Business Analyst Senior

Neethu Janga

Senior Business Analyst

Email: *************@*****.***

Phone No: +1-203-***-****

PROFESSIONAL SUMMARY

● Around 8 years of extensive professional experience as a Business Analyst with proven skills in Business Analysis, System Analysis, Validation, and Project Management within the Healthcare Industry.

● Solid understanding of Business Requirements Gathering, Data Warehousing, Data Modeling, Translating Requirements into Specifications, and Application Design.

● Developed and implemented data governance strategies to ensure the integrity and security of healthcare data.

● Oversaw the implementation of data governance initiatives to enhance data quality and regulatory compliance.

● Validated data in compliance with the regulatory standards set forth by HITECH, HIPAA, HEDIS, SNOMED-CT, and ICD coding.

● Worked with EDI Transactions like EDI 835 (Medical Claims Payment), EDI 837 (Medical Claims Submission), and EDI 270 (Eligibility Inquiry) before, as well as with EDI data migration.

● Maintained knowledge of diagnostic coding conventions such as ICD-9-CM and ICD-10-CM.

● Developed Cerner applications for Citrix Workspace and Relay to handle claims processing and Uniform Billing (UB04) for medical services under CMS (1500).

● Experienced in assessing processes for inefficiencies, bottlenecks, and potential for automation or improvement in the Claims Payment Process.

● Utilized HEDIS data to locate care gaps, create interventions, and create dashboards to monitor development against quality measures.

● Experienced in multiple Software Development Life Cycle (SDLC) models, including Waterfall and Agile methodologies, and created user stories using the JIRA tool.

● Working experience in an Agile environment and using Scrum concepts like Product Backlog, Sprint Planning, User Stories, Daily Standup Meeting, Retrospective etc. Working with Product Owners to develop and prioritize the backlog.

● Employed UML methodology in creating UML Diagrams such as Use Cases, Sequence Diagrams, State Diagrams, Activity Diagrams, and business processes and workflows.

● Assisted in facilitating interoperability by utilizing healthcare standards like HL7 messages and FHIR.

● Managed Epic ambulatory services while working with the clinical applications of the EMR and EHR.

● Examined Medicare and Medicaid reimbursement procedures and provided recommendations that improved operational efficiency and reduced costs for healthcare organizations.

● Created process models, and revised the Business Requirement Document (BRD), Use Case Diagrams and flow charts to support Product Owners to identify Functional Requirement Specifications (FRS), Software Requirement Specifications (SRS).

● Conducted Gap Analyses, Root Cause Analyses, and Impact Analyses to find inconsistencies, analyze problems at their root, and weigh the ramifications so that decisions could be made with knowledge.

● Expertise in designing and developing Test Plans writing Test Scenarios, Test Cases and Test Scripts. Experience in manual testing and User Acceptance Testing (UAT).

● Participated in Joint Application Development (JAD) sessions to develop detailed specifications as per user & stakeholder requests.

● Proficient in using Microsoft Visio for creating detailed process flows, UML diagrams, and data flow diagrams to support system analysis and design.

● Designed and executed ETL processes for healthcare Data Migration across Cloud and Traditional databases using AWS, and Azure.

● Experience with implementing data governance best practices and tools such as Collibra, Informatica MDM, and Alation for data management and compliance.

● Architected and implemented ETL processes using Azure Data Factory to facilitate seamless data migration and transformation for healthcare datasets, ensuring high data integrity and compliance with HIPAA regulations.

● Conducted Data Cleansing, Data Validation, Data Verification, Data migration using ETL tools like Informatica to facilitate data migration processes.

● Proficient in gathering and analyzing business requirements for EDW initiatives, including data integration, data modeling and ETL processes.

● Worked on complex ad-hoc SQL queries using Joins, DML, DDL, pivots, views, constraints, and functions using Oracle, MS SQL Server, and MySQL.

● Leveraged Alteryx to streamline and automate data workflows. Developed workflows for Data Blending, Data Cleansing, and Predictive Modeling, reducing manual effort and increasing efficiency.

● Conducted analysis on more than one million rows of healthcare data to identify healthcare business trends and develop dashboards and stories using Power BI, Tableau. TECHNICAL SKILLS

Computer skills: Data cleaning, Data Mining, Data Visualization, Microsoft office. Analysis tools: My SQL, Microsoft SQL server, Tableau Desktop, Microsoft Azure, Power BI Desktop, Spreadsheets, Visio.

Regulations: HIPAA, HITECH, EDI, ICD-10-CM, ICD-10-PCS, HL7, CPT, FHIR, SNOMED-CT, HEDIS.

Languages: Python, R, SQL, XML

Cloud: Azure Data bricks, AWS, GCP.

Management Tools: Git, Jira, Visio.

ETL Tools: Informatica, Azure Devops, Alteryx.

Databases: ORACLE, MS SQL, MY SQL, SQL server.

