System Analyst
Resume:
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Sr. Business System Analyst
Mar **** – Present
Common Spirit Health
Houston, TX
Roles and Responsibilities:
Collaborated to gather and document BRD and FRD, ensuring alignment with technical solutions, and produced comprehensive project documentation clearly outlining the scope for efficient communication and management.
Incorporated UAT feedback into iterative development cycles, ensuring the EHR system aligned with user needs, while translating business requirements into User Stories and coordinating UAT activities to validate system functionality.
Effectively managed project tasks, User Stories, Issues, Bugs, and impediments in Azure DevOps, ensuring transparent visibility into project progress, and priorities, and seamless communication and collaboration among team members. Led a cross-functional team in the integration of technology within Public Services to enhance operational efficiency.
Integrated Use Case, Workflow, Data Flow, and Entity-Relationship Diagrams to optimize Healthcare Systems, resulting in improved usability, enhanced Data Security, regulatory compliance, and system enhancements
Leveraged Microsoft Office suite to extract insights from Healthcare Data, employing Excel for analysis, Word for comprehensive documentation, and PowerPoint for crafting impactful presentations with clear visualizations.
Carried out thorough Business Analysis for healthcare projects, utilizing requirement, Gap, Root Cause, Risk, Data, and SWOT Analysis to drive impactful improvements in Patient Care, Operations, And Financial Performance.
Designed process Flowcharts, Workflow Diagrams, and organizational charts using Microsoft Visio to visualize complex business processes and systems.
Conducted stakeholder interviews and workshops to Elicit Functional and Non-Functional Requirements for healthcare software applications, documenting requirements in Software Requirements Specifications (SRS) documents.
Developed and maintained Requirements Traceability Matrix (RTM) documents for healthcare projects, mapping business requirements to system functionalities, Use Cases, and Test Cases to ensure alignment with project objectives.
Managed and executed comprehensive System Testing for business applications to ensure stability and functionality
Integrated Healthcare Data from diverse systems, including Electronic Health Records (EHR), claims systems, and external data sources, into the Data Warehousing for comprehensive analysis.
Minimized manual involvement by employing Informatica and Python Scripts to automate and manage EHR Data ETL Procedures, guaranteeing smooth Data Flow from Various Sources into the Data warehouse.
Utilized SQL joins, Indexes, Functions, Stored Procedures, and DML/DDL operations to optimize EHR database performance, automate tasks, and ensure data integrity and compliance within Healthcare Systems.
Utilized Python scripting and Power BI for EHR data manipulation, enhancing quality and accuracy in analysis and reporting, showcasing proficiency in emerging technologies within the health information systems industry.
Designed interactive dashboards in Power BI to visualize key healthcare metrics, providing healthcare professionals with real-time insights to enhance patient care and operational efficiency.
Conducted in-depth requirement elicitation sessions with stakeholders using techniques such as Interviews, Workshops, Surveys, and Focus Groups to capture and analyze business needs.
Conducted Impact Analysis and Risk Assessments for proposed system changes, ensuring that potential issues are identified and mitigated before implementation.
Environment: JIRA, Confluence and Microsoft Project, R, Python, SQL, Power BI, QlikView, Microsoft Excel, SAP Business Objects & Business Intelligence Tools.
Sr. Business System Analyst
Dec 2021 – Feb 2023
Centene Corporation
Saint Louis, MO
Roles and Responsibilities:
Gather and interpret Business Requirements and monitor Data Trends to proactively identify issues using your Power BI experience.
Support the Provider Data Management team’s business initiatives through Data Analysis, identification of implementation barriers, and User Acceptance Testing of various systems.
Maintain and modify SQL scripts based on business requirements.
Present and facilitate meetings with Executive leadership.
Provided end-to-end support for Mainframe and CICS systems, ensuring smooth operation of healthcare applications and transaction processing.
Executed large-scale projects related to Healthcare Data Management with limited direction from leadership.
Identify and analyze User Requirements, Procedures, and Problems to improve existing processes
Serve as the Subject Matter Expert on the assigned function product to ensure operational performance
Diagnose problems and identify opportunities for Process Redesign and Improvement.
