SUMMARY:

• Sr. Business Analyst professional with 8 years of experience in Healthcare, Financial and Retail domains.
• Experienced in gathering user requirements, analyzing and preparing Project Deliverables such as Project Charter, Business Requirement Document (BRD) and Functional Requirement Document (FRD) and proposed changes for process improvement using Rational Requisite Pro.
• Demonstrated ability to work actively in different phases of Software Development Life Cycle (SDLC) using Waterfall & Agile.
• Proficient in transforming Business Requirements into Functional Specifications, focusing on workflow analysis and design, business process reengineering, user interface design, portal design, and process flow modeling.
• Highly proficient in working with Users and Stakeholders to elicit, analyze, communicate and validate requirements using JAD, JAR, and Brainstorming sessions.
• Comprehensive understanding of the Organizational Framework that help to map the AS - IS and TO-BE model using the GAP Analysis, and plan effective approach to build/buy solutions to the business problems/needs/opportunities.
• Skilled in Object Oriented Analysis and Design with experience in creating Use Cases, Class Diagrams, Activity Diagrams, Object Diagrams, State Diagrams, Sequence Diagrams, Unified Modeling Language (UML) using MS Visio and Rational Rose.
• Expertise in Client Relationship Handling, Project and Release Management, Configuration and Change Management, Defect Tracking and Control.
• Solid experience in defect reporting using Test Director, Quality Center and JIRA.
• Excellent skills in Process Flows and Swim Lane Diagrams.
• Proficiency in writing SQL Queries to extract data from databases.
• Sound knowledge in conflict management and configuration management.

TECHNICAL SKILLS:

• RUP
• UML
• Agile
• Waterfall
• MS Visio
• MS Word
• MS Excel
• MS PowerPoint
• MS Project
• MS Outlook
• MS Access
• MS SQL Server
• Crystal Reports
• Rational Rose
• Rational Requisite Pro
• Rational Clear Quest
• HP Quality Center
• HP ALM
• HP Service Manager
• Test Director.

WORK EXPERIENCE:

Sr. Business Analyst

Confidential, Boston, MA

Responsibilities:

• Worked in close collaboration with the Project Manager and Business Users to gather, analyze and document the Functional Requirements for the project.
• Worked for Claims Processing (837/835) including facility claims and professional claims. Worked with FACETS Team for HIPAA Claims Validation and Verification Process (Pre-Adjudication).
• Worked extensively with data streams to PEL system from internal applications and external vendor systems like Trizetto FACETS. Data includes Membership, Enrollment, Medical/ Vision/Dental/Pharmacy/Behavioral Health Claims.
• Addressed the changes made to the Medicare program and created requirements mapping to that of the system requirements.
• Gathered and documented Business Requirements from SMEs, User Groups and Vendors via workshops, interviews and surveys.
• Facilitated and managed meeting sessions with committee of SMEs from various business areas including Benefits Administration, Health Claims Group, HIPAA Administration, Health Policy and Program Evaluation Team and Data Management Group.
• Gathered and documented requirements for Pharmacy Benefit Managers (PBMs) for health insurance carriers.
• Submitted change requests and worked with change request records.
• Involved in various complex custom client requirements for new capabilities and product enhancements to compete in the marketplace.
• Participated in entering, tracking system defects. Provided technical and procedural support for User Acceptance Testing (UAT), Regression Testing, and System Testing.
• Worked with NCPDP 5.1 and D.0 Mail/Retail/Direct Claims, 837 Transaction Claims.
• Used Facets front end to debug claims issues, Provider and Member loads.
• Conducted result analysis and interacted with developers to resolve bugs.
• Interacted with Developers, Business Analysts and discussed technical problems and reported bugs.
• Actively participated and discussed technical issues with the project management team.
• Used UML extensively to draw Business Process Flow, Use Cases Modeling, Sequence, Sequential Diagram and Activity Diagrams.
• Extensively used simple and nested SQL statements for testing purposes.
• Worked as a Liaison between Stakeholders and IT department to fill the GAP by using Simple UML Diagrams.

