Summary
6 plus years of experience working in pharmaceutical, Health Care/CRO, domains practicing Business Analysis and Project Management. Extensive experience implementing COTS products. Particularly effective at requirements gathering and preparation of functional design specifications, Use cases, leading JAD sessions, handled user acceptance testing and preprod and post prod issue management.

Experience:
Business Analysis Planning and Monitoring

• Worked on Business Analysis Planning with Project Management, Worked Closely with Enterprise Project Management to ensure timeliness of delivery and proper communication.
• Estimating LOE for Various Project activities.
• Worked with Top management in developing RFP’s and Analyzing vendor Packages. Very good Understanding of Software development like SDLC, Agile, Scrum, and Prototyping.

Elicitation

• Requirements Elicitation, Conducting Surveys and Leading Focus groups.
• Facilitation of meetings/workshops.
• Leading JAD sessions.

Requirements Analysis and Communication

• Worked on Requirements Documentation and communication.
• Documenting Functional design specification.
• Documenting Data dictionaries.
• Designing Training Modules.
• Worked on GUI Modeling/Mock up and Prototyping.
• Documenting story Boards and use cases.
• Data Mappings and data modeling for Interfaces.
• Conducing Risk and impact Analysis.
• Documenting Gaps between ‘As is’ and ‘To Be’ systems.
• Documenting UAM (User Access Matrix)/CRUD for the Software.
• Documented Process flow diagram for the Enterprise.
• Very Knowledgeable in UML, Flow diagrams like DFD, ERD, and Used Case diagrams, Activity Diagrams, State Chart Diagrams, Sequence diagrams, Swim lanes etc.

Production (Development) and Post Production(Testing)

• Preparing test plans and Scripts.
• Testing of developed software-UAT, Integration testing, Functional testing IQ /OQ/PQ.
• Provided testing guidelines, training, and assistance to test executors and other analysts.
• Liaison between development team and Business. Single point contact between offshore development team and Enterprise.
• Structural walkthroughs and Leading KT (Knowledge Transfer) sessions.
• Worked on CCB (Change Control Board) in stream lining the Change Control Process.
• Maintained Change Request Log, Liaison with Technical team to Obtain estimates for the Changes Requested.
• Worked on Traceability Matrix and follow up on issues.

Health care and Medical Insurance

• Experience with ICD9, ICD 10, HCPCS and CPT Codes.
• Experience in EDI 4010 and 5010 Transactions and Compliant with Companion Guides.
• Experience in Web services, SOA Architectures and reporting to Trading Partners.
• Deep Understanding of X-12 implementation guide for healthcare domain and SOX Compliance auditing.
• Experience in Maintaining EDI Healthcare transactions including health care claims, Health care payments, Coordination of benefits, Health claim statuses, enrollment, and Health care Premium Payments.
• Exposure to HIPAA Compliance requirements and HL7 Standards.
• Experience of Creating Applications that are 21CFR part 11 Complaint.
• Experience with Medicare, Medicaid, and Commercial insurances in HIPAA ANSI X12 formats including 270/271,276/277,820,834,835,837,997.
• Good Knowledge of Accounts Payable, Claims Processing and communication, Automated Claim denials Communication through web portals.

Enterprise Data warehousing and Reporting

• Experience in developing Adhoc reports, Transactional and Analytical reports Analyze trends and suggest improvements.
• Part of Data cleansing, Data transfer and Data mining Strategies.
• Worked in gathering Attributes and data points for Star Schema and Snow flake schema models of data warehouse.
• Requirements Gathering and working with data design team for Enterprise Data warehouse.
• Worked on preparing weekly, monthly and ad hoc reports create operating dashboards and identify data quality issues to the managers of the functional disciplines within IT Professional Services.
• Create reporting dashboards for the Sourcing, Contracts and Contingent Workforce Management Teams within IT Professional Services.

Pharma and CRO (Clinical Research Organization)

• Integration with external systems and Portals.
• Worked on Adverse event reporting system.
• Worked in developing Enterprise Data warehouse.
• Worked on Human Resourcing, Patient Rectruiting, Strategic Collaborations and PI and Employee Resourcing Projects in CTMS.
• Experience of Creating Applications that are 21CFR part 11 Complaint

Education Details:
Bachelor of Pharmacy

Tools and Technologies

Requirements :MS Office, Visio, JAD, Workshop, MS Project
Documentation : MS Office, Visio, Req Pro, Rose, MS Paint, dream weaver, Photoshop. Clear Quest, Share Point.
Testing : Quality Center, Test Director, QTP, Win runner framework EDI, Elabs
Methodology : SDLC, Waterfall, RUP, Agile, Scrum Db.
Web Technologies : UML,
Languages : SQL
Operating system : UNIX, windows 2000, xp, vista,

Projects

Confidential, Sept2011-Till Present
Role: Sr. Business System Analyst

Worked as a BA in the Intermountain Healthcare where I made changes to the existing payer system used for processing claims. Inclusion of the ICD code and billing code were also a part of the project to assign specific code to the disease injury to make it more consistent and precise to that of the provider’s information as a part of the claim process.

