SUMMARY

• Sr. Business Systems Analyst with 8+ years of industry experience and expertise in Requirements Gathering & Elicitation, Requirements Management and Development, Process Modeling, Process Improvement, System Testing, Change Management and Customer Relationship Management with core target on delivery for Solution conceptualization & delivery, Benefits realization, Project Management with IT Service, Support & Services.
• Expertise in Health Insurance/Healthcare domain as a Business Analyst and Test Lead for Confidential . Experience in Banking and Retail domains on multiple projects.
• Lead Scope Finalization, architecture design, develop and maintain test strategies (Black /White - Box Testing, User Acceptance Testing (UAT)), plans and scripts, delivery of IT solutions to the business on time, within budget and to agreed quality standards for different Business domain as Insurance Systems and ERP Systems.
• Experience in creating and maintaining Business documents writing skills: Business requirements document (BRD), User Stories, Use Case Specifications, Functional Specifications (FSD), Systems Design/ Requirements Specification (SDS/SRS), Data Flow Diagram (DFD), Diagrams as UML, Activity and Sequence.
• Strong experience with different SDLC methodologies, i.e. Agile and Waterfall, maintaining Test Matrix, Traceability Matrix and perform GAP analysis including identifying various test scenarios and training of end-users.
• Strong Experience on data Conversion & Migration, mapping, work flow and design. Also mapping legacy data into interface file, develop business rules, value maps, clean legacy data, and perform manual and automated data audits including knowledge of using the HP Quality Center.
• Analysis & Implementation experience on IFS Application and highly skilled in Facilitating and managing meeting sessions taking SME’S from various business & operation areas.
• Managerial and Leading skills with concentration to service accomplishment and ensure system/application management and maintain SLA.
• Well versed in writing SQL query for Validation & creating Data mapping, logical data modeling, class diagrams, ER diagrams and used SQL queries to filter data within database.
• Thorough with practical experiences of Business Analysis with several project deliveries with guidelines of IIBA (BABOK based). Extensive Project Management skill with Business Analysis experience of large projects and service delivery.
• Thorough understanding on Service and System management (ITIL based) with ITIL/ITSM/ISO 20000 guideline to Service & support IT Industry.

PROFESSIONAL EXPERIENCE

Business Systems Analyst

Confidential, Minneapolis, MN

Responsibilities:

• Mapped data and process requirements alongside with data analysis using the data requirements with the Data Architects to provide a standard structure and definition.
• Identified gaps in data and created requests to DBA to add additional fields required on various environments.
• Worked off the Logical and Physical Model to see if changes were implemented.
• Worked on a SRS to capture ETL requirements and also worked as a guide for the QA to create test plans.
• Worked on moving downstream applications consuming data from the Claims Stage environment to the Pharmacy Claims ODS which was the enterprise solution.
• Worked on over 40 STTs making changes that came through the project.
• Created new STTs for published extracts coming out of the Claims ODS.
• Worked with Business Users of downstream consuming applications like KBMG, QBN, Guided Health, RTMT understanding their data consumption patterns suggesting various solutions for a smooth transition.
• Created the Data Flow Diagrams for new implementations using industry standard tools MS Visio.
• Worked with minimal guidance and seek guidance on only the most complex tasks.
• Estimated and organized own work to meet or negotiate deadlines.
• Worked on defining RBAC rules and policies on Teradata with the Data Architects, Principal Developers and DBAs.
• Worked on STT and SRS to move data from the DB2 environments to Teradata.
• Queried and profiled data using AQT on DB2, AS400 and Teradata.
• Aligned changes by checking the source on RxClaims screen on iSeries AS400.
• Worked on collecting requirements from TDD and ERD created by RxClaims.
• Worked on the HIM Reporting project which was a compliance project that helped BCBS and other clients with data required to be submitted to NAIC.
• Worked on identifying fields required for the data elements, creating extracts to feed Teradata and integrate with the population segmentation and Metallic levels of Health Insurance Marketplace in the commercial line of business.
• Worked with business on various Client requirements to finalize the layout.
• Created STT and SRS required for development and QA.
• Created final layout that were sent to Clients.
• Uploaded requirements on QC and reviewed test plans for 14 teams and provided input for better understanding of the test scenarios.
• Coordinated release set up with QA leads and coordinated deadlines with Project managers.

Environment: Waterfall/Agile, Subversion, JIRA, DataStage, Robot, MS Word, MS Power Point, MS Excel, MS Visio, HP Application Lifecycle Management, Teradata, SAS, SQL, AQT.

