Hima Mandali

SeniorBusiness Analyst/ Project Coordinator

Email: ac6no5@r.postjobfree.com

Phone: +1-609-***-****

PROFESSIONAL SUMMARY:

Over 10 years’ of experience as Senior Business Analyst/ Project Coordinator certified as HIPAA Business Associate (CHPA) and Scrum Master(SMAC) with focus on Business Process Flow, Business Process Reengineeringbyhaving extensive and diversified knowledge& experience in HealthcareHealth Enterprise (HE), Medicaid Management Information Systems (MMIS), Health Insurance Portability and Accountability Act (HIPAA), Medicare Medicaid Services(MMS),Children’s Health Insurance Policy (CHIP), Affordable Act, EDI X12 Format transaction code sets(270, 271, 278, 276, 277, 837, 835, 834, 820)Pharmacy E-commerce, Insurance andProperty & Causality insurance(P&C)andCustomer Relationship Management(CRM).

EXPERTISE:

Solid understanding ofBusiness RequirementsandBusiness Process flow.

Served as the Liaison between IT and the business in understanding key business processes, business data, and requirements, as well as analyse processes for technology service solutions.

Assisted in developing effective working relations with client teams to understand and support Requirements, scope & prioritization of requirements, to effectively manage client expectations.

Strong understanding of Medicaid and Medicare rules.

Extensive experience in working with Health Enterprise (HE) from MMIS for State of New York.

Involved in up-gradation of HIPAA 4010 transaction to HIPAA 5010.

Strong Knowledge and understanding of modularity in MMIS.

Experience in working with Affordable Act.

Good understanding about the Electronic Data Interchange (EDI) used in various business processes.

Extensive experience in documenting Business Requirements Document (BRD), Use Case Specifications and Functional Specifications(FRD), Systems Design Specification (SDS) and Systems Requirements Specification (SRS), Potential Shippable Increment(PSI), and High Level Design Document(HLD).

Experience as scrum master to lead team.

Experience in creatingUser Stories (Functional Stories, Logic User Stories, Service User Stories) from Product Backlog and facilitated Sprint Planning meetings and prepared Sprint Backlog.

Had extensive experience in tracing the Burndown charts.

Participated in Sprint Ceremonies to suggest improvements in scrum process.

Experienced in all phases of the Software Development Life Cycle (SDLC), Rational unified process (RUP) and Agile.

Expertise in using Version Oneto track Requirements, Defects and Impediments.

Expertise in understanding of the AS-IS and proposing TO-BE business processes.

Worked extensively on the various types of Requirements Elicitation, Gap,Risk andSWOT analysis.

Extensive experience in conductingJoint Application Development (JAD),Focus Group sessionsand holding interviews, document analysis for user requirement gathering.

Expertise in creating Use Case diagrams, Activity diagrams, Data Flow Diagrams (DFD), Sequence diagrams,State diagrams based on UML Methodology and process flow diagrams using MS Visio and Rational Rose and update use case diagrams in IBM Blueworks.

Expertise in reviewing the Test Scenarios, Test Cases, Test Scripts, Test execution Strategies and collecting Test Data forUATwhich is done in perspective of the users.

Tracing requirements throughout the development process and verifying adherence using the RequirementsTraceability Matrix (RTM) and Resource matrix.

Efficient in reformulating strategies through, Change Management, Release Management and Process Improvements.

Hands on experience in working with Model Officeand IBM Doors.

Expertise in tracking tools like Bugzilla, Clear Quest, ALM/ QC, Team Foundation Server(TFS), Test Managerand Rally for documenting requirements, identifying and reporting defects.

Experience in working with Data Warehouse and ETL.

Experience in assisting Cognos team for requirement understanding.

Hands on Experience in Pencil, Balsamiq, and JavafxforcreatingWire Frames.

Proficient with Microsoft Excel, Microsoft Access and understanding of Structured Query Language

Skilled in team building, conflict resolution & escalation awareness.

Expertise in working with cross functional teams, multi-vendor environment and to deliver deliverables on time.

CERTIFICATIONS:

HIPAA

HIPAA Business Associate

SMAC

International Scrum Master

TECHNICAL SKILLS:

Software Methodologies

Agile (Scrum), Waterfall, RUP

Domain Expertise

Healthcare specialist

Content Management

SharePoint, Documentum, AES 6

Prototyping Tools

Mocqups, Mock flow, Balsamiq, Pencil, Word

Business Modelling

MS-Visio,Rational Rose, Smart Draw

Business Intelligence

Cognos, Crystal Reports, Tableau

Languages

C, Java, HTML, CSS, XML

Software Testing

HP Quality Centre, Selenium

Project Management Tools

Workfront, JIRA, Rally, ALM, MS Project.