Responsibilities:

• Developed and executed strategic initiatives and programs to enhance existing and Medicare claims processing functions in support of corporate initiatives and requirements.
• Working knowledge in ICD 9 ANSI Health codes HL7 in the claims environment for inpatients and outpatients, reviewed the implementation of the changes made in the systems as per the formats and compliance for EDI usage.
• Used EPIC software for tracking and updating the claim report project and provided guidance in the investigation and final disposition of complex claim matters from Executive Senior Management through JAD sessions for analysis and design.
• Used the RUP methodology and related processes for software re-engineering process. Monitored claims inventory, cycle time processing and work quality to assure conformity with corporate objectives and departmental goals.
• Involved in writing USE cases and prepared the Business Requirements Documents for various requirements collected from the business users. Used MS Visio and UML for generating class diagrams and activity diagrams.
• Wrote requirement document for Data Extraction, Data Analysis and Loading process of collected data as a part of data mapping procedures.

Confidential,Rochester MN Jan 2010– Aug 2011

Project: TheHIPAA-EDI (Health Insurance Portability and Accountability Act / Electronic Data Interchange) Project involved the validation and testing of the variousHIPAAtransactions in HL7/EDI X12 formats in order to simplify the way business was conducted with group customers and members. Utilized Facets software to store, send and receive enrollment, billing and health care claims according toHIPAA4010

Responsibilities:

• Gathered requirements and analyzed them to convert into functional and non-functional requirements.
• Conducted meetings/interviews and JAD/JAR sessions with stakeholders to collect business requirements, analyzed the root cause of the problems and developed use cases using MS Visio.
• Interacted with the SME’s to gather information about the health care provider enrolment, billing and health care claims processing and checked if they are processed correctly or not.
• Prepared storyboards and business Workflow/flow charts processes and models that cover "How" business process models are prepared.
• Responsible for defining and documenting System Requirement Specifications/feature requirements and supplementary requirements, creating requirements traceability matrix (RTM )
• Experience working on Medicare, Medicaid insurance,HIPAA4010, health care regulations and CMS terminology.
• Tested the system and applications for compliance with theHIPAA, HL7 and EDI X12.
• Experience working on EDI X12 transactions such as 837, 270, 271, 276 and 835.
• Familiar with ICD 9 codes.
• Experience working on Microsoft SharePoint server for content management applications
• Worked with Facets software for maintaining data about the enrollment, billing and health care claims management and to store, send, receive HIPPA transactions and facilitate the administration ofHIPAAprivacy rights.
• Worked closely with the ETL data warehouse and BI teams while developing data marts, data models and while reporting and data mapping & validation and wrote SQL queries, prepared dashboards and performed data analysis.
• Interacted with the QA team to develop test plans & test the test cases.

Confidential, Jan 2009 – Oct 2009
Business Analyst

Orion Health is a leading provider of clinical workflow and integration technology for the healthcare sector.The project scope involved working on enhancements for Contact Center Technology which included complex call routing strategies, call center setup, variety of interactive voice response alternatives. The project also required to develop a tool for the customer service agents to retrieve customer’s information, protect their privacy and handle customer calls more effectively.


Responsibilities:

• Interfaced with, and interviewed, cross-functional stakeholders to generate requirements.
• Interfaced between users and diverse teams involved in application development to enhance understanding of business and IT processes.
• Successfully conducted JAD sessions to gain clarity and finalize business requirements.
• Translated requirements, and business needs to Business Requirements Documents and Technical Specifications Documents.
• Leveraged Agile methodology for product development.
• Developed Activity Diagrams, Use Case Diagrams, and Workflow Diagrams using Microsoft Visio.
• Accountable for extensive UAT testing.

Confidential, April 2007 –Sept 2009

Business Analyst

ELIXIR develops and manufactures pharmaceutical products. Company was experiencing tough times with escalating R&D costs and long drawn out drug discovery cycles, and started seeking external help to carry out parts of the drug discovery cycle with a view to save time and reduce costs. In order to respond to the increasing demand, Cadila planned to expand its CRO (Clinical Research organization ) The project was to improve the efficiency of managing huge amount of hard copy data, by totally transitioning its clinical trial processes from paper to Electronic mode.

Responsibilities:
• RUP was implemented to accomplish the task. Interacted with SMEs to finalize the Business Requirements, business processes and support critical business strategies for the application.
• Performed feasibility and adaptability study to identify the business critical areas from requirement perspective.
• Elicited business needs, conducted business process modeling work and facilitated work sessions (JAD), to analyze, validate and prioritize requirements.
• Documented detailed Business Requirements Documents (BRD), Technical Requirement Specifications (TRS) and Functional Requirements Specification (FRS
• Worked as a liaison between clinical staff and the technical developers.
• Closely interacted with designers and software developers to discuss application functionality, navigational flow and updated them about end-user sentiments.
• Created Clinical, Regulatory, laboratory, EHR, etc. data segregation and data migration diagrams using MS Visio.
• Coordinated work on XML based Electronic Common Technical Document (E-CTD) application and electronic Case Report Form (E-CRF) application. The application will help in validating electronic regulatory submissions and will enable content contained with the documents to be searchable and achievable.
• Conducted JAD sessions to allow stakeholders with different backgrounds to communicate their perspectives with each other and resolve issues.
• Worked with QA team to design test plan and test cases for User Acceptance Testing (UAT) and Back End Testing.
• Created Traceability matrix between requirements and test cases.

Confidential, Research Assistant Jan 2006 to march 2007

Responsibilities:

• Perform studies as related to research project
• Diagnose and problem solve as it relates to the research project
• Coordinate clinical trials
• Conduct screens and assays
• Prepare samples for analysis by various instrumentation