HARDI DHARIA,

Business Systems Analyst

Email: adbc9p@r.postjobfree.com Phone-908-***-****

PROFESSIONAL SUMMARY: With 6 years of professional experience as a Technical Business Analyst and with detailed understanding of the software development life cycle, I have extensive experience in Brainstorming, Gathering Business and Functional requirements and preparing documentation like Use Case, Business requirement documents and data flow diagrams. Having worked in methodologies like agile and waterfall, I have immense Technical knowledge writing complex queries and stored procedures with SQL Server and with SSRS reporting tools.

Around 6 years of professional IT experience in Design and Development of high scalable Multi-Tiered Web Applications, Desktop Applications and Ecommerce Applications using Microsoft Technologies in HealthCare, Banking/Financial domains.

Lead projects with rapidly changing requirements and multiple client participants across global locations.

Expertise in converting complex business requirements into system requirements, efficient system designing.

Thorough understanding and experience in various SDLC and Agile phases such as Requirement Analysis, Project scoping, Estimation, Cost assessment, Project Planning, Detailed system analysis, Detailed Technical Design, Development, Unit testing, Test Strategy and planning, System Testing, Integration Testing, Code review, Implementation planning, Implementation, Knowledge Transitioning.

Utilized Complexity Point Estimation methodology for project estimation.

Experience in providing weekly status reports, monthly metrics and resource allocation planning details for the client manager.

Involved in creating Dashboards, reports as needed using salesforce and Google Analytics.

Experience in Salesforce Testing and Administration spanning all facets of package software and SaaS application implementation.

Have skills in preparing Business Use Case Document, Business Requirements Documents (BRD), Functional Requirements Specifications (FSD), Project Scope, Project Charter, Project Estimation, Project Plans, User Acceptance Test Case Document etc.

Involved in installation of Tableau desktop 8.0, Tableau server Application software.

Experience in Data Analysis, Data Flow Diagram, Process Models, Dimensional Data Models, Context Models, Event Modeling, State Modeling, Process decomposition, Use Case Scenarios and Data Modeling for System/Application development using Entity Relationship Diagram (ERD).

Investigated and resolved issues within Supply Chain module as well as WMS (Warehouse Management System) software.

Created incremental refreshes for data sources on Tableau server.

Experienced working in Medicare and Medicaid projects.

Extensive experience with process modeling using UML, Flow Charts, Sequence Diagrams, Activity Diagrams and Use Cases by using MS Visio tool.

Quality Assurance: Experience in conducting Joint Application Development (JAD) sessions with end users, expert team, QA team, and stakeholders for project related meetings.

Extensive knowledge of multiple generations of Microsoft Excel software

Experienced with V Lookup and data sorting and filtering

Leveraged testing methodologies like Unit Testing, Integration Testing and Load Testing using tools like N-Unit and Visual Studio.

Involved in preparing System Test cases, User Acceptance Test cases and Bug Fixing.

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

Experienced with Microsoft SharePoint 2010, Business Intelligence Analytics SQL Server Integration services SSIS, SQL Server Analysis services, Performance Point Services, Reporting Tools, Salesforce.com, Siebel CRM and other business applications

Business documentation:

Simplified Business Use Case documentations.

Business Process Flows and Test cases.

TECHNICAL SUMMARY:

Business Modeling Tools:

MS Visio, MS Projects, Power designer, Justin mind, Microsoft office suits

(Excel, Word, Power point, /macros)

Software Development Lifecycle:

Waterfall, Agile methodologies and Rational Unified Process (RUP), Scrum, SOA (Service Oriented Architecture).

Operating System:

Web Technologies:

Windows XP, Windows 2000, Windows Vista, Windows 7

RESTful, SOAP, WSDL, XML, XML Schema, SOA

Project Management:

MS Project, Rally, JIRA

Programming Languages:

SQL,XML

Databases:

MS Access, MS SQL, Warehouse Management Systems

Configuration Management:

MS VSS 6.0

Others:

SQL* Plus 9.2, Data Warehouse, Oracle SQL Developer, SAP,

MS Office (Word, EXCEL, PowerPoint), XSD, API, SharePoint.

PROFESSIONAL EXPERIENCE:

PROFESSIONAL EXPERIENCE:

Client: CVS Health, TX Jul 2018 – Current

Role: Business System Analyst

Project Title: Anthem

PROJECT DESCRIPTION:

Anthem Inc. has established a new pharmacy benefits manager to be named IngenioRx. IngenioRx will begin offering a full suite of PBM solutions starting 2020, which coincides with the conclusion of the company’s current PBM contract. IngenioRx will combine its member and provider engagement initiatives and market leading pricing with CVS Caremark in point-of-sale engagement. CVS Caremark will also provide prescription fulfillment and claims processing services. Below are the detailed process responsibilities of CVS Caremark in this project:

Review plan benefit requirements in XML format

Create detailed client requirements documents and benefit matrix.

Configure the plan in RxClaim system.

Generate detailed testing strategy and test the plan benefit configuration.

Share the detailed testing results with Anthem for sign off.

