Business Analyst Data Analysis

PATHIKA PATEL

https://www.linkedin.com/in/pathika-patel-54767668/

Senior Technical Analyst/Business Analyst

*******.*@*****.***

Location: Haskell, NJ

Mobile: 516-***-****

Summary: -

Dedicated and results-driven Business Analyst with over 8 years of diverse IT experience in Project management, leveraging SharePoint to streamline Business processes, enhance collaboration, and drive organizational growth.

Involves in bridging the gap between business needs and clinical operations.

Evaluating clinical workflows to identify inefficiencies and recommending process improvements to enhance patient care and operational efficiency, implementing automation or digital solutions to streamline services.

Adept at translating complex business requirements into Share Point solutions that improve efficiency and deliver measurable results.

Experienced in all aspects of the System Development Life Cycle SDLC having thorough understanding of phases such as System Investigation and Analysis, Design, Development, Testing and Deployment.

Experience in Business Analysis using Functional Flow charts, Check sheets, Interrelationship diagrams, Workshops and Brainstorming Sessions. Good Understanding of the EDI (Electronic data interchange), Knowledge of HIPAA code sets.

Knowledge of EHR (Electronic Health Records) in compliance with Meaningful use program and HIX (Health Insurance Exchange) etc.

Worked with Business Stakeholder understanding the requirements, both in terms of business processes and data management, and translate into SharePoint functionality.

Practiced in clarifying business requirements, performing gap analysis between goals and existing procedure/ skillsets, and designing process and system improvements to increase productivity and reduce costs.

Solid understanding of Business Requirement Elicitation, Business Process Modelling, Business Process Flow, Data Analysis and Mapping, Business Intelligence and Analysis.

Proactively identify customers and opportunities to convert accounts to an EDI model.

Create strong working relationships with internal customers and understand corresponding account requirements.

Experienced in conducting User Acceptance Testing UAT, Risk Analysis, Cost Benefit Analysis and ROI Analysis.

Develop and continue to refine CRM change management standards and tools.

Be a member of the CRM development community affecting and driving efficiencies across the company.

Utilized tools like Star UML, MS Visio, Balsamiq Wireframing tool, Microsoft Office Project, Access, Excel, Outlook, PowerPoint and Word, and Adobe Creative Suite Photoshop, and Flash.

Worked in SCRUM environment and attended daily SCRUM meetings, Sprint planning, and Sprint review.

Certified in the complete SQL Bootcamp 2020 from Udemy

Strong Analytical and Problem-Solving skills with ability to approach challenges and solve problems effectively, and multi-tasking abilities, with proven experience in utilizing people and process knowledge to assist enterprises in making critical decisions.

Skills: -

SDLC Methodologies

Waterfall, Scrum, Scaled Agile Framework (SAFe)

Project Management Tools

Agile, HP Application Lifecycle Management (ALM), Rally, MS Project, Team Foundation Server, JIRA, Confluence

Requirement Tools

Word, MS Visio, Team Foundation Server

Prototyping Tools

MS Visio, Lucid Chart, Sketch

Reporting Tools

Power BI, Tableau, Crystal Reports

Languages

PL/SQL, SQL, T-SQL, Oracle, Todd

Microsoft Technologies

MS Visio, MS Access, MS SharePoint, MS Project, Visio,

Advanced Excel, Word, Outlook, PowerPoint

Tracking

Clear Quest, Rational Requisite Pro, VersionOne

Control Program

Visual SourceSafe (VSS)

Experience: -

Senior Technical Analyst at Point32Health, Canton, MA Jan 2022 – Current

In the Current project of Data migration, perform maintaining and troubleshooting system equipment including hardware devices. Responsible to correct functioning of customer applications and database systems. Troubleshoot and resolve problems with products, software, and processes. Lead the delivery of technical and functional analysis and artefacts working alongside the Business SMEs and offering advice and feedback on the potential functional and technical solutions and approach. Document and own best practices for developing, executing, and maintaining all aspects of the Datawatch system. Compare database in with post migration and find Negative effects on ETL and work with developer if Backend coding require changes.

Responsibilities:

Produce project inception design proposals for the HR Technology & Change Approval Board setting out the requirements, challenges, and recommended solutions to request funding.

Collaborated with stakeholders to elicit business and reporting requirements, translating them into optimized T-SQL queries for dashboards, data validations, and ad hoc reports.

Developed and maintained stored procedures, views, and functions using T-SQL to support data analysis for time and attendance, payroll accuracy, and scheduling compliance.

Extracted and analyzed large datasets from SQL Server databases to identify trends, support KPIs, and streamline workforce operations.

Created custom reports for leadership and compliance teams by joining complex tables, filtering datasets, and performing aggregations using advanced T-SQL techniques.

Write T-SQL scripts for validating and transforming claims data to support operational and regulatory reporting using SQL-driven extracts.

Ensuring clinical processes and claims comply with healthcare regulations (HIPAA, GDPR, FDA, etc.) Supporting audits and risk assessments to mitigate compliance risks.