Bug Tracking Tools

Clear Quest, Bugzilla, ALM/HPQC, JIRA, Rally, Team Foundation Server(TFS), Version One.

Database Management

MS – Access, SQL Server,Oracle

Document Creation/Management

MS Office Suite – Word, Excel, Outlook, PowerPoint, MS Project, OneNote, Lotus Notes

Operating Systems

Windows, Linux, Mac

Version Control

Git Bash

PROFESSIONAL EXPERIENCE:

Client

Department of Elementary and Secondary Education

Location

Malden, MA

Duration

September 17 – June 18

Role

Business Analyst

Project 1: Next Generation MCAS:MCAS has enhanced its scaled score ranges for Grades 3-8 which has affected all the school reports. Gathered, documented and got approval of requirements from Department of Education and implemented them Edwin Analytics a web application for Massachusetts Primary and Secondary Schools to review their performance reports.

Project 2: Sheltered English Immersion:The Department provided SEI Endorsement Reports to districts that had English Learners. Since July 1, 2016, school districts (including charter schools) have had a basic responsibility to assign English Learners only to those core academic teachers who have the SEI Endorsement. If circumstances arise that make it necessary for a district to assign an English Learner to an unendorsed core academic teacher, that teacher must earn the SEI Endorsement “within one year from the date of the assignment.”

Responsibilities:

Collaborate with the business to understand strategic goals and objectives, define requirements, assess product fit to business needs, and reengineer business processes as needed.

Collaborate with the technical team to understand the data design of the application, and apply that knowledge to define data requirements related to the new functional requirements.

As a member of the team, adhere to the organization’s methodologies and standards, and propose improvements based on business and data analysis best practices.

Fulfill requirements with high quality and customer satisfaction

Conduct all interviews and meetings needed to document current business process.

Assist in the development of and approval of the business process documentation.

Help team members elaborate their requirements; analyze gaps, permutations, inconsistencies, constraints, assumptions, and risks so that requirements are clear, concise, etc.

Review test cases, expected results, and actual results to ensure that the spirit and intent of all functional requirements are being met.

Review deliverables related to new releases

Proactively raise issues and offer solutions.

Participate in daily scrum meeting to discuss current tasks and status.

Environment: Outlook, Microsoft Office(MS Excel, MS PowerPoint, MS Visio, MS Access),RTC.

Client

Xerox/Conduent

Location

Albany, NY

Duration

August 16 – July 17

Role

Senior Business Analyst/Project Coordinator

The Health Enterprise(HE)System represents the next generation of MMIS. It utilizes a web-based core platform to meet New York State’s requirements. This will provide enhanced flexibility, easy configuration, interoperability, and data sharing capabilities. HE Uses a web-native architecture that is scalable to serve the customer needs. State Of New York Department of Health named MMIS as NYMMIS.

Responsibilities:

Incorporated closely with team to facilitate the Gap Sessions to make sure the team is on the same page.

Responsible to extract, anticipate, simplify and verify requirements.

Facilitated all the meetings to gather requirements and get solutions for blockers or cross dependencies.

Ensuring the requirements map to the real business need, are approved by all relevant Stakeholders, and meet essential quality standards.

Responsible for documenting the types and structure of the business data logical and physical modeling

Analyzing and mining business data to identify patterns and correlations among the various data points

Creating report design mock-ups, simulations to show how HE data is to be and how the report output will interact and result.

Creating functional solutions by closely working with the technical team (Developers, Architects and validation engineers).

Responsible for conducting signoff meetings with project managers.

Responsible to resolve cross functional dependencies.

Following Agile methodology in system Development Life cycle according to our ASDA and ASDM and be a part of all the required Sprint meetings such as Sprint plan, Sprint Review, Sprint Backlog, and Sprint Retrospective.

Responsible for data mapping from source to target.

Responsible for analyzing defects and provide solution for validation team.

Designed status reports regarding the project

Ensure that requirements are understandable to both business and technical teams to develop the requirements.

Participated in Scrum of Scrums, defect triage, weekly project status meetings.

Responsible to get update on the blockers and impediments.

Designed PSI, HLD and DSD as documentation for all the Cognos report requirements.