Used JIRA for product and Sprint Backlog Management, dashboard reports creation, and themed user stories to effectively sort and filter for reporting.
Ensured compliance with HIPAA, GDPR, HL7, and FHIR regulations, privacy, and security standards for handling sensitive patient data.
Gathered and documented business requirements Document (BRD) and defined comprehensive functional requirements (FRD) and non-functional requirements for health data integration.
Extensively worked on end-to-end claims payment processing, including Claim Validation, Adjudication, and Payment Calculation, ensuring accuracy and adherence to contractual agreements and regulatory guidelines.
Proficient in EDI standards and protocols (ANSI X12, HIPAA, 837/835) for seamless integration and data exchange in healthcare claims payment processes.
Implemented effective controls and checks to identify potential Fraud, Waste, and Abuse in Claims Payment Processes contributing to cost savings and risk mitigation.
Developed comprehensive Traceability Matrices to ensure end-to-end traceability between business requirements, system requirements, test cases, and healthcare regulatory standards.
Performed Data Mapping from source EHR data structures to the Azure target system to ensure seamless data flow between systems. Utilized data-driven Business Strategies to streamline system processes, resulting in significantly reduced costs
Analysed the Workflow Processes to ensure efficient and effective claims processing and identify areas for improvement.
Conducted Data Cleaning and Data Validation processes to ensure the accuracy and completeness of data.
Implemented strategic changes in Business Function to streamline operations and improve overall business performance
Implemented SQL joins and subqueries to combine data from multiple tables for analysis and reporting purposes.
Experienced in utilizing Data Analysis Expressions (DAX) Power BI, enabling the creation of complex calculations, and formulas to enhance data modeling and analytical capabilities in healthcare analysis.
Ensured compliance with HIPAA and HITECH regulations during the integration of Electronic Health Records (EHR) data, implementing comprehensive Data Security measures that reduced data breaches.
Leveraged expertise in Information Technology to analyze system requirements and provided optimal solutions for complex problems
Led the enhancement of EHR interoperability using Python and HL7/FHIR standards, reducing Data Retrieval times and enhancing provider efficiency.
Leveraged advanced analytics to Extract Actionable Insights from Medicare and Medicaid data, supporting key program evaluations and improving service delivery.
Orchestrated Agile project delivery, Prioritizing User Stories and Collaborating with Cross-Functional Teams to implement incremental improvements in EHR integration, resulting in enhancement in system functionality.
Environment: ICD-10, EDI, HIPAA, Medicaid, Medicare, ETL, JIRA, SQL server, MySQL, Agile methodology, Waterfall methodology, SDLC, XML files, MS Access, MS Excel, MS PowerPoint, Ms Visio, MS Office, ETL, Tableau, Power BI, Testing strategies.
Business System Analyst
Jan 2021 – Nov 2021
Sutherland
Pittsford, NY
Roles and Responsibilities:
Worked as a Senior Business Analyst (Senior Manager) in Customer Experience, Operational Excellence, and Quality and driving projects across Sutherland Global Services. Worked on multiple BIG projects spread across ~40,000 employees under different Geographies (EMEA, APAC, AMERICAS). Leading a team of highly qualified Managers, Senior Associate Managers, and Team Leads of around 20 team members and driving projects across the company.
Worked on a project to understand Productivity Variations amongst employees and was able to determine factors contributing to the deviations and identified the issues and recommended solutions resulting in Production Improvements by 15-22%.
Extensive collaboration with the Operations team across different lines of business to Improve Productivity and Increase EBIDTA.
Implemented a strategic data integration solution for the client Humana that streamlined operations and saved the company ~$200k annually.
Identified inefficiencies in current processes related to documentation maintenance for audit and the response time taken by the team and implemented changes that led to a significant decrease in TAT resulting in 20-30% less time for the response of the final audit and led to cost savings with Productivity Improvements by around 10%.
Experience in preparing, analyzing, and distributing standardized Monthly Data Operational Reports and ad-hoc analysis for Operations Leadership.