Analyzing claims workflows to identify inefficiencies and reduce denials.

Monitoring claim trends, rejection rates, and enrollment statistics, creating reports and dashboards for leadership to track key performance indicators (KPIs). Ensuring data accuracy in claims and enrollment systems.

Develop interactive dashboards and reports using power BI to visualize key performance Metrics and trends.

Extracted, transformed, and loaded (ETL) data from various sources into power BI for analysis.

Work independently when required to elicit, validate, and document business requirements that are specific, measurable, assignable, realistic, and time-bound and testable.

Work with solution architects to formulate the functional solution design.

Customize SharePoint to serve as basic CRM System (Customer relationship Management), Create contact list, track interaction, and develop customer forms for lead generation and customer support.

Collaborated in data design walk-throughs to communicate Data Warehouse and Data Mart table designs to the developmental team, by creating Data Mapping Documents, and ran SQL queries using Tableau to document the clicks and sales of tickets.

Analyze existing conversion processes and identify/address problems impacting the quality of our data conversions and implementations Function as Administrator of Data Watch Monarch platform for Kronos Workforce Ready Participate in and occasionally lead cross-functional internal process improvement projects.

Database comparisons in Oracle SQL and Todd.

Utilized Adobe Creative Suite (including Adobe Photoshop, Illustrator, and InDesign.

Continuously monitored and evaluated the effectiveness of Power BI dashboards.

Webservices Comparisons in SoapUI.

Produce project inception design proposals for the HR Technology & Change Approval Board setting out the requirements, challenges, and recommended solutions to request funding.

Environment: Windows, MS SQL Server, Adobe, Oracle SQL, Notepad++, HRP, Tableau, Todd, SoapUI, MS Office, JIRA, Confluence.

Business Analyst at Aetna Integrated Services, Hartford, CT May 2019 – Dec 2021

The project was to enhance the User Interface of Humana for a better User Experience and incorporate changes as per the HIPAA guidelines. The main objective of the System was to secure health information received by the User at the time of submitting the claim and to ensure the Veracity and privacy of the User information.

Responsibilities:

Used Agile Development methodology throughout Project Life Cycle.

Gathered business requirements through personal interviews, brainstorming, and teleconferences.

Wrote and maintained Business Requirements Documents (BRD) and functional Requirements Documents (FRD) for Portfolio Analytics report.

Designed and implements SharePoint solution to improve document management, collaboration, and workflow automation.

Write complex queries to extract insights from large datasets to Build reports and dashboards using T-SQL queries and analyze trends and provide actionable business intelligence.

Support systems like UKG/Kronos by querying timekeeping, scheduling, and payroll databases.

Validate data between WFM systems and payroll/HRIS platforms.

Perform compliance audits using T-SQL scripts.

Presented findings and actionable recommendations to stakeholders, facilitating data driven decision making in Power BI.

Partner with business units to define reporting requirements by using T-SQL to query data warehouses and create report specifications and Collaborate with developers to optimize stored procedures and views.

Used MS Visio and activity diagrams, sequence diagram, Wireframe and Models.

Wrote Product Backlog and derived user stories from functional requirements.

Monitored, tracked, and documented the progress of the project by use requirement traceability matrix.

Performed GAP Analysis to identify the current situation and the future state want to reach on the current website.

Subject Matter Expert related to the processing and synthesis of claims data in support of settlement operations.

Utilized Adobe Creative Suite (including Adobe Photoshop, Illustrator, and InDesign).

Worked with the business team in Insurance domain to collect the business reporting, reporting standards, security and service level requirements and documented them in Business Requirement Document (BRD) to get a better understanding of client's business processes. Existing solution for insurance claim and credit collection processes by supporting internal project team.

Assisted in the identification of the scope, timeline and budget of the project and ensured the progress at each step with project manager. Subject Matter Expert related to the processing and synthesis of claims data in support of settlement operations.

Helped testing team to test the customizations, Confidential Services, Modified Rules to Accommodate.

Understanding of the business mission and technology environment.

Gathered requirements for HIPAA (Health Insurance Portability and Accountability Act) EDI (Electronic Data Interchange) Transactions in various phases of implementation.

Prototyped and Created Wireframes for the application, by providing screen shots for better visualization.

Followed Agile/Scrum process - Involved in Sprint Planning, Stand-ups, and walkthroughs.

Facilitated JAD (Joint Application Development) sessions with business users and development teams to drive out detailed business requirements.

Strong analytical and problem-solving skills and capability to interface with both internal and external stakeholders and in facilitating a healthy communication between the client and IT department. Prepared PowerPoint presentations to present the updates and status of the project. Assisted the Scrum Master in Creating and Managing the Release Planning Documents in the Version One and Share Point Repository.

Facilitated the Daily scrum meetings, spring planning, spring review, and spring retrospective.

Working knowledge of SQL queries and validate the data in the Warehouse and DataMart.

Prepare cost-benefit and return-on-investment analyses to aid in decisions on system implementation.