Environment: MS Office (MS Excel, MS PowerPoint, MS Visio), Trello boards, SharePoint, Agile Scrum SDLC, Version One, IBM Blueworks, IBM Doors, IBM RQM, Outlook

Client

CVS Healthcare

Location

Woonsocket, RI

Duration

December 15 – July 16

Role

Senior Business Analyst/ Project Coordinator

CVS Health is an innovative Pharmacy company acquired with Target to help people for better health. This project is about POS (Point of sale) of Target CVS. This point of sale application provides interaction between sale person and customer. POS supports to create purchase order based on CVS system prescription information. And also customer can add any item over the counter which is not part of doctor prescription. This helps CVS to provide an accessible, supportive and personalized healthcare experience to customers and maintain data of transactions in CVS centralized RX connect system.

Responsibilities:

•Conducted meetings with users and other stakeholders to elicit, organize and document therequirements and also created project status reports and feasibility reports for stakeholders.

•Worked fordocumenting process flow diagrams and data flow diagrams.

•Incorporated closely with team to facilitate the Gap Sessionsto make sure the team is on the same page.

•Defined User Stories (Functional Stories, Technical User Stories, Service User Stories) by following Agile Scrum Methodology of SDLC.

•Reviewed and approved Test Scenarios and Test Cases based on user stories.

•Experience in grooming product and release backlogs when there is a change, feedback or technical debt.

•Documented healthy backlog for 2 sprints, calculating the capacity and velocity of scrum team.

•Tracing requirements throughout the development process and verifying adherence using the Requirements Traceability Matrix (RTM) and Resource matrix.

•Resolved cross functional dependencies and assisted in budget scheduling.

•Participated in Sprint ceremonies to suggest improvements in scrum process.

•Worked on Quality Centre for bug status tracking, maintained and created status reports for the application

•Responsible forcollecting test data for UAT sessionsand facilitating Defect Triage Meeting.

•Active involvement in continuous integration and frequent releases and patch release.

•Experience in using TABLEAU for the visual representation of data regarding sales in Targetcvs.

•Assisted the Data warehouse team to develop service stories.

Environment:Windows, Workfront, HP Quality Centre (ALM, MS Office (MS Excel, MS PowerPoint, MS Visio), Trello boards, SharePoint, Agile Scrum SDLC, Selenium, Salesforce

Client

Universal Healthcare

Location

Saint Petersburg, FL

Duration

Dec 14 - Nov 15

Role

Senior Business Analyst

Universal Healthcare is a Medicare/Medicaid medical coverage supplier situated in St. Petersburg, Florida. In this projectUHC implemented HIPAA 4010 and HIPAA 5010 changes in the current case preparing coordinated framework. It additionally permitted the suppliers to robotize undertakings like Patient administration, with Monitoring and review backing of Medicare Part D claims.

Responsibilities:

Implemented an integrated RUP SDLC solution with complete line of traceability for all the artifacts of web development projects

Performed gap analysis between HIPAA 4010 and 5010 and claims processing.

Documented Requirement Traceability Matrix(RTM) using DOORS for requirement elicitation and linkup to deliverables

Worked with the individual sub-project managers to translate these into PRDs (Product Requirement Documents) for the development teams, with XML format and being able to read XML files.

Examined, analyzed and model Test plans, Use Case Model cases & Test procedures based on Rational Rose &Clear Quest RUP.

Performed Gap analysis for the modules in production, conducted feasibility study and performed impact analysis for proposed enhancements

Involved in walkthroughs and meetings with development team to discuss related issues

Used Rational Rose to visually determine the proper structure, key elements and optimal design for database and to aid efficient creation of tables, stored procedures

Experience in using Team Foundation Server(TFS) to keep track of defects

Wrote clear, concise detailed System Requirements Specification(SRS)documents and user documentation in accordance to guidelines and standards of a level where developers can interpret, design and develop the application with minimum guidance.

Environment: Outlook, Microsoft Office(MS Excel, MS PowerPoint, MS Visio, MS Access), Rational Suite with RUP SDLC, XML, SQL Server, UML, SQL, Facets, Team Foundation Server(TFS)

Client

American International Group Inc.,

Location

Jacksonville, FL

Duration

Jul 13 – Nov 14

Role

Senior Business Analyst

American International Group, Inc., also known as AIG, operates through three businesses: AIG Property Casualty (P&C), AIG Life and Retirement and United Guaranty Corporation (UGC).This project is enhancement of Property and Casualty claims-handling framework giving an all advanced work process and the capacity to track performance. The robotized, Web-based framework gave the capacity of repair shop performances remotely to improve utilization of cases and rapidly add new functionalities to key frameworks.

Responsibilities:

Involved in the analysis of the functional, technical specifications, data mapping document and conceptual diagrams.

Wrote system requirements specification (SRS) and functional requirements specification (FRS) and Data Requirement Matrix (DRM) documents as per the business requirements and process flow.