Assisted in the Planning, Analysis, Design, Implementation, and/or Maintenance of operational analytic data sources, reports, and tools. Applied expertise in Vital Statistics to effectively audit, monitor, and optimize the performance of various business systems.
Orchestrated cross-functional collaboration among Data Architects, Developers, and Business Stakeholders to conceptualize, engineer, and deploy scalable, secure, and high-performance BI solutions.
Oversaw activities about Data Collection, Analysis, Synthesis, And Narrative Development to support project deliverables and presentation content for clients.
Complete lifecycle implementation experience, including Requirements Collection, Gap Analysis, Functional Specification Development, Solution Description, suggestion of best business practices, User Acceptance Testing (UAT), system setup, and completion of production support.
Excellent documentation skills in creating Use Case Specifications, Data Mapping Documents, test scripts, Requirements Traceability Matrix (RTM), Business Requirements Documents (FRD), Functional Requirements Documents (FRD), As-Is and To-Be flow diagrams, and user acceptance test plans, among other project artifacts.
Proficient in ETL processes, SQL, and Oracle databases.
Designed and implemented comprehensive reports using Power BI, Power Pivot, and SSRS, integrating features like Drill Through & Hyperlinks in Power BI to elevate user engagement.
Developed detailed Functional Design Documents and solutions aligned with business requirements and user expectations.
Optimized SQL queries through indexing and execution plan enhancements to achieve Maximum Efficiency and Performance.
Implemented advanced formatting techniques including Descriptive Tooltips and conditional formatting to enhance report aesthetics and usability.
Automated data refresh processes for Power BI datasets using Power BI gateway and DAX functions, streamlining data updates and enabling real-time insights.
Complete project implementation with a thorough understanding of the SDLC process.
Spent a lot of time working on SQL queries for database validation.
A culture of continuous improvement and productivity growth was built through the use of LEAN Principles.
Attended daily Scrum Meetings, Sprint Planning, Sprint Demo, Product Backlog, Story Board, Story Writing, Sprint Backlog, and Release Plan.
Effectively collaborated with diverse stakeholder groups to Advance Business-Technology Alignment and provided solutions.
Establish Risk Constraints and provide scenario analysis and Stress Tests for project reporting to various internal and external stakeholders on Risk Management matters.
Evaluate previous Budgets and expenditures to develop and implement future budgets and communicate results and recommendations for improvements that will lead to Cost Reduction, Revenue Generation, and Streamlining of Operations.
Analyze complex and varied Healthcare Data to develop insights that influence business decisions and track the financial success of our product.
Extensive knowledge of the US Healthcare industry including complete lifecycle knowledge of Medical Billing (hospital, clinical, and pharmacy PBM), Medical Coding, Denial Management, Collections, Claims, and Pharmacy Benefit Management.
Knowledge of multiple different EHR/EMR systems and complete life cycle of Pharmacy Benefit Managers.
Involved in project planning, coordination, and implemented QA methodology providing overall project management to multiple projects completing them on schedule and budget.
Environment: Agile Scrum, MS Office Suite, MS SharePoint, UML, MS Visio, JIRA, Agile Management, SQL, Tableau, MS PowerPoint, MS Access, MS Excel, PowerBI, ETL, Azure, BRD, ERP.
Data Analytics & Operations - Manager
Apr 2011 – Nov 2020
Genpact
Hyderabad, Telangana
Genpact Limited - Registered on NASDAQ is a professional services company with its headquarters in New York City, New York. The company currently employs more than 125,000 people and provides services to clients in over 30 countries worldwide.
Worked as a Manager in my last role at Genpact. I Handled Two separate teams, one of the Business Analysts and the other team of US Healthcare Operations Management. These were two different lines of business and had complete oversight of Project Development, Project Management, Process Improvement, Analytics, Operational Excellence, and Operations Management. There were ~50 FTEs reporting including Assistant Managers and Team Leads.
