Vidhi Shah

Business Analyst

SUMMARY

Certified Consultant with 3 years of experience with strong domain knowledge in Healthcare Industries.

Offers expertise in the all phases of Software Development life cycle (SDLC), ranging from Waterfall to Agile and Business Process Modeling (BPM).

Experience in conducting Joint Application Development (JAD) session for requirements gathering, analysis, design & Rapid Application Development (RAD) session.

Proficient in creating Business Requirement Documents (BRD) & Functional Requirement Documents (FRD).

Proficient in gathering & analyzing the Business Requirements, documenting System Requirement Specifications, Functional Requirement Specifications & Software Development Plan.

Experience in conducting Gap Analysis, Cost Benefit analysis & User Acceptance Testing (UAT).

Well acquainted with the Workflows and Unified Modeling Diagram (UML) such as Use Case Diagrams (UCD), Activity Diagrams (AD), Sequence Diagrams (SD), Context Diagram (CD) etc.

Extensive knowledge & experience in converting Business Requirements into UML Diagrams using MS Visio.

Good knowledge of HIPPA compliance, HIPPA Insurance Regulations, Claim Processing, Privacy, Security & Medicaid.

Provide leadership & oversight throughout the life cycle of the project.

Proficient in creating Wireframes / Mock up screens using Ms Visio.

Inquisitive, Ability to adapt new technology & learn in order to deliver quality product on time.

Detail Oriented, Excellent organizational, communication & interpersonal skill with the flexibility required to adjust to frequently changing work priorities.

Exceptional mediator between external & internal customers, capable of interpreting their need & positions to ensure the success of the project. TECHNICAL EXPERIENCE

OOAD Tools Rational Rose, Microsoft Visio

SDLC Methodologies Waterfall, Rational Unified Process (RUP), spiral and Agile methodology

Applications MS Office (Word, Excel, PowerPoint, Access, MS Project 2000

Languages UML, Java Script, HTML, SQL

Operating System Microsoft Windows95/98/NT/2000/XP/VISTA/7 Graphical User Interface MS Office Suite, Adobe Acrobat RDBMS MS Access, MS SQL, Oracle, MY SQL

Core Strength Perform JAD/RAD Sessions

Customer Operations

Strategic and Tactical Planning

Establishing priorities and schedule

Time management

Problem identification & Resolving skills

Process and Performance Improvement

Risk and Conflict Management

Effective Communication Skills

EDUCATION

Bachelors of Homeopathic Medicine and Surgery (B.H.M.S.) from Sardar Patel University, Gujarat.

Post Graduate Diploma In Hospital & Healthcare Management from symbiosis, pune. PROFESSIONAL EXPERIENCE

Client: Medco Health Solutions Inc, Richmond,VA

Duration: March 2017 to Till Date

Role: Business Analyst

The project required development of Clinical Management Products Application to lower the plan costs and improve quality of care by voluntarily engaging physicians and pharmacists in addressing inappropriate prescribing, dispensing, and use of drugs. The major features to be included in the project were Coverage Authorization, Coverage Review/Prior Authorization, and Drug Utilization Review (DUR).

Responsibilities:

Gathered Business and Functional Requirements based on Agile SDLC methodology and created User Stories based on it.

Converted Business Requirements into Functional Requirements Specification Document and Technical Specifications.

Jira Tools used to write User Stories, Acceptance Criteria, Story Points etc.

Developed Project Status Metrics for weekly evaluation of Project Status and analyzed the impact of the open issues and Change Request on the Project Plan.

Actively Participate in Grooming Sessions and Capture all the requirements.

Working in collaboration with Scrum Master to discuss any conflicts from Product Integration perspective.

Working with Project Manager and help them with Release Planning.

Facilitated JAR sessions, JAD session, wrote Status Reports, Oral Presentations, Emails and coordinated extensive communication network through interviews with end users, physicians, Tech team and other non-technical team members.

Created Use Cases Diagrams, Use Case Narratives, Activity Diagrams, Class Diagrams, and Collaboration Diagrams using UML modeling tools like MS Visio.

