SUMMARY

• Over 8+ years of professional experience as a Business Analyst in the Health Care domain.
• Extensive experience in analyzing and requirements gathering and writing system functional specifications including use cases.
• Strong knowledge on the Systems Development Life Cycle (SDLC), Rational Unified Process Methodology (RUP), RAD, SWOT, and CRM.
• Strong skills in creating UML Diagrams and Data Models including Use Case Diagrams, Activity Diagrams, Deployment Diagrams, Data Flow Diagrams (DFD) and Entity - Relationship diagrams using Rational Rose and MS Visio.
• Experience in Clinical Data Management and Clinical Trial Management.
• Strong knowledge of Project management skills includes time estimation, task identification, and scope management.
• Proficient in designing Data Models (logical and physical) for Oracle, DB2 and SQL Server databases.
• Knowledge in the ETL (Extract, Transform and Load) of data into a data ware house/date mart and Business Intelligence (BI) tools like Business Objects Modules (Reporter, Supervisor, Designer, and Web Intelligence).
• Organized Joint Application developments (JAD), Joint Application Requirements sessions (JAR), Interviews and Requirement Elicitation sessions.
• Experience in preparing Systems Proposal Reports and performing GAP analysis.
• Experience and skills in creating design models and Extensive use of UML/RUP for modeling views using tools like Microsoft Visio.
• Understanding of BEA WebLogic Portal to simplify the production and management of custom-fit portals, allowing a shared services environment to roll out changes with minimal complexity and effort.
• Hands-on experience on EDI transactions such as 270, 271,276, 277, 278, 834, 835, 837 (P, I, D) for Health Care Industry.
• Hands-on experience using FACETS 4.3, FACETS 4.5, DB2, Oracle Packages, Stored Procedures and Database Triggers, Forms 9i, Reports 9i, PL/SQL, SQL.
• Performing variety of Data Analysis for 270/271, 276/277, ITS - 837P, 837I for BX Home and BX Host HIPAA X12/XML Transactions
• Familiar with HIPAA EDI transactions such as 835, 837 (P, D, I) 276, 277, 278 etc
• Conducted requirement analysis techniques such as Business Process Automation, Business Process Improvement, and Business Process re-engineering.
• Motivated self-starter with exceptional team building, leadership, and verba skills.
• Possess strong technical skills and business knowledge coupled with product knowledge in Oracle E- Business Suite.
• In depth knowledge Rational Unified Process (RUP) methodology, Use Cases, Software Development Life Cycle (SDLC) processes, Object Oriented Analysis and Design (OOA/D).
• Competent in Creating Unified Modeling Language (UML) diagrams such as Use Case Diagrams, Activity Diagrams, Class Diagrams and Sequence Diagrams.
• Extensive experience in developing Use Cases, creating Screen Mockups, conducting Gap Analysis and Impact Analysis, SWOT analysis, Cost Benefit Analysis, Risk Analysis.

TECHNICAL SKILLS

• Unified Modeling Language (UML)
• Rational UnifiedProcess (RUP)
• Agile
• Waterfall
• Rational Rose
• Rational Requisite Pro
• DOORS
• ClearQuest
• Microsoft Windows
• XP
• Vista
• SQL
• PL/SQL
• HTML
• XML
• C#
• Asp.Net
• SQLServer
• Oracle
• Toad
• Oracle Apps
• MS Access
• MS-Office
• MS Outlook
• MS Power-point
• MS Visio
• MS Project
• SDLC
• Test Director
• BMPN
• Balsamic
• Axure
• TFS

PROFESSIONAL EXPERIENCE

Confidential, Marlton NJ

Business System Analyst

Responsibilities:

• Met with client groups to determine requirements and goals.
• Utilized Rational Unified Process (RUP) to configure and develop process, standards, and procedures and create a Business requirement Document.
• Created new database objects like Tables, Procedures, Functions, Indexes and Views using T-SQL in Development and Production environment for SQL Server 2000.
• Involved in with data migration (ETL development), document data manipulation processes and scripts.
• Responsible for preparing Software Requirement Specification (SRS) and documenting them.
• Created Process Work flows, Functional Specifications documents and documented system requirements.
• Performed all necessary programming, testing and documentation for COBOL, DB2 batch programs and sub-routines.
• Extensive involved in Conducting Market Research, Feasibility Studies, Data Analyses, System Analyses, Gap Analyses, and Risks Analyses.
• Responsible for maintaining database of Medicare D inquiries.
• Develop detailed unit test plans and scripts and conducted rigorous testing per requirements and assisted in data mapping.
• Provide implementation assessment, strategy, and mentoring services for Rational Rose, UML and RUP.
• Interacted with various cross-functional teams on building business use cases, and understanding expenses and revenue stream.
• Worked with Quality Control Teams to develop Test Plan and Test Cases.
• Interaction with the developers to report and correct bugs.
• Developed Test Plans and Test Cases according to Business Requirements.
• Use HL7 implementation methodology to create specifications, assist with unit testing, and perform integrated testing for messaging between the state Departments of Health and the location office
• Conducted JAD sessions with extensive involvement from Business, Development, Testing teams, Architects, SME’s (Subject Matter Experts) and Managers of various Business Units
• Analysis of new Business Requirements and preparation of the Functional Design Specifications
• Interacted with clients like SPF Securities to finalize their website look and contents.
• Utilize HL7 implementation methodology to develop Electronic Laboratory Reporting interfaces

Tools: & Technologies: J2EE (JSP 1.1), EJB(2.0), Servlets 2.2, JMS, Java2 (JDK 1.3), STRUTS,JDBC2.0, XML, XSL, XSLT, Rational Rose, PL/SQL, HTML, CSS, JavaScript, Cognos, HL7, Websphere4.0,Oracle 8.0, WebSphere Studio Application Developer v5.0, Cobol, Win2000, Unix(AIX)

Confidential, Trenton, NJ

Business Analyst

Responsibilities:

• Worked as a liaison among stakeholders and IT to elicit and analyze various project requirements.
• Gathered requirements from claim adjudicators, nurses, and documentation specialist to translate the business details into functional specification documents that represent the different type of processes.
• As scrum master involved in Scum Sprint planning sessions, Backlog grooming, Spring Retrospectives, daily scrum meetings, User Stories and burn down charts
• Conduct JAD sessions with high profile decision makers, SMEs, IT team to ensure usability and validation of the new technological platforms
• Created Unified Modeling Language (UML) diagrams like case diagrams and Activity Diagrams using Visio
• Developed test plans, test scripts, use cases for testing of workflow automation tool with business users and IT development staff.
• Prepared training materials and conducted trainings for users highlighting clinical documentation guidelines
• Responsible for creating test scenarios, scripting test cases using testing tool and defect management for Policy Management Systems, Payables/Receivables and Claims processing.
• Involved with all the phases of Software Development Life Cycle (SDLC) methodologies throughout the project life cycle.
• Queried database using SQL for backend testing
• Used Rational clear quest for defect management

Tools: & Technologies: Agile, Microsoft Office, HTML, Microsoft Visio, Share Point, XML schema, UML, Quality Center, QML, Visio

Confidential, Louisville, KY

Business Systems Analyst

Responsibilities:

• Interacted with business heads to finalize the Business Requirements for the application.
• Performed the requirement analysis and documented the requirements using Rational Requisite Pro.
• Used the requirement attributes (priority, effort, and risk) as the basis for negotiating the inclusion of the requirement, to manage the scope of the system efficiently.
• Involved in the full HIPAA compliance lifecycle from GAP analysis, mapping, implementation, and testing for processing of Medicaid Claims.
• Worked on EDI transactions: 270, 271, 834, 835, and 837 (P.I.D) to identify key data set elements for designated record set.
• Interacted with Claims, Payments and Enrollment hence analyzing and documenting related business processes.
• Identified/documented data sources and transformation rules required populating and maintaining data warehouse content.
• Represent Operations Team as Client Liaison for Medicare PartD Plan.
• Provided clear and concise documentation regarding requirements management plans, Functional Requirements, supplemental Requirements, Test Plans and Test Cases.
• Implemented Data Modeling standards, including element-naming conventions.
• Used SDLC (System Development Life Cycle) methodologies like the RUP and the waterfall.
• Understand the As Is system and develop the To Be system concept and also prepare the System Process Maps.
• Designed new Business Intelligence (BI) system using Oracle Discoverer 10g to provide reporting under Oracle Applications.
• Conversion of data from different database environments, while performing Back End Testing.
• Developed extensive experience in eligibility and benefits calculation for state, federal and local services such as Medicare and Medicaid.
• Performed Requirement Gathering & Analysis by actively soliciting, analyzing and negotiating customer requirements and prepared the requirements specification document for the application using MS Word.
• Developed criteria for IVR and online interface preauthorization process for providers.
• Checked Business Readiness and determined activities of flow.
• Worked extensively with the QA team for designing Test Plan and Test Cases for the User Acceptance Testing.
• Developed & executed several Optimized queries in SQL on this data.
• Wrote Procedure Manuals and was responsible for continuity preparedness.