As a Sr. Business Analyst Lead, my responsibilities were:
Responsibility for identifying automation opportunities and working closely with Platform Solutions Group to execute those opportunities to improve Service, Quality, and Customer Experience enabling improvement in productivity and profit margin for the client.
Responsible for execution of Project Life-Cycle including Scope Definition, Business Requirements, Quality Assurance (QA) Testing, User Acceptance Testing (UAT), implementation, and post-mortem analysis.
Expertise in conventional and non-conventional requirement elicitation techniques such as Joint Application Development (JAD) sessions, brainstorming, document analysis, project meetings, prototyping, questionnaires, focus groups, and interviews.
Conducted in-depth Data Analysis using SQL and Python to identify trends, issues, and opportunities within the healthcare domain.
Developed and implemented Procedures and Workflow for gathering and writing Business Requirements, working with subject matter experts, and interacting with the Application Development team.
Coordinated and led Cross Functional Upgrade and enhancement projects involving Application Development, Business Excellence.
Expertise in writing Request for Proposals (RFP), Statement of Work (SOW), and Standard Operating Procedures (SOP), conducting JAD sessions, creating Use Cases, Work Flows.
Experienced in performing Gap Analysis by identifying existing technologies, documenting the enhancements to meet the end-state requirements, and preparing Business Requirements Documents and Functional Requirement Documents.
Utilized Agile Software Methodology using Scrum Framework and acted as a liaison between business stakeholders and IT teams, translating business requirements into technical solutions and vice versa.
Experience in creating Product Backlogs, Sprint Backlogs, and facilitating sprint planning and review meetings.
Analyze data to draw insights and support Decision-Making Processes using tools and techniques such as SQL Queries, Data Visualization, and Statistical Analysis to interpret data and present findings.
Identified and evaluated Potential Risks to the organization, resulting in the implementation of risk mitigation strategies that reduced potential losses by 20%.
Collaborated with Internal and External Stakeholders to ensure Risk Management objectives were met, resulting in a 25% improvement in stakeholder satisfaction scores.
Identify and mitigate Potential Risks and issues that may impact project scope, timeline, or budget and Develop Contingency Plans and strategies to address risks proactively.
Expertise in creating numerous artifacts such as Business Requirement Documents (BRD) and functional Requirement Documents (FRD), and writing and maintaining Test Matrices and Requirements Traceability Matrices.
Used JIRA for product and sprint backlog management, dashboard reports creation, and themed user stories to effectively sort and filter for reporting.
Experienced in working with Jira software, including creating and managing projects, workflows, custom fields, dashboards, and reports.
Worked on complex ad-hoc SQL queries using joins, DML, DDL, pivots, views, constraints, and functions with Oracle, MS SQL Server, and MySQL.
Collaborated with the scrum master in conducting scrum ceremonies including Sprint Planning, Sprint Review, and Sprint Retrospective Sessions. Participated in daily stand-up meetings to assist the scrum team in removing roadblocks.
Performed planning and development of Test Plans, Test Cases, and Test Scenarios to meet product business and solution requirements.
Experience in data analysis and data visualization using Tableau/Microsoft Power BI, Visio model building with machine learning algorithms for prediction and forecasting using data, and statistical tools like SAS and R for data mining using Python and SQL.
Experience in Data Extraction/Transformation/Loading (ETL), Data Conversion, and Data Migration using Microsoft SQL.
Writing Complex SQL queries in Teradata to pull the records with data issues reported by the users using complex joins, partitions, ordered analytical functions, aggregate functions, etc.
Implementation of Agile Framework (SDLC) using Scrum methodology in the Payer domain.
Conducted thorough data cleaning processes to address Missing Values, Outliers, Duplicates, and Inconsistencies within datasets, ensuring data accuracy and integrity before analysis.
Conducted descriptive statistical analysis to summarize key characteristics of the data, including measures of Central Tendency, Dispersion, Frequency Distributions, And Graphical Representations to gain insights into data distributions and patterns.
Create innovative executive Dashboards, Scorecards, and Weekly/Monthly Reports on the status of key business measurements using Tableau features such as parameters, sets, calculated fields and table calculations, user filters, action filters, and applying advanced technical charts.