Involved in Joint Application Development (JAD) sessions to develop and agree upon a system that focuses on a Business Requirement.

Reviewed and approved Test Scenarios and Test Cases based on user stories.

Worked on Salesforce for handling the customer claim inquiries, validation and case creation.

Actively involved in design of wireframes for the different UI’s with UX architects by mitigating the requirement and business validation rules.

Highly interacted with the development team and claim settlement experts making sure that the development of the project is meeting the business requirements.

Created Wireframes & Mock-ups,Analysis Models, Design Models, Activity diagrams.

Jointly responsible for monitoring the progress of the system development by preparing status reports.

Conducted daily interaction with the development team, stake users, business executives and Quality assurance to coordinate all the engineered process.

Analyzed the security implementation of the application with respect to user’s perspective.

Worked with the data architecture and data analyst team in designing the model and in creation of the data mapping documents.

Environment: Microsoft Office (MS Word, MS Excel, MS PowerPoint, MS Visio, MS Access), Agile Scrum SDLC, MS Project, SQL Server, HTML, UML 2.0, MS Project

Client

American Family Insurance

Location

Newark, NJ

Duration

May 11 – Jun 13

Role

Business Analyst

American Family Insurance provides insurance products to customers. This project is a web-based application enabling actions like registering new policy holders on the internet directly and incorporating complete details of the customer and their vehicles. It also helps validate all these service operations at the end.

Responsibilities:

Involved in generating Test cases for property and casualty Insurances for Different Levels of Business.

Gathered all applications used by Property and Casualty users across all business units like Claims, Consumer, Underwriting, Specialty Lines, PCG (Private Client Group), and Travel Guard.

Reviewed test cases and test data for Business Users.

Implemented traditional Software Development Life Cycle SDLC waterfall.

Developed the Test plans for quality assurance based on functional requirements.

Prepared Use cases and Activity flow diagrams and Work flow diagrams, considering the scope of the project.

Provide support across different domain areas such as Payments, Claims Documentation, and Auto Estimations, Fire Claims etc.

Responsible for improved service, reduce coding errors, improve consistency, improve profitability, improve cash flow and reduce facultative placement errors through a front-end reinsurance system.

Analyzed scope of the Edge project was to create a Web-based application for agents to submit and maintain commercial insurance claims.

Assisted in creating wireframes for web interface with the GUI design team.

Documented functional requirements documents (FRD) by interacting with development team for improving client's legacy system.

Environment: SQL Server, Windows, Share Point, MS Office, MS Project, Waterfall SDLC.

Client

Novartis

Project 1

VIPS Inc.,

Towson, MD

Nov09 – Mar11

Project 2

Magellan Health Services Inc.,

Lemoyne, PA

Jun07 – Sep09

Role

Business Analyst

Project 1:

VIPS Inc., is building up the Drug Data Processing System (DDPS) for Centers for Medicare and Medicaid Services (CMS). This framework is intended to handle the monstrous stream of Medicare doctor prescribed medication advantage exchanges. It will bolster extensive variety of handling and diagnostic assignments, get and accept remedy exchanges, populate information distribution Center, create various information shops, interface consistently with a few different CMS frameworks, and backing broad information investigation and instalment compromise

Project 2:

Magellan Health Services, Inc. gives managed behavioural social protection, radiology focal points organization, distinguishing strength pharmaceutical organization, and Medicaid association things and organizations in the United States. The association's radiology points of interest organization organizations involve managing the transport of characteristic imaging organizations, which are outfitted under the concurrences with directed consideration associations, prosperity move down arrangements and other prosperity courses of action, Medicaid, and Medicare people.

Responsibilities:

Involved in meetings like JAD sessions to gather requirements and incorporated these JAD minutes to business requirements.

Assisted in creation of Business Vision and Glossary documents

Analysed consumer and business needs for application development.

Documented requirements and translated into proper product specifications.

Defined implementation procedures.

Actively involved in testing the responsiveness of interface.

Created Use Case diagrams, Sequence diagrams, Process flow diagrams and Data flow diagram.

Identified gaps between the AS-IS and newly developed systems by performing GAP Analysis.

Provided system developers with a better understanding of the system requirements through creation of SRS (Software Requirement Specification) document using One Note

Created and managed the Business Use-Case model to define functional requirements during the inception, elaboration and construction phases using MS Visio

Developed Complex Reports having many calculations, and HTML items.

Responsible for claim adjudication like Medicare claims, professional claim, institutional claims.

Performed walkthroughs of the prototype with end users to better understand user needs.

Environment:MSOffice Suite 2010, MS Visio 2010, Waterfall Methodology SDLC, JIRA, HTML, Share Point, Facets

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