PROFESSIONAL SUMMARY:

• Senior analyst with over 8 years of experience in IT industry specifically in healthcare domain working with business process analysis/modelling, business requirements gathering, design and development of Web
• Based, and Client/Server applications. Present strong industrial experience in Business/System Analyst capacity performing responsibilities of data validation, data warehousing, data modelling, evaluating data sources, and translating requirements into specifications.
• Expertise over several SDLC methodologies implementations namely Waterfall, Agile and RUP while delivering new and improved solutions to the client. Possess excellent communication, presentation and interpersonal skills that have resulted in long standing relationship with team members, stakeholders and users.
• In - depth knowledge of creating use case, activity, logical, component and deployment views with rational tools to extract business process flows and workflows thereby helping development and quality assurance teams in understanding the requirements.
• Knowledge in ETL (Extract, Transform and Load) of data into a data warehouse/data mart by Informatica, SSIS, and ODI.
• Experience in Designing, Creating and maintaining the Crystal Reports, WEBI reports in Business Objects.
• Expertise in creating source to target mapping (STTM), data mapping and requirement traceability matrix (RTM) document.
• Results-oriented Joint Application Development (JAD) Facilitator and meetings coordinator with excellent interpersonal skills.
• Experienced infollowing HIPAA compliance in HealthcareSystems, Health insurance plans - Indemnity plans ManagedCareplans (HMO, PPO & POS), Government Sponsored Programs (Medicare, Medigap, Medicaid, FEP & SHBP) & Consumer Driven Health plans (CDHP), Obamacare (Affordability Care Act).
• Extensive experience in relational and dimensional data warehousing for creating logical and physical data model and ER Diagrams using multiple data modelling tools like ERWIN.
• Worked extensively on forward and reverse engineering processes.
• Experience handlingHIPAA ANSI X124010, 5010 formats includingEDI transactions (270/271, 834, 835, 820,837, 276/277), ICD9/10, NDC, DRG codes, Facets, HL7, EMR, EPIC.
• Strong Experience in Revenue Cycle Management such as CDM (Charge Description Master), Charge Capture and Charge Routing.
• Worked on web services/site design for member enrolment and benefits.
• Strong understanding of the principles of Data warehousing, Fact Tables, Dimension Tables, star and snowflake schema modelling.
• Experience in conducting SWOT Analysis, Cost Benefit, Finance analysis and ROI Analysis.
• Expertise in broad range of technologies, including business process tools such as Microsoft Project, Primavera, MS Access, and MS Visio.

TECHNICAL EXPERTISE:

Programming Languages: T-SQL, PLSQL, VB Scripting, C,C++,C#.

Development Methodologies: RUP, AGILE, Waterfall

Databases: MS-Access, MySQL, SQL Server, Oracle, Teradata, DB2

Automation Tools: MS Visio, JIRA, Rational Rose Suite, Rational ClearCase, Documentum.

Bug Tracking Tools: Mercury TestDirector, HP Quality Center, Rational ClearQuest

Reporting Tools: Crystal Reports, SQL Server Reports (SSRS), WebI

Data warehousing Tools: Informatica, Toad, Business Objects, Cognos, CA ERwin

Testing Tools: HP Quick TestPro (QTP), WinRunner, LoadRunner

PROFESSIONAL EXPERIENCE

Confidential, Chicago, IL

Sr. Business Systems Analyst/Integration Analyst

Responsibilities:

• Developed new web site design/ portal for members over 65 years age and with pre-existing disorders for NGEN workflow.
• Studied in-house requirements for the MPI (Master Patient Index) Data warehouse to be developed
• Analysed database requirements in detail with the project stakeholders by conducting Joint Requirements Development sessions
• Developed aConceptual modelusing Erwin based on requirements analysis
• Developed normalizedLogicalandPhysicaldatabase models to design OLTP system for insurance applications by forward and reverse engineering
• Created dimensional model for the reporting system by identifying required dimensions and facts using Erwin r7.1
• Conducted one-on-one sessions to determine logic with business users to gather MPI data warehouse requirements
• Responsible for defining the naming standards for data warehouse.
• Generated ad-hoc SQL queries using joins, database connections and transformation rules to fetch data from legacy DB2 andSQL Serverdatabase systems.
• Integrated data from the databases (Oracle and SQL Server, DB2, FLAT FILES) using Informatica to load it into a single data warehouse repository.
• Generated Crystal Reports from SAP Business Objects to monitor the volume of tickets that are created and the approach used for resolving them.
• Enhanced existing Web-services for Claim Transactions via Facets like EDI270-271 for Eligibility Inquiry, EDI276-277 for Status Check, EDI837 for Submission to comply with the HIPAA 5010 standards, wherein integrated all HIPAA 5010 rules with ICD-10.
• Identified risks, problems, requirements and concerns of the healthcare providers in order to comply with ICD-10 changes from ICD- 9.
• Collected the information related to ongoing application upgrade and their impact on ICD-10 implementation and created awareness within the departments regarding the need, impact, benefits and risks of ICD-10 code application with several business rules.
• Developed HL7 CCD messaging for bi-directional case and disease report exchange, in text and XML formats through IBM Websphere MB-MQ and it was transferred by IBM Sterling MFT.
• Managed multiple projects implementation in ECM during NGEN RAMO (Risk Assessment Member Orientation), AMS (Applicant Member Services) and MC (Manage Correspondence) delivery as a lead QA working along cross functional development teams.
• Interacted with business users and developers to identify change requests, issues and defects and maintained timelines via IBM RTC so that they can be resolved.
• Developed test cases and scenarios in HP Quality Center for IP2CM large scale project.

Environment: Microsoft Office 2007 Professional (Word, Excel, Visio, Access, etc.), IBM ECM,UML, UAT, Explorer 2, HP Quick Test Professional, Facets 4.2, IBM Websphere MB-MQ, Informatica, CA Erwin, HP Quality Center, IBM RTC, IBM Lotus Notes

Confidential, Huntsville, AL

Sr. Business Systems Analyst

Responsibilities:

• Gathered and documented business requirements for existing and future business systems using web services tool - Microsoft Foundation.
• Acted as a liaison between business staff and technical staff to articulate needs, issues and concerns.
• Worked on Agile methodology where Scrum meetings were conducted every day and burn down of hours related to each tasks was carried out.
• Storyboarding and story writing of the meetings were shared with team members.
• Used MS-Visio for flow-charting, Use- Case process model and architectural design of the application.
• Reverse engineered the reports and identified the Data Elements (in the source systems), Dimensions, Facts and Measures required for new enhancements of reports.
• Conduct Design discussions and meetings to come out with the appropriate Data Mart at the lowest level of grain for each of the Dimensions involved.
• Designed a STAR schema for the detailed data marts and Plan data marts involving confirmed dimensions.
• Created and maintained the Data Model repository as per company standards.
• Performed ETL through SSIS for integration of records using complex Data Transformation logic.
• Successfully conducted JAD sessions, which helped synchronize the different stakeholders on their objectives and helped the developers to have a clear-cut picture of the project.
• Participated in testing various user interfaces (Inbound and Outbound) of Facets.
• Experience in Forward Mapping and Backward mapping analysis of ICD 9 - ICD 10 Conversion for CM (Diagnosis Codes) and PCS (Procedure Codes).
• Troubleshoot file transmission problems and assisted customers in a web service portal environment with EDI and Medicaid Insurance claim related inquiries; explained and enforced guidelines in the X12 5010 format Implementation guides (837P, 837I, 837D, 834, 270/271, 820).

Environment: Microsoft Office 2003 Professional (Outlook, Word, Excel, Visio, Access, etc.), Microsoft SharePoint 2003, Facets System, Agile, UAT, CA, Erwin, SSIS, Mainframe AS400, Mercury Test Director

Confidential, MD

Business Systems Analyst

Responsibilities:

• Played key role in System Development Life Cycle Process consisting of: Design and Gap Analysis, Business Requirements, Systems Requirements, Test Criteria, and Implementation to have the outputs of project dealt with the automation of correspondence directed to Insurance policy owners.
• Conducted Functional Walkthroughs, User Acceptance Testing (UAT), and supervised the development of User Manuals for customers.
• Consult with new and existing clients and foreign vendors to gather data, analyse and determine interface requirements.
• Design and develop interface solutions from sending systems to receiving systems.
• Assisted in monitoring patient data transactions and addressed problems with HL7 ADT messages.
• Integration development for IBM Websphere MB-MQ, creating code to process HL7 messages for ADT, Lab Orders/Results, Rad Orders/Results, Transcription.
• Foreign systems include hospital information systems, practice management systems, reference laboratories, pathology systems, blood bank systems, pharmacy systems, EMR systems, data repositories and billing systems.
• Establish communication between systems through connectivity methods such as TCP/IP and FTP.
• Followed the UML based methods using Rational Software Modeller/MS Visio to create: Use Cases, Activity Diagrams / State Chart Diagrams, Sequence Diagrams, and Collaboration Diagrams.

Environment: RUP, IBM Websphere MB-MQ, UAT, HL7, GAD (Gap Analysis Document), Microsoft Office 2003 Professional (Outlook, Word, Excel, Visio, Access), Microsoft SharePoint 2003.

Confidential, Minneapolis, MN

Business Analyst

Responsibilities:

• Involved in Inception Phase and prepared vision statement and initial data models that contain Business Requirement Documents and supporting a document that contains the essential business elements and detailed definitions.
• Accurate processing of Medicare claims using the Diamond system
• Gathered user and business requirements through open-ended discussions, brainstorming sessions and role-playing.
• Identified various facts and dimensions from the source system and business requirements to be used for the data warehouse.
• Reviewed the logical model with Business users, ETL Team, DBA’s and testing team to provide information about the data model and business requirements
• Worked with DBA to create the physical model and tables. Scheduled multiple brain storming sessions with DBAs and production support team to discuss about views, partitioning and indexing schemes case by case for the facts and dimensions.
• Gathered requirements and modelled the data warehouse and the underlying transactional database (OLTP) with the help of CA Erwin.
• Analyzed data and created class diagrams, data flow diagram and ER diagrams for designing databases.
• Performed felid-by-field mapping of interface between parent EMR system and downstream system.
• Planned and defined Use Cases created Use Case diagrams, Scenarios and Use Case Narratives using the UML methodologies.
• Created Activity Diagrams, Sequence Diagrams and ER Diagrams.
• Used SDLC (System Development Life Cycle) methodologies like the RUP and the waterfall.
• Designed and Administered Teradata Scripts, Tables, Indices and Database Objects
• Authored progress and completion reports which were then submitted to project management on a weekly basis in MS project.

Environment: Windows 2000 Advanced Server, MS Visio, RUP, UAT, Rational Rose 2002, Rational Clear Quest, Rational ClearCase, Rational requisite pro, rational test manager, Rational Robot.

Confidential, Dallas, TX

Business/Systems Analyst

Responsibilities:

• Collected requirements in agile methodology from department managers and users for enhancements.
• Interacted with users for verifying User Requirements, managing Change Control Process, updating existing Documentation
• Created reports from SAP modules using Business Objects / Crystal Reports based upon business requirements.
• Designed and implemented basic SQL queries for testing and report/data validation
• Conducted Joint Application Development (JAD) sessions with IT groups. Identified the Key Changes, and participated in Stakeholder Management to communicate effectively with them
• Developed and Documented timelines for Project Delivery, and managed Projects and Resources to successful completion.
• Assisted to develop the Test Plan, Test Cases and Test Scenarios to be used in testing based on Business Requirements, technical specifications and/or product knowledge.

Environment: Microsoft Office Suite, Microsoft Visio, Windows NT/XP, Oracle, SQL, Agile, SQL Server, Business Objects, TestDirector.

Confidential, TN

Business Analyst

Responsibilities:

• Created context and workflow models, information and business rule models, Use Case and Object Models during the analysis using Rational tools.
• Prepared Functional Specification Documentation (FSD) and communicated these to the stakeholders.
• Actively interacted with different business groups to perform Gap analysis to identify the deficiencies in the system by comparing the actual objectives with the system objectives desired.
• Conducted Business Requirements, Functional and Technical meetings with Business groups.
• Used Aggregator stages to sum the KPI (key performance indicators) used in decision support systems.
• Participated in UAT phase with end users to check the solution.

Environment: Rational Enterprise Suite (Rose, RequisitePro, ClearCase, ClearQuest), UAT, MSOffice2000