SUMMARY:

● About *+ years of professional experience working in various comprehensive projects in Health Insurance, Hospital, Pharmaceutical domains as a Sr. Business Analyst, Business Analyst.

●Thorough knowledge and working of Software Development Life Cycle (SDLC) Methodologies: Waterfall, Agile - Scrum, SAFe, and Waterfall-Scrum Hybrid and involvement in the entirety of the SDLC phases - requirement gathering, design, development, and software release.

● Highly skilled in conducting analysis like GAP Analysis, SWOT Analysis, Feasibility Analysis, Cost Benefit Analysis, Risk Analysis and Impact Analysis.

●Employed various Requirements Gathering Elicitation Techniques like Brainstorming Sessions, Joint Application Development (JAD), Interview Sessions, Workshops, Focus Group, Surveys, Questionnaires, Document Analysis, and Observations with Subject Matter Expert (SME's), Business users and Business Owners.

●Expertise in analysing the Business Requirements and documenting them into artefacts’ like Business Requirement Document (BRD), Functional Specification Document (FSD), Functional Requirement Document (FRD) and System Requirement specification (SRS) and Requirements Traceability Matrix.

●Experienced in Handling Change Request Management and implemented the change effectively by using change management process.

●Acted as a liaison between Domain SME and Development Team ensuring smooth work flow. Worked closely with project managers, SMEs and staff to understand and brief the requirements and specifications for new applications along with re-engineering the existing applications, evaluate the cost/benefit analysis on requirement requests and change requests.

●Managed the requirements and prioritized user stories by proficient use of management tools like TFS, HP ALM and used JIRA for defect management.

●Proficient in process modelling and created UML Diagrams (Use Cases, Sequence Diagrams, and Activity Diagrams) Workflow diagrams employing MS Visio, and Rational Rose.

●Possess through knowledge in designing Prototypes, Mock-up screens, and Wireframes using MS Visio and Balsamic during developing Graphical User Interface based application.

●Expertise in designing and developing Test Cases, Test Plans including Defect Logs.

●Expertise in facilitating UAT testing, Regression testing, Smoke testing, and System Integration Testing.

●Extensive experience in writing User Stories by breaking down Epics into small stories with the help of Product owner and cross-functional development team.

●Experienced in recording and maintaining the artefact’s like Sprint Burn down charts, Product Burn down charts, product backlog and impediments list.

●Working knowledge of XML including validation of Web Methods, Web Services, WSDL, SOAP, UDDI, HTML, AJAX, CSS Knowledge in Data warehousing concepts- Data modelling, Data mapping, Conceptual, Logical & Physical Data Model, Star schema, Snowflake schema, and Normalization.

●Experienced on Healthcare Claim Processing and HIPAA Standard Transactions X12-837 for Equivalent Encounter Information, X-12-835 Claims Payment and Remittance Advice, X12- 276/277 Health Care Claim status request and response, X12-270/271 Eligibility inquiry and response for a Health Plan, HL7 standards.

●Good Knowledge in Medical Management Information Systems (MMIS), Eligibility and Managed Care concepts (Medicaid and Medicare), Procedural and Diagnostic codes and Claims Process, Electronic Medical Records and Electronic Health Records which used EPIC systems.

●Evaluated business processes, anticipating requirements, uncovering areas for improvement, and developing and implementing solutions.

●Lead ongoing reviews of business processes and developed optimization strategies.

●Staying up-to-date on the latest process and IT advancements to automate and modernize systems.

● Able to manage project execution and IT delivery of healthcare payer projects by providing day-to-day project leadership and support.

●Handled multiple work streams of IT project delivery including financial management with Business Leads and IT Technical Leads

● Able to facilitate/lead requirements gathering sessions and build the business requirements document.

●Conducting meetings and presentations to share ideas and findings.

●Performing requirements analysis.

●Documenting and communicating the results of your efforts.

●Effectively communicated insights and plans to cross-functional team members and management.

●Gathered critical information from meetings with various stakeholders and producing useful reports.

●Well versed with all aspects of Healthcare Payer processing systems (Claims, Membership, Eligibility, etc)

●Worked closely with clients, technicians, and managerial staff.

●Allocating resources and maintaining cost efficiency.

●Ensuring solutions meet business needs and requirements.

●Performing user acceptance testing.

●Managing projects, developing project plans, and monitoring performance.

●Updating, implementing, and maintaining procedures.

●Prioritizing initiatives based on business needs and requirements.

●Serving as a liaison between stakeholders and users.

●Managing competing resources and priorities.

●Monitoring deliverables and ensuring timely completion of projects.

●Self-motivated, flexible, knowledgeable, hardworking, and detail oriented person. Good communicator, coordinator and organizer.

●Worked with business users as well as senior management and Participated in walkthroughs with the management and developer team.

●Demonstrated proficiency in leading and mentoring individuals to maximize levels of productivity.

●Capable of adapting to new and fast changing technologies quickly in order to deliver quality product on time.

TECHNICAL SKILLS

Methodologies: Waterfall, Agile-Scrum, Agile-Waterfall.