CLIENT DESCRIPTION:

CVS Caremark is the prescription benefit management subsidiary of CVS Health, headquartered in Woonsocket, Rhode Island. It is the second largest prescription management and pharmaceutical services business in the United States. In March 2007, Caremark merged with CVS Corporation to create CVS Caremark, later re-branded as CVS Health. Today the company is one of the nation's leading pharmacy benefit management (PBM) companies, provides comprehensive prescription benefit management services to over 2,000 health plans, including corporations, managed care organizations, insurance companies, unions and government entities.

Rxclaim: This tool is an online business system and pharmacy claim adjudication tool that manages all aspects of pharmacy benefits and is a real time adjudication of prescription drug claims at the point and time of service.

BenefitServ: This is a Cognizant’s web based enterprise solution that can integrate the healthcare benefit configuration to provide flexibility, to efficiently conduct core Benefit administrative functions, while providing with the additional competitive edge that organization needed in the health care industry

EZTest: It is a testing tool integrated with Rxclaim and has the ability of run thousands of claims in mere minutes as compared to many hours when using other testing methods. It is designed to replace or enhance existing methods of testing and validating benefit plan design.

Salesforce : using CRM tool -SFDC . This is used for building the plans and tracking purpose and prepare Reports on salesforce dashboard.

Develop, design implement department plan to operationalize new claims processing system, to include but not limited to, workflow, and management oversight and performance analysis.

Work closely with stakeholders and SME's for requirements gathering and identified end-to-end requirements for all systems and business units that may be impacted by the project.

Create Documentation Analysis reporting, strategy planning, risk analysis, contingency plans for company executives.

Conducted & Facilitated various Requirements meetings with key stakeholders from development teams & the external clients.

Ability to write Excel VBA Macros.

Successfully Created user stories, business/functional requirements, by soliciting valuable high level information from the business.

Prepared standard reports and analyze to support the business Needs

Client: Cardinal Health, Dublin, OH Oct 2017 – Jun 2018

Role: Business Analyst

Project Title: ParMed

ParMed is a supply chain company for medicines based out of Niagara Falls, NY that was acquired by Cardinal Health, Dublin, OH. It prides itself in providing high quality generics to the pharmacies like Target, CVS and many more. The features of this project included Medicare/ Medicaid Eligibility and Billing Verification, Self-Pay/Commercial Eligibility and Billing Validation, Real Time Processing, Billing Address Verification with Address History and Insurance Eligibility Verification and HMO/PPO member valification and provider list. Wellpoint is using HIPAA 4010 transactions to support the analysis of current business, also analyzing and testing HIPAA 5010 for claims. An entire new web ordering platform was developed and integrated with existing ordering system to help all new acquisitions like ParMed to integrate on a common Cardinal Health System. Effective planning, development, implementation and maintenance of system wide managed care strategies and activities across the organization

Responsibilities:

Worked closely with a project team for gathering business requirements from different teams and interacted with business users to translate business requirements into Use Case document and technical specifications documents.

Worked on Agile Methodology (Scrum Framework) to meet timelines with quality deliverables.

Tested different functionality of the application like Medicaid eligibility data, state available funds program, Medicaid claim processing etc.

Manages administration of the assigned portion of the contract portfolio. Understands and interprets managed care contracts and reimbursement terms which impact the revenue cycle.

Responsible for testing Medicaid Claims for peach state health plan using MMIS.

The system primarily aimed at handling Medicare / Medicaid insurance claims and process exceptions.

Serves as advisor and point of contact for all CHS revenue cycle personnel for trended managed care operational and administrative issues.

Resolved a complex enhancement bug by creating and utilizing a professional network of Scrum Masters, Product Owners and Technical Leads within ParMed.

Analyzed existing business processes and logic in the various functional areas within purchasing / inventory / warehouse operations through personal observation and user interaction.

Managed a complete set of high quality, well formatted and consistent User Stories, Acceptance Criteria and Tests using Blueprint software.

Claim validation and Pend/Denied Claims Analysis for the Health plans Medicaid programs.

Knowledge in Salesforce.com SFA, Force.com Apex Classes, Apex triggers, Integration, Visual force, Force.com API, SQL,

Worked on Agile and Scrum Methodology for Salesforce custom app implementation.

Customized page layouts for Salesforce standard and custom objects for tracking the health care plans

Building, publishing customized interactive reports and dashboards, report scheduling using Tableau server.

Mapped the Functional Requirements, User Requirements to the test cases.

Conducted WebEx sessions with stakeholders to gather requirements needed for the ISOtrain Project.

Conducted workflow, process diagram and gap analyses to derive requirements for existing systems enhancements and created data flow diagrams, data mapping from Source to stage and Stage to Target mapping documents indicating the source tables, columns, data types, transformations required and business rules to be applied.

Worked with Testers on resolving application defects

Generated use case diagrams to demonstrate the critical processes using UML.

Provided the flow diagrams for various modules of the project using UML.

Defined best practices for Tableau report development.