Evaluated and documented business requirements for consumer and small business banking systems, focusing on improving customer experience, streamlining account management, and enhancing online banking functionalities.
As a US Healthcare Operations Manager, my responsibilities were:
Managed US Healthcare operations function in support of client Walgreens managing a team of over 35-45 members, including Assistant Managers and Team Leads.
US Healthcare experience with experience managing Billing and Collections, Denial/Dispute Management, Payments Trends Analysis, DSO Tracking, Cash Reconciliation/Cash Application, Aged Trial Balance, Governance Deck, Scorecards and overall reporting of Accounts Receivable Management.
As a manager, helped in managing a BIG client (Walgreens) for Genpact where I managed a portfolio of yearly receivables of ~$4.5B.
Developing and managing all client metrics reporting definitions and requirements for both internal and external usage.
Identified a billing error which resulted in a savings of $500k to the client Walgreens.
Six Sigma Green Belt Certified. Completed a project on Bad Debt Reduction and gave a benefit of $1.5M Reduction in Bad Debt to the client Walgreens which led to an increase in cash flow. This project also gave Genpact a Gain Share OF $250K.
Did a CI (Continuous Improvement) project and helped in reducing the unmatched cash/deposits from $108M to $12M. This project involved matching the invoices/remittances with the open receivables.
Transitioned a process of 20 FTEs and traveled to the USA for the transition for the 3-week duration and completed the entire transition phase after coming back to India and created SOPs.
Monitored and analyzed operational performance metrics, identifying areas of improvement that led to a 10% increase in claims productivity
Worked with the Robotics team (Automation Anywhere) to create Robots and successfully implemented 12 Robots in production related to tasks that were repetitive and could be automated, this led to significant cost savings for the company.
Preparing Scorecard for the entire Accounts Receivables team which has 450 FTEs and around 50 different sub-processes. This is an extensive exercise done quarterly to see how all the processes/sub-processes within the accounts are progressing. The Scorecard gives a complete analysis/understanding of how the business is trending. This involves gathering data from multiple sources including Power BI Tools (SAP) preparing the scorecard and publishing up to the level of Sr. Vice President and GOL (Global Operating Leaders) of Genpact.
Worked on Medicare Advantage, Medicare Part D, Medicare Part B, Pharmacy Benefit Management, Managed Care (Care, Disease, and Case Management and in Insurance regulations and Claims Processing and claim scrubbing in HMO, PPO, Medicare, and Medicaid).
Experience in claims adjudication, migration, provider eligibility, and prior authorization for Medicaid and Medicare programs.
Experience in the Payer and Health Plan Industry, including projects involving enrolment and Billing, Claims Processing and Adjudication, member/customer support, member care management, and wellness processes.
Worked on a Sequence Digital Project – an end-to-end workflow tool to improve audit recovery rate. I played a critical role in the implementation of the tool from the design phase till the UAT and Final Deployment. The tool helped in avoiding manual follow-up touch points and improved auto follow-up with all the pharmacy stores of Walgreens. This led to Savings of $1M from audit recovery.
Preparing Quarterly Reserve reports, annual Fiscal Year End Bad Debt write-off reports, Governance Decks, weekly deck reports, receivables aging reports, collection reports, and analyzing Trial Balance reports.
Working to achieve the Key Performance Indicator (KPIs) as per the SLAs designed between the client and Genpact.
Ability to make Strategic, Operational, and Administrative Decisions in response to emerging conditions with proven ability to analyze Complex Healthcare Data and strategize different aspects of RCM business including billing, collections, payer management, and opportunities for improvement.
Worked on EDI transactions like 835, 837, and X12 to identify key data set elements.
Healthcare Systems: Knowledge of Electronic Health Records (EHR) systems, and healthcare data standards (e.g., HL7, ICD-10).
Excellent computing skills with a high level of Proficiency in MS Office Suite, and SAP Business Objects using SQL for working on Huge Data Sets.
Analysing data and workflow to identify opportunities for improvement leading to Cost Reduction Initiatives.