Requirements Management: JIRA, Team Foundation Server (TFS), HP ALM.

Database: MS Access, MS SQL, SQL Server, Oracle 11g.

MS Office Tools: Word, Excel, PowerPoint, Visio, Project, SharePoint.

Business Modeling tools: MS Visio, Rational Rose.

ETL Tools: Informatica, IBM-Cognos.

Reporting tools: Tableau, IBM cognos v8.0. SSAS, SSRS, SSIS.

Testing Tools: HP Quality Center, JIRA, Load Runner.

Operating Systems: Microsoft Windows /Xp/ vista/7/8.

Healthcare: HIPAA compliance, Medicare, Medicaid, MMIS, HL7, ICD-10.

PROFESSIONAL EXPERIENCE

Community First Health Plans February, 2021-Present

San Antonio, Texas

Sr. Business Analyst /Delivery Lead

Responsibilities:

●Served as Communication Bridge between non-technical users and technical solution developers.

●Performed GAP analysis and prepared workflow diagrams, designed new process flows and documented the business process and various business scenarios.

●Conducted Requirement Workshop to gather requirements from various departments.

●Conducted Focus Groups and Interviews with physicians to understand additional functionalities deemed critical on top of mandated functionalities in Hospital's Information system support system.

● Able to manage project execution and IT delivery of healthcare payer projects by providing day-to-day project leadership and support.

●Handled multiple work streams of IT project delivery including financial management with Business Leads and IT Technical Leads

● Able to facilitate/lead requirements gathering sessions and build the business requirements document.

●Segregated business requirements by analysing them into low level and high level.

●Converted Business Requirements into Functional Requirements Document.

●Worked with UI team to create the User Interface screenshots, and presented to the business for their approval.

●Developed wireframes to fully define the customer needs and requirements in brainstorming and review sessions.

●Used MS VISIO to create Use Case diagrams and Sequence diagrams so that the development team and other stake holders can understand the business process.

●Created and maintained Sprint burn down chart and release/product burn down charts.

●Helped team to maintain optimal Velocity, and complete story points in each sprint consistently.

●Well versed with all aspects of Healthcare Payer processing systems (Claims, Membership, Eligibility, etc)

●Evaluated business processes, anticipating requirements, uncovering areas for improvement, and developing and implementing solutions.

●Lead ongoing reviews of business processes and developed optimization strategies.

●Stayed up-to-date on the latest process and IT advancements to automate and modernize systems.

●Conducted meetings and presentations to share ideas and findings.

●Performed requirements analysis.

●Documented and communicated the results of your efforts.

●Effectively communicated insights and plans to cross-functional team members and management.

●Gathered critical requirements from meetings with various stakeholders and producing useful reports.

●Worked closely with clients, technicians, and managerial staff.

●Allocated resources and maintaining cost efficiency.

●Ensured solutions meet business needs and requirements.

●Performed user acceptance testing.

●Assure adherence to corporate policies and project delivery procedures.

●Managed projects, developing project plans, and monitoring performance.

●Updated, implemented, and maintained all procedures.

●Prioritized initiatives based on business needs and requirements.

●Served as a liaison between stakeholders and users.

●Managed competing resources and prioritized them.

●Monitored deliverables and ensured timely completion of projects.

●Managed Requirement Churn carefully to minimize the influence on the current/next sprints that developers would implement.

●Performed duties of scrum master and led the team to produce quality software on a predictable schedule using agile principles and practices.

●Managed Product Backlog with the help of Product owner and Scrum development team by using JIRA also generated reports to analyse the performance of the project.

●Assisted the Product Owner and the cross functional team in break down the epics into appropriately sized User Stories.

●Owned and managed the Sprint Backlog, Impediments list.

●Tracked defects using JIRA and assisted QA teams to resolve defects.

●Analysis for making system compliant with HIPAA.

●Management of patient profile transfer (PPT) reports created by data team by verifying the associated data.

●Participated in the analysis of the existing processing, worked with fellow business analysts in methodology for defining ICD-10 mapping processes and documenting business requirements.

●Worked with the Business Team to review UAT validation scenarios and execute the UAT test cases.

●Assisted in creating materials for hospital employees to get them familiarized with the new technological advancements to be incorporated by the hospital.

●Configured HIE API to allow user applications to communicate with the modules of the system.

●Manage project execution and IT delivery, providing day-to-day project leadership.

●Demonstrated understanding and experience with SQL queries.

Environment: SDLC(Waterfall), MS Project, Windows8, Web Services, MS SQL, MS-Visio, MS Excel, HP ALM, Oracle 11g.

Cox Health Plans July,2020-December,2021

Springfield, MO

Sr. Business Analyst/ IT Delivery

Responsibilities:

●Conducted JAD session with project’s stakeholder identifying problems and coming up with the best alternative to resolve that.

●Well versed with all aspects of Healthcare Payer processing systems (Claims, Membership, Eligibility, etc)

●Demonstrated excellent verbal and written communication skills and the ability to interact professionally with a diverse group, executives and managers.

●Worked as a Liaison between the users and the different teams involved in the application development for better understanding of the business and IT processes.

