SUMMARY

• Over 8 years of diverse experience in the field of Information Systems with emphasis on Business Analysis, Healthcare Processes, and Strategic Planning focused on Financial, Healthcare industries.
• Good understanding of GAP analysis, requirements management, risk analysis and project plans. Proven expertise in creating UML diagrams, flowcharts, screen mockups, systems requirements specifications, and test plans.
• In depth noledge of Software Development Life Cycle (SDLC) with Waterfall and Agile methodologies thorough understanding of various phases like Requirements Analysis, Design, Development and Testing. Extensive experience in SCRUM and SPRINT planning and execution.
• Practical noledge of Rational Unified Process (RUP) as iterative SDLC with implementation of all four phases: Inception, Elaboration, Construction and Transition.
• Strong project management skills including planning, scheduling, monitoring and budgeting with experience in gap analysis, risk analysis, effort estimation etc.
• Experienced on Batch Processing & EDI interfaces in healthcare domain.
• Working noledge of requirement gathering by conducting personal interviews, developing questionnaire, brainstorming, conducting JAD (Joint Application Development) sessions, or role playing to get a better understanding of client business processes and creating requirements traceability matrix for tracking the requirements.
• Experience in BABOK principles and techniques in Requirement Elicitation & Management, Enterprise Analysis, and Solution Analysis & Validation.
• Experience in Revenue Cycle Management (RCM) for Insurance claims processing and payment.
• Experienced in Health insurance exchange, Medicare/Medicaid claims processing in compliance with government compliant processes like HIPPA/EDI formats.
• Deep noledge of Medicare - Medicaid rules, NCPDP, HIPAA (4010, 5010), ICD9/ICD10 codes, CPT, EMR, pharmacy benefit management, EDI transactions (270/271, 276/277, 834, 837/835)
• Experienced in FACETS claims management system.
• Experience in HL7 electronic health information exchange.
• Proficient at creating and transforming business requirements into software requirement specification (SRS) using Rational Requisite Pro, Rational Requirement Composer and designing business models using UML diagrams such as use case model, class diagrams, activity diagrams, sequence diagrams and collaboration diagrams in Rational Rose and MS Visio theirby helping development and quality assurance team in understanding the requirements.
• Experience in Team Foundation Server, Microsoft CRM case management tools, and Pervasive maps.
• Experienced in gathering requirements, preparing requirement specifications, workflow diagrams, and wireframes.
• Experienced in product models and data flow diagrams and highly experienced in change request or new solutions during the project.
• Experienced in RDBMS, data warehouse, data modeling tools, SQL queries and Stored Procedures.
• Experienced in data mapping document and functional design document and worked with stakeholders and helped during the project.
• Have excellent communication skills, leadership and presentation skills, time and group management skills.
• Conducted user acceptance testing (UAT) with business users and post production maintenance support once the product is in the use.

TECHNICAL SKILLS

Methodologies: RUP, Agile, Waterfall,, Six Sigma,, UML, Business Process Modeling and Data Modeling

Office Tools: MS Word, MS Excel, MS PowerPoint, MS Access, MS Project, M Outlook, SharePoint, Lotus Notes

Process/Modeling tools: MS Visio, Rational Rose, Rational Requisite Pro, Smart Draw, Clear Case, ClearQuest

Database: MS Access, SQL Server 2000, Oracle 9i & 10g, Teradata.

Testing tools / QA: Test Director, Quality Center, WinRunner. Selenium

Quality Management: HIPAA, CMMI, CMM, Six Sigma, TQM

Operating System: Windows Vista, NT/2000/2003/ XP/98, MS DOS

Languages: SQL, PL/SQL, HTML, XML

PROFESSIONAL EXPERIENCE:

Confidential, OAKLAND, CA

Sr. Business Systems Analyst

Roles and Responsibilities:

• Followed Agile Software Development Methodology and through various iterations and storyboarding interviewed stakeholders and end users using user stories in order to create use cases for the development team.
• Used unified modeling language (UML) to create artifacts for the project related deliverables.
• Involved in interviewing Subject Matter experts (SMEs) and carefully recording the requirements in a Business Requirements Document (BRD) for the eCPR system.
• Experienced in writing Technical Requirement Document following API.
• Performed gap analysis between the “As-Is” model of the legacy system and the “To-Be” model to identify the gaps, logged issues relating to the identified gaps and worked with the SME to get clarifications.
• Performed Security testing for unauthorized access of the Web application with valid and invalid data.
• Created RTM (Requirements traceability matrix) mapping Requirements to Design Artifacts to SIT Cases to UAT Cases.
• Used Rational Requirement Composer (RRC) for requirement gathering and Rational Team Concert (RTC) for project planning and implementation
• Created Process Flow Diagrams, Activity Diagrams, Sequence Diagrams and ER Diagrams in MS VISIO and Rational Requirement Composer (RRC).
• Created Use Cases and Use Case Diagrams in Rational Requirement Composer (RRC).
• Analyzed Business Requirements, performed gap analysis and segregated them into high level and low level Use Cases, Activity Diagrams/State Diagrams and Class Diagram.
• Documented and maintained requirements traceability matrix to ensure dat all requirements are traceable from top to bottom and to provide a basis for test plan
• Worked with MS Project, MS Access, MS Excel and MS Visio graphs to represent the charts and data.
• Wrote standard SQL Queries to perform Data Validation using Microsoft SQL Server Studio.
• Designed wireframes in MS Visio for the user interfaces of the eCPR system.
• Involved in the creation of Request for Offer (RFO) for application development.

