements into transformation rules.
  • Comprehensive knowledge of SDLC with experience in regression, integration, UAT, load and performance testing.
  • Experience in ETL and BI platforms in creating Requirements and providing solutions.
  • Excellent communication and presentation skills with experience in development, implementation and integration of strategies within a team oriented environment.
  • Expert on business operation models, database planning and solutions.
  • Strong leadership skills, technical expertise, effective communication and ability to provide guidance.
  • Management of both the team and stakeholders; prioritization of multiple tasks to meet the deadline.
  • Involved in creating project plans. Managing the Scope, Time, Cost and Resources on the Project.
  • Excellent business knowledge in managing and facilitating projects in Finance Planning and Budgeting, Sales, Marketing and MIS applications.


Methodologies: Waterfall, Agile (Scrum), RUP

Tools: Rational Rose, IBM Requisite Pro, Snag IT,Map force, MS Visio,TOAD,MS Project,Informatica,Version One,Azure,Light Shot

Database: Oracle, DB2,SQL Server,Sybase

Applications: Web Services,Microsoft Office, HP Quality Center,SOAP UI,Facets,Web Services,XML,HTML

Operating Systems: UNIX, Mac OSX


Confidential, OH

Lead Business Analyst

Confidential, a leading non-profit public sector Managed Care Company based in Dayton Ohio has been meeting the needs of health care consumers for more than 24 years. The project involved successfully implementing an EDW (Incremental data load) for which the Claim Administration system was the primary source. The project also involved integration of other sources such as Med Impact (Drug claims) into the EDW.


  • Creation of several Data models, Logical Data Models, Relational Models, dimensional Star/snow flake schemas etc.
  • Strategic development of the Data warehouse while performing Analysis from Operational Data sources to an Enterprise Data Warehouse (EDW).
  • Gathered user Requirements by interviewing focus groups and brainstorming with SMEs, Business users and Product owners by creating questionnaires for SMEs to refine requirements into Business rules.
  • Used AGILE methodology and worked in short SPRINTS to achieve goals.
  • Participated in SCRUM meetings and discussed the open issues and statues.
  • Conducted Data analysis at different data sources and performed detailed Data profiling.
  • Worked Extensively with HIPPA EDI 834 forms received from various Vendors, partners and producers in validating the Data in Stage Environments along with Test running the formats and conducting issue Analysis.
  • Worked with HIPPA EDI 837 files for Data validation and created Data mapping and ETL process Requirements for loading data into the EDW.
  • Conducted extensive Analysis on all of the Data flows from various data sources and identified the sources.
  • Analyzed Data quality issues such as Data redundancy, Data consistency and Data schema study etc.
  • Performed and analyzed in detail the databases using SQL queries.
  • Prepared detailed Data mapping specification documents from various sources to the data warehouse.
  • Performed detailed GAP Analysis and analyzed closely the newly built Data Model.
  • Assisted Data Modelers with ad hoc Requirements and analysis.
  • Applied business requirement into transformation rules and created logic for data flows and selection of data.
  • Conducted walkthroughs with the Business users, stakeholders and rest of the team.
  • Worked on the Mapping specifications, gathered requests to upgrade or change any business requirement.
  • Worked very closely with ETL developers and assisted them with any open issues related with Data mapping.
  • Tested data using SQL queries and conducted Data profiling.
  • Involved in User Acceptance Testing (UAT), SIT and documented the test scenarios and outcomes.
  • Performed executive walkthroughs for clients, for sign-offs on specifications and other deliverables.

Confidential, PA

Sr. Business Analyst

Confidential Inc. ( Confidential ) is the largest health insurance company in Pennsylvania based on membership and one of the largest health insurers in the United States. Confidential has a long history of nearly 70 years serving health insurance needs, and currently provides fully-insured and self-funded health products to over 4.1 million members in Pennsylvania.


  • Identified and Defined Application Requirements - Conducted Business Process Gap Analysis.
  • Worked on Error handling & logging Requirements, Security & Audit Requirements and Data Requirements.
  • Developed a business process in Facets, HIPPA and Claim processing, ICD-9, ICD-10
  • Supported strategic planning and goal setting in relation to existing technologies.
  • Worked extensively with HIPAA 837I & HIPAA 8372 formats for Data validation and Data Mapping.
  • Performed Logical Database Design, Created Data Descriptions and Designed Data Conversion.
  • Evaluated and Defined a User Interface while following Platform conventions and Consistency standards on the User look & feel.
  • Project lead planning and directing all day-to-day development activities of the development team.
  • Creating the Test Approach document: (Test Phases, Test Types, Test Process, Test Planning Guidelines, Test Execution Process, High-level Schedule, including timeline, Test Tools, Status Reporting and Defect Metrics, Quality Checkpoints and Risks).
  • Building the Test Effort document i.e. to define the test effort in terms of scope, objectives, process/system interfaces and test types for the Project

Confidential, Dublin, OH

Systems Analyst

The project encompassed developing a “Web-Sales Solution”, a web based application for the Individual Retail Marketing domain, which includes individual enrollment, membership and billing and Collections and Payments (CBPP). This project will enable users to choose health products, get quotes, submit applications and receive support without the assistance of an agent. This was the first web-based application developed by the company for the Individual market.