●Documented the requirements to meet end-state requirements and complied Business Specification Document, Software Requirement Specification Document and Use Case document.

●Overseeing/maintaining a multi-year cross-program execution schedule

●Monitoring inventory and development of technical widgets, vendor deliverables and other work packages involved in delivery of multiple, concurrent, cross-Program releases.

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●Performed SWOT and GAP Analysis to discover new functionality requirements, prioritized them on the basis of actual business needs.

●Involved in Risk Analysis and auditing business processes.

●Communicated with the stakeholders throughout the lifecycle of the project, constantly updating them on benefits and risks associated with the project.

●Developed an analysis model that includes Use Case diagrams, and Activity diagrams using UML methodologies in MS Visio, which provided the development team a view of the requirements for design and construction phases.

●Supervised and Maintained the Requirement Traceability Matrix (RTM).

●Effectively managed change by deploying change management techniques such as Change Assessment, Impact Analysis and Root cause Analysis.

●Created sample Wire frames for better understanding of the system by Business and technology teams.

●Implemented UML methodologies to design Use Case, Activity diagram, Sequence Diagram.

●Reviewed Test Strategy, Traceability Matrices and Test Plans to ensure that test cases reflect user needs for the functional, performance, usability and security requirements.

●Experienced in designing and development of use and test-case scenarios, developed test plans, and test cases.

●Facilitated User Acceptance Testing (UAT) and Black box testing.

●Demonstrated understanding and experience with SQL queries.

Environment: SDLC (Scrum-Waterfall), MS Office, MS Visio, MS SQL Server, SLA, SSRS, SSIS, SSAS, UML, Enterprise Data Warehouse, HPQC, TFS

Health Plan of San Joaquin July, 2017- April, 2020

French Camp, CA

Sr. Business Analyst

Responsibilities:

●Involved throughout the Software Development Life Cycle (SDLC) Scrum-Waterfall.

●Performed SWOT and GAP Analysis to discover new functionality requirements, prioritized them on the basis of actual business needs, prepared Functional Requirements and Use Case Specification document.

●Experience in GAP Analysis of the AS-IS and TO-BE processes to identify and validate the requirements.

●Conferred with Business Users to elicit requirements and worked with design & development team on solution design.

●Interacted with users to verify User Requirements, manage Change Control, and update existing documentation.

●Created use cases, process flow diagrams, and designed solutions using the Functional Specification Document (FSD).

●Facilitated JAD sessions and conducted peer review meetings.

●Defined requirements for client side validation & server side validation.

●Identified and documented all business rules for Middle Tier, communicated the rules to technical team to provide scope and requirement clarification on a low-level.

●Worked on GUI development: created screen-mockups to review the requirements and provide feedback on the screen design, created ad-hoc screen mock-up to review with the users.

●Kept the application extremely simple by encapsulating all the complexity of the system in coarse grained services.

●Integrated static data with other systems to maintain a central repository of common data by implementing SOA, which provides cross platform communication, in XML data format, among independent web services.

●Scripted rules for Data Validation. Validated all web methods by ensuring the requirements have been met.

●Experience in documenting the Requirements Traceability Matrix (RTM).

●Assisted the Product Owner and the cross functional team in break down the epics into appropriately sized User Stories.

●Assisted in scripting rules for Data Validation. Validated all web methods by ensuring the requirements have been met.

●Assisted in developing the Test Plan, Test Cases and Test Scenarios, based on business requirements and technical specifications.

● Collaborated with the QA team to ensure adequate testing of software by conducting UAT.

●Demonstrated understanding and experience with SQL queries.

Environment: SDLC (Waterfall), MS Office, Rational Requisite Pro, Rational Rose, SQL, UML, Quality Control.

Independent Care Health Plan February, 2014- June, 2017

Milwaukee, WI

Business Analyst

Responsibilities:

●Interacted with the stakeholders for requirement gathering by Brainstorming, Interviewing, preparing questionnaire and getting feedback.

●Interfaced with the client as part of the Requirements engineering team to finalize the project scope.

●Analysed client requirements and prepared Analysis documents.

●Analysed Business Requirements and segregated them into high level and low level Use Cases.

●Involved in Issue assessment, Risk analysis and Change management to articulate and resolve the business needs.

●Created use case scenarios and documented work flow and business process.

●Created Activity Diagrams/Sequence Diagrams (UML) using Rational Rose.

●Linked business processes to organizational objectives, identifying opportunities for business process improvement and involved in the performance of cost/benefit analysis.

●Recorded, maintained & tracked defects, assigned type & priority/severity levels.

●Worked with business stakeholders in creating user acceptance criteria and conducted/coordinated UAT.

●Demonstrated understanding and experience with SQL queries.

Environment: SDLC (Waterfall), MS Office, Rational Requisite Pro, Rational Rose, SQL, UML, Quality Control.

EDUCATIONAL QUALIFICATIONS

●Beverly Training Center-

Certified Nursing Assistant completed in March 31, 2005

●Boston Reed College

Pharmacy Technician completed in January 2009

●Grayson community college

Phlebotomy course completed 2013

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