Business Systems/Solution Analyst

Confidential, Minneapolis, MN

Responsibilities:

• Anticipated customer needs and proactively developed solutions to meet them. Customers include Senior Leadership, Application Owners, Enterprise Project Managers, and Business Partners.
• Worked on projects on MIIM and ICUE systems including pharmaceutical assistance to Medicare and retiree population.
• Worked within teams of Capability, Program, and Project Managers to define system scope and objectives through research, fact-teams using standard SDLC processes Iterative/Agile, including Technology Requirements Solution Analysis process.
• Collaborated with customer and technology and guided others including project teams, cross-functional teams and peers, and acted as a resource for others with less experience.
• Provided guidance on ways to standardize process flows across Clinical Domain to business partners where process steps impact applications. Translated concepts into practice.
• Negotiated, resolved and prioritized complex issues and conflicting requirements by user groups.
• Provided clear, concise explanations and information to others on difficult issues.
• Identified innovative solutions to complex business problems and document them in a standard Solution Summary Document format.
• Mapped data and process requirements alongside with data analysis using the data requirements with the App Architects to provide a standard structure and definition.
• Created the Business Area and Systems Area Context Diagrams within the SSD/SOD using industry standard tools MS Visio and Enterprise Architect with Archimate 2.0.
• Worked with other capability owners to identify similar project objects to build reusable development outputs.
• Collaborated in the creation of estimates and worked to identify common project needs to drive out opportunities for consolidation and reuse.

Environment: Waterfall/Agile, SharePoint, Rally, Enterprise Architect, Archimate 2.0, MS Word, MS Power Point, MS Excel, MS Visio, HP Application Lifecycle Management, Oracle SQL, XML, JAVA/J2EE, JavaScript, PEGA.

Sr. Business Analyst

Confidential, Minneapolis, MN

Responsibilities:

• Worked on gathering the business requirements from SME’s and impacted systems. Created BRD for review and sign-off from all the stakeholders.
• Worked with business on defining and documenting clinical rules for IT team.
• Utilized corporation developed Agile SDLC methodology, used Scrum Work Pro and MS Office Suite to perform required job functions.
• Conducted daily Scrum Meetings to assess progress in the project and structuring the future course of action.
• Prepared data mapping documents.
• Acted as a liaison between vendors and stakeholders and was actively involved in vendor management.
• Integrated application developments through ServiceNow tools.
• Acted as a SME for Medicare (Part D) and Medicaid clinical rules and programs.
• Scheduled core team meetings involving PM’s of different work streams, Program Owner and Stakeholders.
• Documented and described the workflow which integrated pharmacy and medical claims data into a single, consolidated data source.
• Worked with Corticon developers for the clinical rules clarifications.
• Communicated with the external vendor (Bolger) for the engagements files.
• Gathered business as well as system requirements for engagement options like Member Letter, Provider/Prescriber Letter, Telephony, Blue Plan, CM/DM, etc.
• Interviewed Stakeholders to elicit and document business needs for system modifications.
• Defined functional, high-level and detailed system requirements for the requested changes in an iterative process.
• Presented requirements on behalf of the Stakeholder to Business and IT Leads and facilitate discussion to build consensus on the completeness and accuracy of requirements.
• Analyzed and documented the business requirements and processes and communicated these requirements via the necessary tools/templates to the appropriate team members.
• Assisted in providing UAT and BA related project tasks and their corresponding estimates.
• Created and executed UAT plan, scenarios and cases. Documented and reviewed results with subject matter experts and program owner.
• Worked on HP Quality Center for testing requirements, writing test cases and running them.
• Collaborated with Prime’s Test Management on planning and execution of UAT testing.
• Actively managed issues, risks, actions, decisions and deliverables for infrastructure in conjunction with the PM.
• Collaborated with Prime’s project team to plan the project test and to plan environment migration.
• Participated in planning for remaining phases.
• Wrote and executed testing scripts in SQL. Worked on creating joins, looking up tables, updating tables, deleting rows.
• Planned and held meetings with the clinical specialty pharmacist for reviewing and discussing the test cases of almost all the clinical rules.

Environment: MS Visio, MS Word, MS Excel, IBM Lotus Notes, PowerPoint, HP Quality Center, SQL, Oracle, J2EE, Java, Corticon, ETL, DB2, Notepad++, AQT v9, Text Pad.