Working closely with Business Transformation team and Development team to ensure requirements through design integrity and also responsible to setup and hold workshops with key Business and Technology stakeholders to receive sign-off.

Partner with Business Transformation teams on defining business processes/Rules associated with requirements. Mapping those Business requirements with the Attributes/Data elements captured to validate the data as per Business rules.

Responsible for architecting integrated HIPAA, Medicare solutions, Facets.

Identify Member, Provider, Coverage, Medicare, and Medicaid.

Elicited requirements from the Human Resource department for process improvements for way SharePoint was being used

Client: Facebook Oct 2015 – Jul 2017

Role: Ad-Analyst, Community Operations

Responsibilities:

Reviewed content reported by users for policy compliance and documented activity through internal data management system to improve processes.

stay connected and be more productive by providing access to the team.

Performing usability testing and organizing focus groups to discuss and ensure effective adoption of feedback to improve the usability of the mobile applications and web based applications.

Perform API inspection and make Recommendation.

Have in written user manual and API Manual.

Used Data warehousing for Data Profiling to examine the data available in an existing database.

Superior Excel and PowerPoint skills

Understanding the user requirements through conducting interviews, ethnographic research, creating audio/video recordings to capture consumer insights and convert them into innovation mobile applications.

Represented the business requirements in various alternative views such as analysis models, process flow diagrams and user stories.

Creating user flow diagrams, wire frames for developing the prototype of a mobile phone application.

Responsible to import the data from Crystal reports by using Business Objects Live office into Microsoft Excel and Word.

Analyzed customer profiles and make critical decisions to detect and mitigate user-sensitive content and fraudulent activity

Developed and led end-to-end project plans and ensure on-time delivery of initiatives.

Providing man hour estimates to the management team and create road map for the mobile application development based on market research.

Collaborated cross-functionally to prioritize projects and communicated status and impact of product changes to stakeholders.

Functioned as technical expert on all internal tools used across the company and as point of contact for requests regarding updates and issues.

Received recognition and awards listed and described below:

Silver Award- Awarded for ramping up 10 new joiners on internal process.

Silver Award – Awarded for improving efficiency of internal tools.

Reviewed and investigated advertisement requests for compliance to company policies and procedures

Led Customer Care Division and reduced average customer complaint closure time 20%.

Ensure great advertiser experience and help resolve issues on Community Forum Help Centre and Ad Review Appeals.

Identified and analyzed advertiser behavior trends to improve effectiveness of social media promotions

Informed, executed, and influenced new strategies for enforcement using data analysis and impact quality metrics

Utilized data from advertiser behavior trends to develop detection policies to improve process and collaborative efficiency.

Client: India Money Guru Jul 2012 – Aug 2015

Role: Business Analyst

Responsibilities:

Document and assist in the resolution of problems and issues identified during requirements and development process.

Document Business requirements and Business process flows (as-is and to-be application modules) using diagrams.

Review and approve various documents produced such as the system requirement specification document and business requirements documents.

Techno-functional assessment of gathered requirements with respect to technology in consideration (SharePoint 2010).

Involved in creation of the use cases and data flow diagrams.

Communicated and ensured compliance of all policies and procedures within the retail organization.

Collaborate with business users of Digital Marketing teams, Vendors, and IT teams to introduce process to implement AEM/CQ5 for the IT/Digital Marketing teams.

Reduced payroll costs by over 30% by analyzing retail traffic patterns and creating staffing models based on location performance.

Increased net revenue of retail locations by 40% through individual analysis of CPGA of each location. Based on performance analysis, designed and implemented action plan for each location to reduce costs while increasing revenue. Closed or relocated stores unable to meet action plans

Acute understanding of concepts related to Student Lending, Consumer/Business Credit Cards and Consumer loans.

Process Knowledge of AR/AP/GL, Credit management, Fixed income analysis, Risk management, Mortgage Banking basics (Mortgage cycle), Mortgage Underwriting and (Unsecured Loans) Personal Loans Operations.

Attend Project Team and other status meetings to document issues, risks, and action items and provide tracking in these areas. Also responsible for preparing the Risk assessment worksheet.

Validate and enhance Business Test Cases as required to meet implementation goals.

Reviewed loan applications and analyzed data required to process loan documents and performed validation to ensure loan documents are transmitted to appropriate departments.

Worked with clients to gather technical and business requirements from various sources to create Functional Specs, User Requirements, Use Cases and Process Flows relating to Warehouse Management.

Attend governance board meetings, which involve proposing solutions, training solutions and status updates with regard to the project development and also be involved in the post project implementation to support the users.

Key liaison to bridge the gap between IT and Business.

Implemented Traceability Matrix to verify the functionality coverage.

Participate in writing, drafting and documenting business policies, business procedures and rules.

Present Business requirements and proposal to Business stakeholders to get final approval.

Setup meetings with the development groups to get them up to speed on the functional requirements and be involved in the architecture meetings to get an understanding of the to-be system and to monitor and manage Business user expectations all along the project.

EDUCATION:

Master’s in Business Administration /Concentration in Finance &Marketing

University: St. Mary’s College, Hyderabad, India

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