Environment: Rational Requirement Composer, Rational Team Concert, Microsoft SQL Server, MS-Visio, SharePoint, Windows, MS Office suite

Confidential, IRVINE, CA

Sr. Business Systems Analyst

Roles and Responsibilities:

• Followed Agile Software Development Methodology and through various iterations and storyboarding interviewed stakeholders and end users using user stories in order to create use cases for the development team.
• Worked on ICD9, ICD10 transactions. Involved in ICD-9 to ICD-10 conversion project.
• Worked on standard 837 (Health Care Claims or Encounters) file validation, 835 (Health Care Claims payment/ Remittance), 270/271 (Eligibility request/Response), 834 and 820 transactions. Worked on Procedure codes (CPT).
• Worked on Team Foundation Server for generating change requests and project follow up, Microsoft CRM case management tool for resolving production issues, and Pervasive maps for data conversion and creating maps.
• Experience in Revenue Cycle Management (RCM) for claims processing.
• Mentored business analysts in methodology for defining ICD-10 mapping processes, gathering requirements, and documenting business requirements. Developed additional processes specifically designed to handle Benefits Administration.
• Involved in gathering reporting requirements with emphasis towards default columns in reports, filtering criteria (mandatory/optional prompts, dynamic/static filters).
• Worked on report to report interfaces and report drilling. Worked on dashboard designs, making sure dat the dashboard would be an value add to business community with an eye towards maximum utilization of the dashboard real estate.
• Expertise in coming up with naming standards for different kinds of reports (eg. Webi, Crystal reports, Dashboards in Business Objects and also Cognos reports).
• Worked on making sure the standards are followed in building Business Objects universals and Cognos packages.
• Worked extensively on report look and feel validation.
• Knowledge of Project management principles and practices, defines and creates schedules, statements of work, directs, and coordinates projects by establishing a work plan, arranging staffing, assigning duties, producing reports, and ensuring the progression and completion of the project.
• Experience of various BABOK principles and techniques used for Requirement Elicitation & Management, Enterprise Analysis, and Solution Analysis & Validation.
• Experience in Cost Estimation for the project for various clients.
• Worked on Pharmacy benefit management program like claiming issues from the pharmacy, drug stores and resolve those issues.
• Worked on Workers Compensation Claims, Medical Billing, Provider Payment System, and State Regulatory Reporting.
• Performed data analysis and assisted solution architect to drive the delivery of analytics and business intelligence upon Health Information exchanges (HIX).
• Experience working with MS Access for storing healthcare information, importing data from other databases.
• Analyzed Requirements and created Client Requirement Documents (CRD), Business Requirement Documents (BRD), Functional Specification Documents (FRD), Technical Requirement Document, Software Change Request Documents, current business process flow, future business process flow, use case diagrams, data flow diagrams, and activity diagrams using Microsoft Visio.
• Proficient in conducting GAP analysis using AS-IS and TO-BE business, Impact analysis, Risk analysis.
• Experienced in scrum based system development.
• Prepared and maintained project plans and track activities against the plan, providing regular and accurate reports to customers and line management as appropriate. Also managed and handled changes while project in progress within all project phases.
• Experienced on product models and data models and coordination with the data analyst and developers during the project.
• Experienced in validating user requirements, provided the necessary written test plans, and verified product functionality during the development stage.
• Facilitated JAD session for requirement gathering wrote Status Reports, Oral Presentations, Emails and coordinated extensive communication network through interviews with end users, tech team and other non-technical team members.
• Performed data analysis by using SQL queries using Microsoft SQL Server Studio and PLSQL Developer. Experience working with Query builder to write queries, edit data, extracting data, join tables, and update databases.
• Worked on Data mapping document during the project and helped the stakeholders and business experts.
• Worked on FACETS claims management system for claims and billing issues.
• Involved in Regression Testing, prepared UAT Materials, UAT Test Cases to include various steps involved for UAT and performed UAT to have proper coverage of requirements.
• Had experienced in Electronic Medical Records (EMR) in health care sector.
• Assure the Traceability of application’s functional, performance, and security requirements to the business process steps while independently carrying out change controls based on business requirements.

Environment: Rational Suite, NCSS, Ms-Visio, HRA, SAS, SharePoint, Windows, MS Office suite, Rx-Claim, Medicaid.