Evaluate key criteria such as KPIs and create assessment reports. Participated in Business Demonstrations and Decisions for the Release of the Sprint Output to Production.

Environment: Windows, MS SQL Server, Oracle, Adobe, Data Mapping, Clear Quest, MS Office, MS Visio, JIRA.

Business Analyst at Cigna-Health Spring, Nashville, TN April 2017- May 2019

Virginia Department Cigna-Health spring is a leading health services company with Medicaid and Medicare Advantage offering. TriZetto QNXT is a third-party Enterprise Managed Care System used at Cigna-Health spring for claims processing and care management. As a Analyst I was involved in the migration from legacy MHC to TriZetto QNXT system for data management and configured all sorts of contracts.

Responsibilities:

Analysed change requirements for Providers, Contracts and Claims processing modules configuration in QNXT system for Medicaid and Medicare Advantage for AL, FL, GA, IL (ICP &MMAI), IN, MD, MS, NC, SC, PA and TN plans.

Conducted user training sessions and provided on going support to ensure the successful adoption of SharePoint Solutions.

Utilized SharePoint to map out existing and future-state business processes, creating visual work flows for analysis.

Supported the Project Manager in co-ordination, scheduling, and planning activities.

Defined and documented the vision and scope of the project.

Created GAP analysis report and conducting Gap Analysis of client requirements, generated workflow process, flow charts and relevant artifacts.

Used a mix of SDLC Process and Agile Methodology while working on the projects in order to be able to deliver in a phased approach and meet the deadlines.

Created/authored documents like High Level Requirements and Detailed Level Requirements document.

Created documents to address simple work efforts that required less than 80 hours of design and testing before implementation to address new business requests.

Utilized Member module to verify eligibility, benefits and PCP assignment to maintain accuracy.

Update and analyse Claims 101 edit errors for missing contracts in an accurate and timely manner to avoid penalties.

Ensured system configuration and functionality adheres to HIPAA 5010, Medicare, Medicaid other market-specific regulations and business rules.

Used provider-credentialing module in QNXT to change the status of the provider.

Prepared reports and presentation using variety of programs (Word, PowerPoint, Excel, and Visio.)

Developed Database packages, procedures, functions, triggers using SQL.

Environment: MS Office, MS Visio, MS Project, Quality Centre, SharePoint.

Business Analyst at Virginia Department of Health, VA July 2016 - Mar 2017

Virginia Department of Health (State of VA) has a continuum of health management solutions to help improve customer’s overall health, prevent illness, and optimize their care dollars. This comprehensive suite of health and wellness programs touches people in every stage of health. This program helps those in good health stay healthy and prevents disease, offers one-on-one support for people dealing with chronic conditions, or severe and complex illnesses, provides for member’s health needs to be integrated throughout the entire continuum of services to ensure coordination of care.

Responsibilities:

Activities in Agile SAFe environment & time-boxed sprint planning & execution.

Gathered requirements from Business Managers, Supervisors, stakeholders, Data Governance Team and the subject matter experts through meetings to understand needs of the system.

Provided detailed documentation, including functional specifications and user guides, to support SharePoint implementation.

Participated in SCRUM of SCRUM in SAFe framework, conducted daily Scrum meetings Sprint review meetings, Sprint Retrospective and Backlog Grooming worked closely with other product owners to groom Product backlogs, maintain burn-down chart, and kept track of other agile metrics to make sure team is aligned with the PI Objectives.

Advocated and educated Agile and SAFe best Practices. Maintained a strong connection with resources outside the organization to bring in recent research, data, and tools.

Defined best-of tooling and automation to optimize data flow & accessibility through Program Teams & PI Process. Created business workflows on the claims module for the client to get a better understanding of the software and prepared a detailed BRD including all functional and non-functional requirements.

Successfully conducted various retrospective techniques such as Silent writing, mad/sad/glad, Happiness Histogram to understand team opinion on improvements.

Established strong partnership with the Agile team, work stream leads and product owners and conducted coaching sessions regarding Agile development methods.

Participated and hosted in meetings, technical discussion, reviews and release planning.

Extensively used Jira to create and manage sprint and product backlogs, to track issues, trace requirements and team collaboration.

Used Confluence for managing documents and for hosting websites which were used to access shared workspaces and documents and assisted the team in repository management and collaboration.

Environment: Scaled Agile Framework, Scrum, Facets, JIRA, Confluence, MS Office suite, MS Visio, XML, Quality Centre, MS SQL, Informatica PowerCenter.

Education: -

Campbellsville University, master’s in information technology management Louisville, KY. 2019-2022.

Brooklyn College, City University of New York. associate degree Public Health. Health Service Organisation and Administration (HIPAA Laws) 2017-2018

Gujarat University, Ahmedabad, India. Master’s Degree in FSN. 2010-2012.

Maharaja Sayajirao University of Baroda, Vadodara, India. Bachelor’s degree in mass communication, Business, Home Management, Human Resource and Food Science. 2007-2010

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