Worked on Medicare Advantage, Medicare Part D, Medicaid, and Managed Care (HMO, PPO, Medicare, and Medicaid).
Claims experience in the Medical Claims Industry on both the Provider/Payer side.
Responsible for managing all aspects of Business Delivery – Recruiting, Training, Career Progressions, Performance Improvement Planning, Quality Control and Improvement, Reporting Business Operations, SLA monitoring, Stakeholder Management, Client Interactions, and Improving Cost.
Environment: Medicaid, Medicare, ETL, Familiarity with ICD-10 & CPT, HIPAA/GDPR Compliance, Jira, Confluence or Microsoft Project, R, Python, SQL, Power BI, QlikView, or Microsoft Excel, Familiarity with Electronic Health Records (EHR), Health Information Systems (HIS), Pharmacy Benefit Management PBM, SAP Business Objects & Business Intelligence Tools, EPIC, McKesson, Change Healthcare, Population Health Management Tools like Health Catalyst.
Sr. Business System Analyst
***************@*****.***
Huntsville, Texas.
SAYEED SHAIK
PROFILE SKILLS
Business Intelligence: Business process modeling, SWOT analysis, requirement gathering, data warehousing, risk management, ERP Systems (SAP, Oracle).
Project Management: Agile Methodologies, Waterfall, Scrum, Kanban, JIRA, Confluence, Six Sigma, Lean.
Data Analysis: SAP BI/BO, Tableau, Power BI.
Programming Languages: Python (Pandas, NumPy), SQL, HTML, XML. SQL: Advanced proficiency in querying, data manipulation, and database management.
Database: MS Access, Oracle (SQL Series), DB2.
Automation Tools & Analytical Proficiencies: High Radius, Automation Anywhere. Excellent Business Acumen, Financial Acumen, and Leadership Skills.
Microsoft Office Tools: Word, Excel, Visio, PowerPoint, Access.
Documentation Standards: FRD, BRD, SRS, User Stories, Mock-ups, Business Process Flow Diagrams.
Analytical Proficiencies: Cost-Benefit Evaluation, Impact Determination, GAP Identification, Risk Assessment, SWOT Analysis.
Experienced Sr. Business Analyst with over 13+ years of extensive experience in Business Analytics, Stakeholder Management, Agile Methodologies, and Data Analytics, US Healthcare. Proficient in Python, SQL, Power BI, Tableau, PowerPoint, and Excel. Exceptional organizational skills, project management, and leadership skills that will assure project success.
Proficient in requirements gathering, functional analysis, and agile methodologies. My accomplishments include leading successful projects resulting in Bad Debts Saving $1.5M, reducing Unapplied Cash by $96m, and implementing multiple automated Robots in the process resulting in high savings to the company.
I am a dynamic individual with an excellent understanding of business process management with skills inclusive of Business Data Analysis, Operational Excellence, Process Improvement, Healthcare Data Analysis, Statistical Analysis, Accounts Receivables Management, Order to Cash, Denial Management, Billing and Collections, and Revenue Cycle Management.
Expertise in conventional and non-conventional requirement elicitation techniques such as Joint Application Development (JAD) sessions, brainstorming, document analysis, project meetings, prototyping, questionnaires, focus groups, and interviews.
Expertise in data analysis, including Data Profiling, Data Mapping, And Data Validation, to ensure data integrity and accuracy.
Experience in data analysis and data visualization using Worked closely with cross-functional teams to gather, document, and validate business requirements for GCP-based data analytics and machine learning projects.Tableau/Microsoft Power BI, Visio model building with machine learning algorithms for prediction and forecasting using data, and statistical tools like SAS and R for data mining using Python and SQL.
EDUCATION CERTIFICATIONS
Osmania University,
MBA – Finance
May 2008 – Apr 2011
Osmania University,
B. Com, Computers
May 2005 – Apr 2008
Six Sigma Green Belt Certified.
Lean Certified.
Microsoft Business Analyst Professional Certificate Trained.
Certified Medical Reimbursement Specialist.
(CMRS)
WORK EXPERIENCE
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