Tools: & Technologies: Rational Rose and Requisite Pro, MS Visio, MS Office, MS Project, Agile, UML, XML, Windows XP, NT/2000, HTML, Cobol, SQL Server 2000, HL7, Vignette Content management Tool, J2EE (JSP1.2), XML, XSL, XSLT, HTML, Oracle 9i.

Confidential, Harrisburg, PA

Business Analyst

Responsibilities:

• Developed Test Cases for manual and automated testing of an application.
• Gathering the requirements and analyzing the requirements.
• Conducted Functional, Integration and Regression testing.
• Involved in testing web testing with automated tool SOAPUI.
• Analyzed HIPAA 5010 standards for 837P transactions, related to providers, payers, subscribers and other related entities.
• Worked on 834 and 835 projects, including syntax and business rules for X12 HIPAA 4010 and5010 validation for loops, segments, elements, qualifiers and code sets.
• Worked with providers and Medicare or Medicaid entities to validate EDI transaction sets or Internet portals. This includes HIPAA 4010; 837, 835, 270/271, and others.
• Also worked on 837 and 835 projects, including syntax and business rules for X12 HIPAA 4010 and 5010 validation for loops, segments, elements, qualifiers and code sets.
• UAT testing for HIPAA 4010 and 5010 projects including legacy testing and HIPAA requirements and compliance mandates.
• Performed back-end testing procedures using SQL statements
• Recorded scripts in QTP to perform Functionality testing.
• Using VB scripting in the expert view did enhancements to the scripts.
• Created different types of checkpoints (Standard, Text, Text Area, Bitmap, and Database) and checked for properties of fields with respect to requirements.
• Imported/Exported Excel sheets with Parameterized values into/from QTP.
• Managed property values for objects in the Object Repository.
• Developed automation test scripts for performing regression testing on the application using Quick Test Pro
• Perform Backend testing by extensively using complex SQL queries to verify the integrity of the database.
• Performing GAP analysis for the existing systems and processes.
• Conducted Back-End Testing and Regression Testing using various phases of the application.
• Completed several HIPAA 4010 and 5010 Projects, included Medicaid and Commercial entities. Projects include claims and enrollment testing as well as NPI and medical coding and ICD-9 EDI testing.
• Validated triggers using Toad for Oracle.
• Involved in exporting data from the database to flat files using Toad for Oracle.
• Identified, analyzed and documented defects, error and inconsistencies in the application using Quality Center.
• Created and maintained Test Matrix and Requirement Traceability Matrix and performed GAP Analysis.

Tools: & Technologies: HIPAA EDI, QTP, SOAPUI, Quality Center, Oracle, UNIX, Toad, Windows.

Confidential, Charlotte, NC

Business Analyst

Responsibilities:

• Prepared the Business requirement Document (BRD) and functional requirement document (FRD) for the SecureTrack web portal.
• Provide support and assisted technical analyst team with preparing Technical Design Document (TDD).
• Analysis and Design transaction sets, and modification of these transaction sets to ensure HIPAA compliance.
• Gap analysis between HIPAA 4010 and 5010. Prepare a PDF document of claims issue and challenges by comparing HIPAA 4010 and 5010 implementation guideline.
• Define project scope, to identify the business flows and determine whether any current or proposed systems are impacted by the new development efforts.
• Created workflow diagrams, UML diagrams, process models, activity diagrams, use cases, E-R diagrams for incorporating business process modeling & design changes in the order creation/ management system.
• Assisted with UAT such as producing test plans and test cases, conduct user testing.
• Design and execute test plans, tracking defects and getting them resolved to ensure that business requirements and functional specifications are tested and fulfilled.
• Provide mapping document of HIPAA P, I & D, 278 and 835 transactions and 837P, I & D, 278 and 835transactions.
• Prepare the document for Claims Editing & Resubmission and verify the backend process to resubmit the claim by transferring correct X12 files.
• Perform X12 test with the help of Spec Builder tool and make sure the system passes correct X12 data file.
• Planned, coordinated, and monitored project levels for performance and activities to ensure project completion using Work Breakdown Structure in MS Project.

Tools: & Technologies: SQL Server, HTML, XML, MS Visio, BPMN (Visio), MS Office, MS Project, Snipping Tool, GEMs, Edifecs-Spec Builder