- 7+ yrs. in Business Analysis: encompasses proven ability to work resulting in maximizing productivity.
- MBA - qualified, self-starter: adept at moving into new environments and extrapolate from existing experience to quickly adapt to new technologies. Expertise in documenting business vision, business requirements, functional requirements, Requirement Traceability Matrix, use cases, user stories, test plans, test cases and writing SQL queries.
- First-rate communications and collaboration skills: combined with an analytical, methodical, and resourceful approach to problem solving resulted in consistently meeting short and long-term business, financial and system requirements and project goals. Solid understanding of SDLC methodologies like RUP, Agile Scrum and JAD and business analysis processes like GAP analysis, SWOT analysis, Data mapping and Data dictionaries.
- Healthcare, Retail and Supply Chain Domain: encompasses strong knowledge of HIX and ACA, HIPAA, Medicare, Medicaid, Claim Processing, Membership/ Enrollment, Appeals & Grievance, Care Management, Utility Management, Disease Management, Vendor Selection, RFP/RFQ, and other related industry-specific jargons.
Office: (Word, Outlook, PowerPoint, Excel), MS Visio,
Wireframes: JIRA, Confluence, Axure, Rational, Requisite Pro, Clear Quest, Balsamiq Mockup 3 UML, Rational, RoseToad, Lotus Notes, MS SharePoint, SQL
- Translate complex business requirements into tangible functional, non-functional and data requirements by working collaboratively with business and technical subject matter experts for the implementation of Appeals & Grievance application and Care Management Applications of the Next Gen Project designed for Medicare Advantage Plans.
- Understand current/existing system landscape across multiple applications, document current state and identify gaps between current state and future sate from a business need standpoint. Create source to target mapping documentation.
- Analyze the current state (As Is) and develop future state (To Be) process/work/data flows.
- Work closely with QA teams to help them understand and align with project scope and requirement while supporting various QA activities like UAT.
- Business Analyst for Staples Exchange Drop Ship Platform Project.
- Create and refine artifacts such as use cases, user stories, and process flow diagrams to communicate features to both the development teams and the stakeholders.
- Elicit, document, analyze and prioritize requirements considering the product roadmap and any constraints within product development schedules.
IT Business Analyst
- Independently managed, identified, analyzed, elicited and documented cross-functional requirements and workflows for Small Group Expansion project as per Affordable Care Act and its sub project Composite Premium Billing with Riders.
- Conducted various requirement gathering workshops and JAD sessions with SMEs and business owners to gather client business requirements, functional requirements, and develop processes.
- Conducted customer review sessions to validate business requirements and IT functional requirements documents, workflows, process diagrams, and gap analysis and obtain appropriate approvals.
- Documented business requirements and process changes for Continuity of Care project under the Maryland Insurance Administration.
Sr. Business Analyst
- Work closely with business areas/ stakeholders in defining project scope; SWOT analysis, create business case and eliciting requirements for Private Exchange where employees can self-enroll themselves and choose from the various available health plans most suited to their needs.
- Worked with multiple vendors in coordinating the requirements while working under intense time-pressure in a results-driven environment.
- Managed user expectations, conducted interviews, meetings and facilitated JAD sessions and clearly communicated project scope and timelines.
- Implemented RUP methodology for iterative and incremental development of the system.
- Developed and executed test plan, test cases and test scenarios from the requirement. Took part in functional and manual and GUI testing
- Coordinated UAT with the SME’s and business users and obtained necessary sign offs.
Confidential, New York
- Performed GAP analysis between HIPAA 4010 and required 5010 changes for EDI transaction sets 837 (Institutional Professional, and Dental Claims), 834 (Benefit Enrolment and Maintenance) and 835 (Electronic Remittance)
- Created data dictionaries, ETL data mapping and data flow diagrams for new 834 enrolment data EDI transaction formats and ensured these data are integrated into the Enrolment and Membership database with rigorous attention to quality and consistency. Also mapped data for EDI 837 transactions sets to be uploaded in the Claims processing system and out bound EDI 835 files.
- Identified, elicited, analyzed and documented requirements for the enhancement of their legacy Claims Management System as per HIPAA 5010 regulations.
- Used SQL to filter out data for accuracy, duplicity and errors, performed manual testing.
- Developed User stories, Themes in an Agile SDLC process.