Operating Systems: Windows, Mac OS, Linux.

PROFESSIONAL EXPERIENCE

Senior Business Analyst September 2021 - Present

Client: Elevance Health Indianapolis, IN

Responsibilities:

● Performed Data Migration and Converted paper-based medical records' data into the new system.

● Developing annual operating plans, capital budgets, and forecasts and building business cases for new business initiatives (cost/benefit analysis).

● Engaged with 40+ Lead product owners to align company roadmaps with team members’ practical software development needs.

● Integrated the laboratory, regulatory, and insurance data from various databases with the Hospital and Patient data.

● Participated in User Acceptance Testing (UAT) and Quality Assurance (QA)testing to ensure functionality.

● Handled facility, professional, and Medicaid and Medicare claims processing.

● Leveraged Electronic conducted data mapping from the internal database and validated HL7 messages to ensure regulatory compliance.

● Health Records (EHR) system expertise to analyze and optimize data workflows, ensuring accurate and efficient health tracking.

● Used Agile Methodologies for iterative development, rapid prototyping, and adapting to changing user needs.

● Implemented effective business processes, a business requirement document (BRD) was created.

● Configured and deployed a data governance tool for a hospital system, enabling better data quality monitoring and management.

● Proficient in creating complex Excel spreadsheets for Data Analysis, including pivot tables, charts, and advanced functions to extract valuable insights and support decision-making.

● Developed intricate data models and data flows in MS Excel to streamline information gathering and analysis, improving data accuracy and reporting efficiency.

● Acted as liaison between external clients and SMEs token rate and standardized product requirements specification documents such as URS/FRS/Use Cases.

● Leveraged AWS services such as S3, Glue, and Athena to extract, transform, and analyze large-scale datasets, enabling data-driven decision-making and insights generation as a Data Analyst.

● Leveraged Azure Databricks distributed computing capabilities to optimize data processing workflows, reducing data processing time by 40%, enabling faster data access and analysis for healthcare providers.

● Successfully integrated Electronic Health Records (EHR) systems with ServiceNow, enhancing data accessibility and reducing administrative overhead.

● Conducted thorough requirements gathering and analysis for a Healthcare Logistics project, resulting in streamlined transportation processes and a 10% reduction in delivery times.

● Demonstrated expertise in conducting gap analysis to identify discrepancies between current coding practices and ICD-10 requirements.

● Performed Data Mapping and data lineage analysis to ensure accurate data flow and integrity throughout the EDW environment.

● Created Use Case Diagrams in accordance with the Functional Requirement Document (FRD).

● Automated data extraction and migration from the old legacy system to the new system were accomplished using ETL tools.

● Documented system interactions and data flow between different modules of the EHR system using Visio, ensuring comprehensive understanding among the implementation team.

● Responsible for optimizing data workflows within Informatica to enhance performance and scalability, as well as troubleshooting and resolving any data-related issues that arise during the migration process to maintain seamless system.

● Used Data Definition to maintain data quality while storing hospital data in a MySQL database.

● Worked on numerous Ad-hoc data pulls for business analysis and monitoring by writing SQL scripts.

● Created SQL queries to add information to the database, including patient information, diagnoses, and treatment plans.

● Created UMT tables, aggregate tables, Trend reports, DDL, DML, Pivot reports, and List reports using sophisticated SQL queries.

● Utilized Python to explore and analyze large datasets, identify patterns, and generate visualizations for data- driven insights.

● Skilled in creating data visualizations with Python using matplotlib and seaborn, effectively communicating key findings and trends through plots, charts, and graphs.

● Leveraged Power BI to amalgamate disparate data sources from health records systems, enabling real-time integration of patient information, treatment plans, and administrative records into comprehensive dashboards.

● Combined sheets and dashboards using Power BI and stories were created to review hospital activities. Senior Business Analyst May 2019 – August 2021

Client: State of New York

Responsibilities:

● Proficient in analyzing and documenting end-to-end claims payment workflows, including claim submission, adjudication, reimbursement, and payment reconciliation.

● Participated in the development of Cerner Applications like Citrix Workspace, Health Quest, Relay to Access Claims Account Server, and Claim Processing.

● Performed ad hoc analysis and offered suggestions to support business requirements.

● Developed and put into practice a data management process that increased data security and quality..

● Experience in conducting thorough system testing and user acceptance testing (UAT) to ensure compliance with ICD-10 coding requirements.

● Data that has been verified in accordance with HITECH, EDI, PHI, and HIPAA regulations.

● Checked the validity of the EDI X12 271 ("eligibility response"), EDI 276 ("claim status"), and EDI 834

("enrollment") for the processing of claims.

● Led initiatives to streamline insurance workflows through the customization and optimization of Duck Creek's modules.

● Participated in Software Development Life Cycle (SDLC)methodologies like Agile and played integral role in sprint planning sessions, contributing to backlog refinement, and tracking progress to ensure timely completion.

