SUMMARY:

• Over eight years of experience as a Senior Business Analyst in Healthcare.
• Experience in all phases of software deployment life cycle (Agile, RUP) including application demos, requirement analysis, business analysis, design and construction phases of application development, change management, ongoing support.
• Analysis business issues and provided recommendations for possible solutions, work with Business users and IT project teams to drive decision making and define requirements for application development, ensuring that business needs are met. Worked closely with the Development team and Business teams to ensure successful implementation of business requirements.
• Support the development and maintenance of the business requirements process used to define requirements for systems projects, assist with the definition of project scope and create appropriate scope documentation.
• Evaluate opportunities to improve application reliability, provide recommendations for possible solutions, and work with IT and Business partners to implement solutions.
• Experience in conducting JAD sessions, Scrum session, Brainstorming sessions and Focus Groups.
• Advanced knowledge of Meaningful Use 1 and 2 "BIG BANG" implementations Post Go - Live and Support for Inpatient and Ambulatory.
• Worked on the claim routing and claim processing Scenario in FACETS
• Experience in inventory Control quantity control and placement provider of jewelry throughout the store
• Excellent knowledge on writing complex Teradata SQL using OLAP functions derived tables and complex joins.
• Responsible for implemented Win Forms to provide GUI components using .NET
• Established database connectivity between SAS platform and data sources like Oracle Teradata and SQL Server.
• Experience in facilitating Joint Requirement Planning (JRP) sessions with Business User Groups, conducting Joint Application Development (JAD) sessions with IT Groups and Conflict Management with Project team members.
• Experience in Pay and process claims data within designated authority level and adjusting reserves.
• Facilitated Roadmap, Release, Sprint Planning, Agile Scrum & Retrospective meetings.
• Revenue Cycle Management and Different Health Insurance Plan and Benefits.
• Strong working Knowledge of HIPAA Regulations and Claims Processing.

TECHNICAL SKILLS:

Platforms: Windows 2000/XP/NT, Linux,.NET, Windows Vista and 7

Content/Change Management Tools: MS Share Point, Rational Clear Case, Jira

Modeling & Analysis Tools: Rational Rose, MS Visio, Rational Requisite Pro, Caliber RM

Web Development/Design Tools: Flash, Adobe Creative Suite, Balsamiq, iRise Studio

Testing Tools: Rational Clear Quest, SQL, HPQC, ALM, Load Runner, Rational Test Manager

Project Management Tools: MS Project, Rational Team Concert

Office Tools: MS Word, PowerPoint, Excel, Outlook

PROFESSIONAL EXPERIENCE:

Confidential, Tampa, FL

Sr. Business Analyst/ QA

Responsibilities:

• Analyzed HIPAA 5010 related to 837,835, 834. Transactions and performed gap analysis between HIPAA 4010 and 5010.
• Knowledge of created and modified queries utilizing Facets data tables
• Good Knowledge on Teradata Architecture (Indexes, Space, Locks, Data distribution and retrieval, Data protection).
• Experience in provider Served Lunch and dinner to the residence according to their specific diet plan. Assist with continental breakfast and special functions.
• Extensively Worked on SSRS & SSIS
• Strategic planning, budgeting and sales of contract research organization (CRO) laboratory testing services
• Automated a multiple level metric reporting process using MS Access and Excel.
• Experience in tested the Members, Claims, Providers and Services in Facets.
• Experienced in active participant in tools and technology upgrade for Life ray.
• Provides technical thought leadership to the Lawson space works with teams to effectively resolve challenges.
• Responsible for the team and evangelize Scrum / Agile principles. Proactively participated in developing and maintaining team standards, tools, and best practices.
• Worked on CMS (Centers for Medicare & Medicaid Services) requirements within the project.
• Worked on various .NET web server controls that included Menu, Tree View, Grid View and Details View to develop web forms.
• Maintain and troubleshoot an MS Access Application in very active use by a dozen users.
• Responsible for complete analysis of Facets for benefits and medical definition
• Facilitated all communication with the sponsor to assure understanding of expectations for and scope of work.
• Research and analyze provider data to ensure it enforces corporate policy as it relates to system maintenance.
• Resolve complex, severe exposure claims data, using high service oriented file handling.
• Strong ability to assess existing business processes Modeling(BPM), identifying areas for improvement and to document changes using accepted business practices
• Designed and developed dynamic SSRS & SSIS to process dynamic queries and dynamically produce flat files at runtime.
• Created Programs to extract data from Excel spreadsheets and load a MS-Access database for report generation.
• Experience in organized demonstrations for new SAS products to the business users
• Restructured marketing strategies developed by predecessor to better reach the Academy's cash niche markets
• Effectively maintained Monthly state MMA files via correspondence with CMS to implement change requirements to file structure and data real-time and as often as needed.
• Presented documentation on key elements of HIPAA compliance to ensure the development teams were on track.
• Experience in Published MS Access tables as a list on SharePoint server.
• Performed service management duties responsible for Provider handling large sums of cash, cashiering, inventor, and stocking
• Documented benefits and medical definitions in Facets.
• Worked on exporting data to flat files using Teradata Fast Export.
• Working with Teradata DBAs on automated scripts for stats collections on tables, indexes and
• Columns.
• Generated database monitoring and data validation reports in SQL Server Reporting Service (SSRS).
• Modified the existing SSRS & SSIS packages to meet the changes specified by the users.
• Responsible for developed understanding of HL7 v.2 and 3 protocols, MPI models and issues, and HL7 interfaces
• Experience in Positioned patients for Life ray procedures and shot radiographs using digital imaging.
• Experience in securing web applications using .NET authentication and authorization.
• Worked on data mining project imported SAP-generated text files into MS-Access normalized tables.
• Implemented legacy reporting system migration to the Enterprise Data Warehouse utilizing SSRS and SSIS
• Maintained traceability of requirements through to the testing phase; created and executed test cases; coordinated with testing teams during QA and UAT testing activities.
• Developed innovative Technical Expertise Database for business lines (Contract research organization) CRO identify passive icons and senior- and mid-level individuals and their corresponding technical expertise.
• Worked on Migration of packages from DTS using SQL Server Integration Service (SSIS).
• Automated daily backup and compact & replace MS Access databases.
• Responsible for keeping SAS platforms up to date by applying licenses and hotfixes as needed

Environment: Agile, MS Visio, MS Project, UML, SQL, .NET, Win Runner, MS Office, Microsoft SharePoint.

Confidential, Brooklyn, NY

Sr. Business Analyst/ QA

Responsibilities:

• Worked in close collaboration with the Project Manager and business users to gather, analyze and document the functional requirements for the project.
• Assisted in healthcare application and environment testing for Lawson upgrades and patches.
• Identified analyzed, defined, and documented detailed requirements to support projects and associated business objectives as well as experienced with common web delivery platform and in depth data analysis.
• Developed a vision plan that defined the primary goals and objectives of the project. Invited business and technical teams to gathered requirements by following JAD session process.
• Conducted Validations for different FACETS modules Providers, Claims and Membership.
• Responsible for handled incoming phone calls from member data and other departments to research errors and member issues.
• Determine the provider loading requirements to ensure adherence to Provider Data Management Policies and Operating Procedures.
• End-to-End Application Deployment: selected technology, developed funding model, worked with cross functional teams to package, test, deploy, and support new software, including developing user’s stories guides & training, incorporated requirements from labor unions, e.g.
• Responsible for architecting integrated HIPAA, Medicare solutions, Facets.
• Conducted workflow analysis and GAP analysis to understand the shortcomings of the existing process and evaluated the benefits of the new system.
• Support directly business UAT people to execute different test cases and documented defects accordingly.
• Prepare the list of UAT defect and prioritize those defects accordingly to the business criticality and start working on change request document.

Environment: Agile, MS Office Suite, Rally, MS Excel, Visio, SQL, Azure, SharePoint, Health Rules COTS software, UML, Quality Center.

Confidential, New York, NY

Sr. Business Analyst

Responsibilities:

• Responsible for creating project scope document for EHR model.
• Used Electronic Health Record (EHR) to extract useful information regarding patients for patient history, radiation information, allergies, additional medications, patient demographic information, physician information and many more.
• Involved in Modeling and developing Business Requirements, Design process and providing Knowledge Transfer to the Support Teams.
• Gathered Business Requirements from SME’s and drafted Business Requirement Document (BRD) and presented for approval.
• Working with Facilities and helping them setting up into Lawson Environment.
• Facilitated all aspects of the scrum framework, including sprint planning sessions, backlog grooming sessions,
• Responsible for Follow company work Business processes modeling(BPM) to receive, open an in pack carton & totes.
• Responsible for supporting design and implementation of hardware and/or software in the Resolving data issues
• Understood the Business Logic and developed User Interface Specifications.
• Developed Business Flow Diagrams, Dataflow diagrams, Activity diagrams and Use cases diagrams using MS Visio.
• Coordinated between Test team, Development and Business team in clarifying the Functionality issues and Requirement Specification.
• Developed an MS Access system to track test scripts and provide project managers with problem test reports.
• Worked as a Liaison between Technology and the Business clients to improve Business processes and Strategies.
• Coordinated UAT with the stakeholders for Pilot and Go Live implementations and support.