Sr. Business Analyst

Confidential, Princeton, NJ

Responsibilities:

• Created end-to-end workflow diagram for various Stop Loss Products encompasses Proposal Management, Underwriting, Policy Issuance & Administration, Finance/Accounting, Claims Processing, Renewals and Broker Management.
• Reviewed current state business processes and operational activities, performed GAP assessment, and utilized the observations to create a future state roadmap.
• Created Data Mapping Document and created roadmap for transition from current state to future state.
• Interviewed various business units in Provider Excess Loss (PEL) product; captured functional data and reporting requirements; authored Request for Proposal (RFP) document for PEL-system.
• Coordinated all the RFP distribution efforts to external vendors and been a crucial member in evaluating the Claim Submissions, Rejects, Validation of Claims for the PEL Product.
• Reviewed claim loads in the backend and produced ad-hoc reporting.
• Worked extensively with Actuaries understanding the Pricing and reserves for healthcare stop loss products.
• Captured business requirements for Managed Care Business Unit who was looking to enhance client/Broker experience to submit premium and claims via Client Portal.
• Worked on a migration project for Employer Stop Loss product transitioning from Delphi system to .NET for various Line of Business.
• Documented data requirements, data mapping analysis for Confidential Health Data warehouse project.
• Responsible to perform GAP Analysis for current system data elements vs reporting needs vs data requirements to analyze the scope of the data warehouse.
• Conducted various brainstorming sessions to discuss the standardization of the incoming files with various formats coming from various channels on how to perform Content Management and Data Management.

Business Analyst

Confidential, Jersey City, NJ

Responsibilities:

• Implemented project management tool and workflow process, improvements for the design and development teams to effectively organize, manage and deliver all Discovery network requests.
• Interacted with SMEs to gather system requirements for building the new Trading Platform.
• Coordinated with teams within the project to collect the high-level estimates and release requirements.
• Conducted JAD sessions to gather requirements from the clients for web interface built.
• Documented system requirement document.
• Documented Business Plan and Test Plan based on gathered requirements.
• Interacted with underwriters from both PFG and Merrill Lynch to come to common policy premiums.
• Involved in writing and executing Test Scripts based on Requirements, Design, and Use Cases.
• Used Quality Center to keep track of the requirements and the Test Cases related to the requirements.
• Involved in executing existing Test Scripts, writing and updating new Test Scripts, and writing Test Plans.
• Played a vital role in Data Analysis, which involved in date transfer process between Merrill Lynch Client and PFG.
• Involved in testing the newly built up applications and making the clients test the newly built applications.
• Involved in UAT for the newly developed Trading Platform.
• Played a major role in resolving the defects that developed in the transitions phase.

Business Systems Analyst

Confidential, River Woods, IL

Responsibilities:

• Interacted with Stakeholders by interviewing them, by preparing questionnaire and getting feedback.
• Communicated Project Requirements, Business Issues, Solutions and made recommendation.
• Responsible for defining scope of the project, gathering business requirements, doing GAP Analysis and documenting them textually or within models.
• Supported the assigned Project Manager with creating detailed project plans and assisted in developing, scheduling and tracking project timelines.
• Identified KPI aligning with business rules.
• Conducted JAD sessions to allow different Stakeholders to communicate their perspectives with each other.
• Used Rational Requisite Pro to prepare BRD, Use Cases and Process Flow Diagrams.
• Created Use Case Models and Process Flow Diagrams using MS Visio.
• Created Use Case Scenarios and documented workflow and business process.
• Conducted Functional Walkthroughs and User Acceptance Testing.
• Developed and managed project plans and schedules.
• Managed resolution of project issues and conflicts.
• Managed (UAT) sessions and processes to review user feedback.
• Interviewed, investigated, and analyzed the current system.

Business Analyst

Confidential, Buffalo, NY

Responsibilities:

• Functioned as a liaison between the TOPS and HP to create a roadmap and project plan (SDLC) for this initiative.
• Conducted GAP Analysis in the existing architecture to understand the “AS-IS” and “TO-BE” process and created workflow scenarios, designed new process flows and documented the Business Process and various Business Scenarios and activities of the business from the conceptual to procedural level.
• Involved in requirement gathering Business requirements from Sponsors and Stakeholders through multiple client interviews, e-mail, group discussions and JAD sessions.
• Understood the workflow involved within various groups, nature of work performed, and validated the change process deliverables translating the strategies into project and programs on IT Strategic roadmap.
• Created a process document to depict the flow of critical information, wrote Use Case that described the flow of events creating a report at the end of each business day.
• Implemented Unified Modeling Language (UML) Methodologies to design Use Case Diagrams, Data Flow Diagrams, Activity Diagrams, and Sequence Diagram.
• Captured and resolved conflicts between stakeholders.
• Designed plan for implementation of order management system.
• Focused on site metrics, site navigation, functionality, product search, site quality assurance, and operational efficiencies.
• Assisted project manager using MS Project to maintain project schedule and help identifying the “lags” of project, assigning proper resources considering budgeted hours.
• Used Business Process Models (context, data flow), Entity Relationship Diagrams (ERD) as precursors to re-engineering, functionality enhancements and migration to new technology and value-addition of existing business solutions.