  • Interfaced between Business users and the different teams involved in the application development for better understanding of the business and IT processes.
  • Conducted JAD sessions for requirement gathering, and Analysis.
  • Conducted GAP Analysis and formulated the TO-BE features based on the business Requirements.
  • Responsible for the delivery of Business Requirement Documents (BRD) and Functional Requirement Documents (FRD).
  • Worked extensively on UI mockups for the Web Solution using Interactive Mock up designer tool, Azure.
  • Created User Interface Documents and documented the screen element functions and Business Rules.
  • Developed Requirements for the Ektron CMS tool, Widgets, Smart forms and Page Templates.
  • Defined Adobe Site Catalyst Requirements for the tracking of the UI activity on the Website.
  • Worked with Meta keywords and Descriptions for improving the Search Engine Authorization ratings on the Google and yahoo Search.
  • Worked with External vendors to define the Website Requirements for iPads and other mobile devices for IOS operating systems.
  • Defined Requirements for Apple Quality screen UI’s for the website to track the most viewed and eye-catching components of the Website.
  • Analyzed system Requirements and created Use Case Diagrams, Activity Diagrams using Rational Rose.
  • Validated various HIPPA 5010 EDI formats such as 837 (Healthcare Claims), 835 (Healthcare Claims payment/ Remittance), 270/271 (Eligibility request/Response), 834 (Enrollment/Dis-enrollment to health plan) for Part B and Part a of Medicare health claims.
  • Created scenarios for User Acceptance Testing and conducted the actual Acceptance Testing.
  • Designed and implemented test scenarios for the application.

Confidential, NJ

Business System Analyst

The role involved a BPR project, which involves reengineering of the content workflow across various business processes and development of a comprehensive Workflow management System supported by Content Management System. The project also involved redefining various business processes to suit the new Systems under development.


  • Created Process Flow Document and designed high and low level Process / Activity Diagrams using MS Visio.
  • Performed Workflow Analysis and Task Analysis for various operational teams in the company.
  • Performed GAP Analysis and Impact Analysis involving the current state and proposed state.
  • Worked Closely with Application Architects and Business teams to converge on Requirements for the New Workflow Management System and CMS.
  • Assisted Business Analysts in development of the FRD and other relevant documentation.
  • Identified the Key Business Processes to model by analyzing the Requirements and modeling using MS Visio.
  • Worked in a team to develop Use Cases for their newly added application layout. I understood all the Business processes related to the newly added layout and designed Use Cases assisting the Application Developers in building the application.
  • Prepared Logical Data Models that contain set of diagrams and supporting documents containing the Essential Business Elements, detailed definitions, and descriptions of the relationships between the actors to analyze and document business data Requirements.
  • Participated in various sessions with the business to understand the business rules and to come up with naming conventions to standardize the data...
  • Played a key role in the User Acceptance Testing (UAT), and implementation of system.
  • Gathered Requirements through a series of interview sessions and group meetings with the identified users, SMEs and developers to design build and release the Public facing Website.
  • Conducted Joint Application Development sessions with the various Stakeholders throughout the SDLC to resolve open issues.
  • Performed GAP Analysis by identifying existing technologies, documenting the enhancements to meet the end state Requirements.
  • Worked closely with the Architects and Content Engineers for Design and Development of associated Content in Alfresco CMS.
  • Produced Visuals for the application using Azure tool and created Use Cases, State diagrams, Sequence Diagrams and Activity Diagrams.
  • Worked extensively with Ektron CMS during the Web UI Designing and Development Phases.
  • Developed FRD, Detail Design Document 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.
  • Developed design for Retrieve form for Data Capture via XML, XForm and XHTML.
  • Extensively performed XML Data validation and tested the validation Business Rules.
  • Worked with QA team to go over the various test scenarios for different types of Data Elements and Fields in the adverse event Reporting Form.
  • Created the UAT document and conducted the UAT testing and Smoke Testing for the Release.

Confidential, NJ

Business Analyst


  • Worked with the core team to gather business Requirements from multiple stakeholders, Business Teams and management groups having reconciled conflicts by conducting Joint Application Development (JAD) sessions based on the project scope.
  • Created Functional Specifications Document and designed high and low level Use Cases and Process / Activity Diagrams using MS Visio.
  • Defined Work Flows and Business Modeling documents for the Business Process Reengineering of the systems
  • Performed GAP Analysis and Impact Analysis involving the current state and proposed state.
  • Worked Closely with Application Architects and Business teams to converge on Requirements for the Enterprise Consumer Matching Web Services.
  • Worked closely with Data Architects and ETL Leads/Managers and was responsible to perform detailed data Requirements Analysis and create design specifications and operational documentation.
  • Provided the ETL team with the Data mapping document and assisted them to create the mappings.
  • Worked closely with the architects, database administrators and technical team during Data mapping and Data Integration
  • Involved in data modeling and building fact and dimension tables.
  • Analyzed and presented the Business with information on data anomalies, issues, input errors, field value ranges, data patterns, referential integrity gaps and the level of record incompleteness that is in the source systems.
  • Organized meetings with the SMEs and Data Owners to walk through the findings and determine the cleansing process.
  • Played a key role in the user acceptance testing (UAT), and implementation of the new system.

Confidential, Bloomington, IL

Business Analyst


  • Assisted the strategic and planning architecture of the SMEs on behalf of their specific area with the development of deliverables as needed.
  • Participated in Agile Planning Sessions and assumed 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 tasks.
  • Designed acceptance criteria for validating the output of each SPRINT.
  • Reviewing the Team Velocity on a frequent basis and advising the Scrum Master at various stages.
  • Participated in SPRINT Planning and SPRINT review meetings for Finalizing the SPRINT Backlogs and Verifying the SPRINT outputs respectively
  • Participated in Business Demonstrations and decisions for the release of the SPRINT Output to Production.

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