Confidential - BLOOMINTON, MN

Sr. Business Systems Analyst

Roles and Responsibilities:

• Used unified modeling language (UML) to create artifacts for the project related deliverables.
• Systems Support Management: Managed daily operations and applications support for logistics systems, including custom and COTS warehouse management systems. Maintained system availability above 99%.
• Involved in interviewing Subject Matter experts (SMEs) and carefully recording the requirements in a Business Requirements Document (BRD) for the e-portfolio system integration.
• Performed gap analysis between the “As-Is” model of the legacy system and the “To-Be” model to identify the gaps, logged issues relating to the identified gaps and worked with the SME to get clarifications.
• Performed Security testing for unauthorized access of the Web application with valid and invalid data.
• Created RTM (Requirements traceability matrix) mapping Requirements to Design Artifacts to SIT Cases to UAT Cases.
• Used Quality Center to get an easy interface to manage and organize activities like Requirements coverage, Test Case Management, Test Execution Reporting, Defect Management and Test Automation.
• Created Activity Diagrams, Sequence Diagrams and ER Diagrams in MS VISIO.
• Analyzed Business Requirements, performed gap analysis and segregated them into high level and low level Use Cases, Activity Diagrams/State Diagrams and Class Diagram Documented and maintained requirements traceability matrix to ensure dat all requirements are traceable from top to bottom and to provide a basis for test plan
• Worked with MS Access, MS Excel and MS Visio graphs to represent the charts and data.
• Performed report validation writing SQL queries using TOAD on an Oracle database.
• Wrote standard SQL Queries to perform Data Validation.

Environment: UML, RUP, MS Office, MS- Visio, Quick Test Pro, Rational Requisite Pro, Rational Clear Quest.

Confidential, NJ

Business Systems Analyst

Responsibilities:

• Linked business processes to organizational objectives, performed critical path analysis, and identify opportunities for business process improvement.
• Performed Feasibility Analysis and Gap and Risk Analysis on certain modules
• Worked on Digital Marketing on electronic devices such as computers, laptop and other devices and helped the stakeholders throughout the project.
• Participated in JAD Sessions for gathering requirements and user needs and generated Use Case Specifications and business Use- Case Models.
• Developed, documented requirements and system concepts and maintained tan in a standard framework for the collection, storage, validation, and management of system requirements using Rational Requisite Pro.
• Developed Traceability Matrices for associating identified requirements.
• Maintained all business process artifacts in Rational Clear Case.
• Generated use-case diagrams and process workflows using MS Visio.
• Participated in demonstrating prototypes to the clients and receive feedback.
• Participated in Configuration Management Process.
• Involved in HIM (Health Insurance Management), to manage the administrative, financial and clinical aspects of a hospital and also encompasses paper-based information processing as well as data processing machines
• Worked on Logical database design.
• Participated in design review meetings and translated the requirements to the developers and guided the team when issues related to business requirements arose.
• Change requests based on business requirements, allowing sufficient time frame to ensure accuracy and consider deadlines.
• Assured dat all artifacts were in compliance with corporate SDLC Policies and guidelines.
• Worked on crystal reports documents and well experienced with business experts and developers.
• Worked closely with the QA/Test Engineers in Conducting Quality Control and creation of test plan strategy and test suite for User Acceptance Testing (UAT).

Environment: Rational Tools Suite, Windows XP, MS Office Suite, Microsoft .Net framework, Microsoft SQL Server, Internet Information Server 6.0 and Microsoft SharePoint Portal Server.

Confidential, Buffalo, NY

Business Analyst

Roles and Responsibilities:

• Followed Agile Software Development Methodology and through various iterations and storyboarding interviewed stakeholders and end users using user stories in order to create use cases for the development team.
• Analyzed Requirements and created business requirement document (BRD), current business process flow, future business process flow, use case diagrams, and activity diagrams using Microsoft Visio.
• Conducted JAD sessions for requirement gathering with committee of SMEs from various business areas.
• Experience in Revenue Cycle Management (RCM)for Insurance claims processing and payment.
• Supported the LeadProject Managerin control and refinement of project's risk, scope, quality, schedule, communications, and integration plans.
• Responsible for interacting with Business and end users to gather, analyze the business requirements and prepare Business Requirements Document, converted to Functional Requirements Specifications and Technical Specification using Rational Requisite Pro.
• Created and Modified Edits and Audits for enhancing claiming process and worked on Acute Care Claims Processing and Long Term Care Claims Processing.
• Experience in HL7 electronic health information exchange.
• Worked on Medical malpractices and medical claims during the project.
• Experienced in Claims Master and Revenue Cycle Management (RCM) suite.
• Responsible for project planning, business process reengineering, current process definition and future mapping.
• Provided ongoing study maintenance and application support to all levels of Oracle Clinical, Remote Data Capture (RDC) and RDC Onsite users.
• Designed Use Cases and created UML models such as Use Case Diagrams, Activity Diagrams, Sequence Diagrams, Flow Diagrams, and Process Flow Diagrams using MS Visio.

Environment: MS Visio, MS Office Suite, Java, Test Director, Client Server, UML, RUP, Windows XP, Test Director, MS Project, MS Access.