Business Analyst

Confidential, Hartford, CT

Responsibilities:

• Responsible for gaining a good understanding of user needs and accurately representing them in a well-documented software functional specifications document.
• Gathered Business Requirements, interacted with the users, designers and developers, project manager and QA team to get a better understanding of the Business Processes.
• Documented the Business Requirements Document (BRD) and the Functional Specification Document (FSD).
• Interacted with the “End-Users” by interviewing them, by preparing appropriate questionnaire to better understand end-user needs and the business process.
• Supported PL/SQL development for Contingency and Internal Audit Reports.
• Conducted walkthroughs and code reviews with developers, project managers and stakeholders and users to comprehend business workflow of applications.
• Followed a structured approach to organize requirements into logical groupings such as requirements for Customer, Client, Group, Member and Reporting to make sure that the critical requirements are not missed.
• Performed GAP Analysis of 5010 EDI transaction using implementation guide to identify the changes in the segments and data elements.
• Created test cases for System Testing (Development Environment), Integration Testing (UAT) and Production (Post Implementation Review) in Agile/Scrum environment.
• Supported the testing team with Defect Management, Requirement Analysis and SQL development for back-end and regression testing and maintaining the Mercury Quality Center with the latest updates on the defects.
• Created and maintained data mapping document(s) in reference to the HIPAA transaction: 837.

Environment: Windows XP/NT, UNIX, C++, Java, HTML, XML, Java Script, Oracle, Rational Requisite Pro, UML, Win Runner, Load Runner, Test Director

Business Analyst/Test Lead

Confidential, Chicago, IL

Responsibilities:

• Worked on HIPAA-EDI (Health Insurance Portability and Accountability Act / Electronic Data Interchange) Project involved the validation and testing of the various HIPAA transactions 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 to HIPAA 4010.
• Gathered requirements and analyzed them to convert into functional and non-functional requirements.
• Conducted meetings/interviews 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, HIPAA 4010 and health care regulations. Tested the system and applications for compliance with the HIPAA, 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 of HIPAA privacy 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. Involved in Requirement Analysis and Writing Scripts for Automating the test cases for Health Claims.

Environment: MS Word, MS Excel, MS Visio, MS Project, HIPAA, SQL, Rational Suite, MS SharePoint, MS Outlook, RUP, UML.

Business Analyst/Test Lead

Confidential, Chicago, IL

Responsibilities:

• Managed requirements from system users and preparation of business requirement documents which provided appropriate scope of work for technical team to develop prototype and overall system.
• Created UML based diagrams using MS-Visio for Use Cases and Activity Diagrams, for better understanding of the layout of the new process.
• Gathered the functional and business requirements by conducting JAD sessions and participatory Design Sessions involving major leads from the Technical Department.
• Adopted process based on agile methodology; Partnered with Directors of business organization to identify gaps leading to IT infrastructure improvements.
• Extensive use of Excel, PowerPoint, Visio, and other MS Office products was required.
• Gathered requirements and participated in database design and development as well as report design and development, testing plan co-development and quality assurance.
• Optimize advertising campaigns to increase clicks and ROI for customers by editing campaign elements such as ad copy, keywords and geographic targeting.
• Extracted data from SQL server into temporary tables in order to cleanup and standardize column entries for re-import into new SQL data structures. Used extensive SQL to create/modify/delete data.
• Participated in conference calls Net Meeting and Daily Stand up Meetings with offshore and onshore team.
• Prepared custom reports and performed SQL query, data analysis and verification.
• Created UAT test scenarios and test cases and coordinated UAT.

Environment: MS Project, UML, SQL server, MS Word, MS PowerPoint, MS Excel, XML, SharePoint, Rational Requisite Pro.

Business Analyst

Confidential, Chicago, IL

Responsibilities:

• Interacted with clients to write business objectives into detail business requirements and ensuring that the requirements documented and what was developed was what was requested.
• Participated in requirements gathering from business users and developed BRD’s, FRD’s, conceptual design documents and ensured that client’s requests were delivered as accurately.
• Responsible for analyzing and resolving issues affecting the processes and systems in regards to Collective Billing across all Retail businesses.
• Coordinate with representatives of Sales, IT, Operations and other teams whose processes either impact Collective Billing or are impacted by Collective Billing.
• Regularly engage business processes, conduct analysis, define; plan, track, and complete project tasks while making recommendations for system and process improvements.
• Skills and knowledge to effectively address and resolve issues across multiple functional groups including but not limited to Information Technology, Back Office Operations (including invoicing, service initiation, remittance processing), Consumer Operations, and Sales.
• Created training programs that helped others understand how to handle tickets and resolve them properly using WBT Awareness courses.
• Responsible for updating project status using MS Project and maintaining the Dashboard

Environment: MS Excel, MS Word, SQL Server, MS Project, MS PowerPoint, MS Enterprise Library and Application Blocks, Visual Studio, MS Access, Adobe Acrobat.