Working within a growing knowledge of HIPAA 837, 835, 834, 270, 271, 276, 277, and 278, EDI, Privacy, Security, and Medicaid.

Extensively interacted with the stakeholders and the IT Department in finalizing the requirements according to the CMS Compliance/Regulations and HIPAA Regulations.

Provided assistance in developing Test Plans, Test Cases, Test Reports, and Defect Tracking as and when required.

Created Work Breakdown Structures (WBS), Project Schedule and Project Timelines using MS Project.

Performed Data Analysis by evaluating Age, gender, SSN, Date of birth, Procedure codes inclding all financial information.

Performed data mining using SAS to detect relevant patterns in a database from the current and historical data.

Developed and executed overall testing strategy, plans, and test cases for User Acceptance Testing (UAT) and Operational Acceptance testing phases. Environment : MS Project, MS Visio, Rational Requisite Pro, SQL, SAS, MS Excel, UAT. Client: Tenet Healthcare Corporation,Dallas,TX

Duration: April 2016 to Feb 2017

Role: Business System Analyst

Tenet Healthcare Corporation (THC) is a holding company that owns and operates 63 hospitals in the United States. The project was to develop an application for the hospitals to use as a central repository, storing reports from different departments of the hospital. Responsibilities:

Involved in reviewing the business process and possible improvements based on user requirement, interviewing the HOD’s and other end users, asking detailed questions and carefully recording the requirements in a format that can be reviewed and understood by both business people and technical people.

Used MS Visio to create business process flowcharts and Workflow diagrams.

Involved in detailing project mission, Data Process Flow Diagrams and timeliness.

Formed a bridge between the Project Manager and different teams with effective presentations.

Prepared Workflow diagrams, analyzed AS IS and TO BE scenarios, designed new process flows and documented the business process and various business scenarios.

Utilized Waterfall SDLC methodology to configure and develop processes, standards, and procedures.

Involved in the calculations and documentation using MS Excel, MS word, MS Access and PowerPoint.

Participated in data modeling; planning, designing, implementation of the data warehouse and conducted testing. Produced data mapping and data definition documentation.

Involved in reviewing and writing User Requirement Specification (URS) and Functional Requirements documents.

Analyze business requirements and segregated them into high level and low level Use Cases, Activity diagrams/State Chart Diagrams according to UML methodology thus defining the Data Models.

Involved in process modeling, conducted & Participated in Joint Application Development

(JAD) sessions with System Users.

Performed the user acceptance test (UAT) and suggested recommendations for the applications.

Worked with SQL queries for data manipulations.

Thorough documentation of the entire process along with all its activities. Environment :Rational Rose, Microsoft Visio, Microsoft Project, MS Excel, MS Access. Client: Antares, Cleveland OH

Duration: Sept 2015 – March 2016

Role: Business Analyst

Antares, sister concern of Medical Mutual of Ohio; is a Solution partner for all the software needs. QRS was developed for the Individual buyer. Project required an in-depth understanding of the underwriting process for health insurance. Complex algorithms were developed to come up with appropriate amount of premium for the individual after taking into consideration a variety of risk factors, which are standard for the industry. Responsibilities:

Worked extensively with the users and with different levels of management to identify requirements, use cases and to develop functional specifications

Created Use-Cases and Business Use-Case Model after accessing the status and scope of the project and understanding the business processes.

Designed use cases and sequence diagrams using Rational Rose

Created requirements analysis and design phase artifacts using Rational RequisitePro, Rational Rose and to create Use cases, Activity and Sequence diagrams.

Used the change management from rational to track changes to multiple artifacts by versioning artifacts, associating requirements specific change requests to streamline the defect/change tracking process.

Participated in regression and User Acceptance Testing (UAT) and documentation of executed test cases that were developed in pre-testing phase.

Interacted with external user community and developed customer support plan.

Managed the Change Request Process closely with the Customer and the Development Team.

Environment :Rational Rose, Microsoft Visio, Oracle, MS Excel, MS Access.

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