Environment:: Agile, Rally, MS Excel, Visio, SQL, Outlook, UML, Azure, Share Point, Quality Center.

Confidential, Bronx, NY

Sr. Business Analyst/ QA

Responsibilities:

• Gathered analyzed, documented business and technical requirements from both formal and informal sessions and validate the needs of the business stakeholders.
• Participated in the initial Impact Analysis (ICD-10) for all the critical functions, i.e., Membership & Enrollment, Claims Processing, Utilization Management, Medical Policy, Reporting, Vendor Management, etc.
• Worked with internal team to build out of a high level roadmap and time line to achieve compliance.
• Performed impact analysis on HIPAA 5010 upgrades and ICD-10 conversions.
• Responsibility and timing of documents for regulatory Content Management.
• Defined ICD-9 to ICD-10 mapping process using GEMs (General Equivalency Mapping) crosswalk file.
• Created custom mapping between ICD-9 and ICD-10 codes.
• Directly responsible for Extraction, Cleansing, Transformation and Loading of data from multiple feeds and sources into Data Warehouse.
• Maintained warehouse metadata, naming standards and warehouse standards for future application development.
• Documented the UAT Plan for the project and worked with the UAT Team to ensure every acceptance criteria for the requirements has been included in the UAT task plan.
• Maintained the Traceability Matrix table to uniquely trace the identified business requirements to general design to testing as proof that requirements requested have been developed into a solution and that it has been tested and tracked.

Environment: RUP, MS Office Suite, SAS, Rational Rose, SQL, MS Project, SharePoint, UML, IBM Rational DOORS, Quality Center.

Confidential, Lawrenceville, GA

Business Analyst

Responsibilities:

• Involved in preparing project scope document which focus on what are the areas we are going to develop and also mentioned the risks, assumption, dependences and limitation of the project.
• Worked with business representatives to understand requirements and priorities and ensure that software development work is appropriately aligned.
• Involved in the meeting with Business Process Owners, SME (Subject Matter Experts) and Health Center users for Requirement gathering in Definition Stage using Rational Requisite Pro.
• Responsible for writing Functional Requirement Specifications (FRS).
• Participated in user meetings, gathered Business requirements for the Data- warehouse design.
• Created various Use Cases and workflow diagrams, sequence diagrams, and Class diagrams using MS Visio and used UML methodology to define the Data Flow Diagrams (DFD) and UAT.
• Developed user stories, project backlog, and prioritization for timely & smooth execution of the project.
• Maintained Traceability Matrix in Excel.

Environment: Windows XP, cloverleaf, open Link, .net, Oracle, Rational Requisite Pro, UML, UAT.

Confidential, Philadelphia, PA

Business Analyst

Responsibilities:

• Interfaced with the client as part of the Requirements gathering team to finalize the project scope.
• Facilitated daily meetings and gathered Business Requirements.
• Conducted user interviews, gathered Requirements, analyzed the Requirements and managed changes using Rational Suite.
• Assisted PM in developing Use Cases and project plans and also managed changes to the scope of the project.
• Customizations for workflows, transition screens, issue types, including configuration of components, quick filters and Kanban boards
• Assisted on customized the Employee Manager Self-service pages in Lawson to fit the business needs.
• Responsible for manage all regulatory Content Management activities for assigned projects, including representation on project development teams, as appropriate.
• My ongoing work with this practice includes safeguarding that they meet Stage Meaningful use 1 ((MU 1) and continue to take advantage of Adoption
• Interacted with the users and logged any defects, enhancements from the UAT.
• Worked with the Training Group to build training materials as well provided any suggestions/ tool tips to assist in User Training.

Environment: Rational Enterprise Suite (Rose, Requisite Pro, Clear Case, Clear Quest), RUP, MS Visio, SAS, MS Project, MS Office.