SUMMARY

• 5+ years of experience as a Business Analyst in the Information technology and healthcare industry with strong knowledge of SDLC having knowledge of the methodologies like Agile Scrum, Waterfall with expertise in conducting interviews and requirement gathering sessions with the business users, stakeholders and development team.
• AHIP certified Healthcare professional.
• Knowledge on Balance sheet & leverage ratio.
• Experience in working with Medicare and Medicaid projects.
• Extensively worked on Product management for CMS star rating, HEDIS and Population Health Management
• Proficient in EMR, HL7 and other healthcare terms
• Knowledgeable in Facets
• Experience in working in entire Revenue Cycle Management
• Experience in using Sales Force tool in managing the revenue cycle of DME client
• Extensive acquaintance in gathering Business/Functional user requirements, creating Use Cases as per user requirements, developing/designing diagrams such as Activity, Class, Sequence Diagrams and in addition to creating Business Requirements Document(BRD)
• Strong skills in performing data analysis, risks analysis, analysed workflows and created Use Cases, Requirement Specifications, Report Specifications, Data Requirements, Data Mappings and Data Flow Diagrams.
• Knowledgeable in identification of the Data Sources, ETL methods, Data Conversion process, OLAP designing and Reports generation needed for purpose of reporting
• Development, implementation and integration strategies in a team oriented environment by employing qualitative and quantitative analytical skills
• Knowledge of Life Science processes. Worked on Order Entry Process and integration of a Pharma client
• Design and review of the various documents including Software Requirement Specifications(SRS), Business Requirement Document (BRD), Functional Requirement Document(FRD), Testing documents
• Knowledge of Data Warehousing, Extraction, Transformation and Loading (ETL)
• Ability to manage workload under deadlines in addition to multitask projects or tasks
• Excellent verbal/written communication skills and strong analytical abilities working independently and as a team player

TECHNICAL SKILLS

Operating System: Windows 2000/XP/Vista.

MS Office: MS Excel (Creating Pivot table, data cleaning and analysis)

Databases: SQL Server and Oracle.

Business Modelling Tools: MS Visio .

Project Management Tools: MS Project, COGNOS

PROFESSIONAL EXPERIENCE

Business Analyst

Confidential

Responsibilities:

• Market analysis of Payers and Population health management organizations for Medicare and Medicaid contracts
• Development of HEDIS and StarServ Products to deliver better care and reduce costs
• Identifying key issues in the patient data that is impacting the score
• Provide corrective actions to improve quality rating
• Prepare use case requirements document and technical specification document
• Communicating the requirements to the Developers and other technical team
• Market profiling to understand the gaps in care and provide solution approach documents
• Data as a service and Quality as a service used in decision making process
• Revenue modelling and pricing analysis for the products
• Worked on BRD, FRD documents
• Track, analyse and interpret trends from Medicare and Medicaid claimsdata.
• Ensure compliance with HEDIS technical specifications, policies, operating procedures, and goals in compliance with internal and external guidelines
• Analysed data related to HEDIS, Consumer Assessment of Healthcare Providers and Systems (CAHPS), and other clinical data related to quality outcome reporting
• Actively reviewed and suggested improvements to current or planned systems and processes based on knowledge of healthcare claims data
• Worked closely with Star managers and analysed strategies to improve the star rating
• Experienced in working across the product life cycle right from market research & conception, writing business case, requirements management and supporting pre - sales & marketing.
• Documented process flows and developed requirements for functional improvements and enhancements.

Confidential

Responsibilities:

• Understanding of complete RCM cycle for a DME client
• Responsible for the entire claims processing cycle right from claim entry to billing
• Managed Team of 80+ associates and trained the team on RCM processes and ensured all the protocols are followed
• Organized, identified and improved the workflows through daily and weekly productivity reports
• Worked on Sales Force tool on managing the revenue cycle
• Automated the manual process using sales force modules and reduced the resources cost
• Designed workflows using MS Visio
• Use Six sigma to improve the process efficiency
• Reduce claim errors, optimize revenue, manage denials

Confidential

Responsibilities:

• Good understanding of Pharma drug development process
• Understands Order management process
• Automated the Order management process using Sales Force modules
• Monitor and manage the inventory data and generate reports on a routine basis
• Used Informatica Master Data Management tool for better decision making and enhanced customer experience
• Gathered requirements, reviewed and suggested improvements to the current process
• Worked on COGNOS and ETL tools
• Provided IT solution, development and supportin data warehousing and integration area.
• Worked on TIBCO integration tool to integrate their routine applications across globe.
• Deployed code into production environment, checked for errors and provided migration between development, test and production environment.

Confidential

Responsibilities:

• Provided technical solution that helpedin maintaining their store information, marketing their products to the customers and enhance their web visibility.
• Worked on Windows, Linux and Data Base administration
• Managed a team and handled administrative issues.