● Developed and maintained detailed documentation of Business Requirements and workflows for Healthcare Logistics projects, enabling seamless knowledge transfer and process continuity.

● Proficient in utilizing Jira for project management and task tracking, facilitating effective collaboration and communication within cross-functional teams to ensure project milestones and deadlines are met.

● Skilled in collaborating with stakeholders, including insurance providers, claims processors, and IT teams, to gather requirements and implement system enhancements for efficient claims payment processing and to verify EDI transaction sets.

● Performed in-depth analysis of SQL queries used to build tables, pivot tables, and list reports, ensuring that the queries were efficient and optimized for performance.

● Used SQL to perform comprehensive source-to-target data mapping for EDI transactions, ensuring that all necessary data fields were accurately transformed and loaded into the target systems.

● Handled bundles of FHIR resources with Mirth using the FHIR extension, and mapping FHIR resources with Mirth using the RESTFUL API to interact with non-FHIR systems.

● Code reuse and efficiency improvements for new C-CDA interfaces.

● Conducted comprehensive vendor assessments and evaluations for Warehouse Management Systems (WMS), ensuring the selection of a solution that aligned with healthcare regulatory requirements.

● Conducted root cause analysis for Supply Chain Disruptions, recommending process improvements that led to a 25% reduction in inventory shortages during critical periods.

● Developed custom DAX (Data Analysis Expressions) formulas to calculate complex financial metrics and ensure accurate representation of co-payment, deductible, and co-insurance amounts in the dashboards.

● Used Power BI, for creating several business intelligence dashboards and reports.

● Implemented advanced data visualization techniques such as heat maps, trend lines, and scatter plots to highlight patterns and trends in patient data, supporting clinical and operational analysis. Business Analyst November 2017– April 2019

Client: Clover Health- Tennessee

Responsibilities:

● Demonstrated expertise in analyzing healthcare data to ensure compliance with regulatory standards, optimizing processes for filing insurance claims and policies

● Proficient in analyzing diverse clinical trial datasets, including demographic, efficacy, safety, and adverse event data, to extract valuable business insights.

● Applied statistical methods, such as hypothesis testing, regression analysis, and survival analysis, to assess treatment efficacy and safety outcomes, providing informed decisions.

● Leveraged Alteryx Designer to streamline and automate complex healthcare workflows, enhancing efficiency and accuracy across multiple departments.

● Prepared comprehensive business reports and documentation in MS Word, ensuring clarity, consistency, and professionalism in all project communications.

● Designed and delivered visually appealing and impactful presentations in MS PowerPoint, incorporating data visualization techniques to convey complex information effectively.

● Created clear and concise documentation, including BRD (Business Requirement Document), FRD( Functional Requirement Document) and use cases.

● Implemented Agile methodologies, including Scrum and Kanban, to manage and deliver the project, resulting in improved team collaboration and project transparency.

● Worked closely with QA automation engineers to integrate automated test scripts into the development pipeline, automating regression and functional testing processes for greater efficiency.

● Demonstrated expertise in conducting requirement gathering sessions with stakeholders to define business rules and criteria for claims eligibility determination.

● Gathered patient information from electronic medical records (EMR’s) to determine how many patients had insurance.

● Proficient in analyzing and interpreting complex medical documentation to ensure accurate ICD-10 code assignment.

● Utilized data-driven insights to optimize Medical Supply Distribution, reducing transportation costs by 20% while maintaining timely and accurate deliveries.

● Played a key role in the development of a Supply Chain Analytics dashboard, providing healthcare executives with real-time visibility into inventory levels, demand forecasting, and distribution performance.

● Effectively managed test assets, including test scripts and test data, in GitHub, promoting version control and seamless collaboration with development teams.

● Collaborated with third-party logistics providers (3PLs) to integrate their systems with healthcare networks, improving data accuracy and enabling seamless information exchange.

● Developed comprehensive documentation of PY-Spark workflows, methodologies, and analysis results, enabling knowledge sharing and supporting reproducibility of analytical processes.

● Developed process flows, data models and user interface designs using tools like Visio.

● Proven track record of conducting data analysis to identify trends, patterns, and anomalies in Claims Data ensuring accurate and timely payment processing.

● Conducted thorough analysis of business requirements and collaborated with stakeholders to define data mapping rules for Source to Target Data Integration.

● Converted patient data in XML format from the CDA to the MySQL server database.

● Proven track record of conducting data profiling and data quality analysis to identify gaps, inconsistencies, and anomalies within EDW systems.

● Created a Use Case Diagram in accordance with the requirements after creating and compiling the business requirements.

● Performed data extraction from EHRs, claims systems, and pharmacy systems using ETL processes.

● Created extensive SQL queries for data validation using the primary key, foreign key, and unique key constraints.

● Proficient in creating interactive and visually compelling data visualizations using Tableau, transforming complex datasets into actionable insights and storytelling dashboards.

● Experienced in developing dynamic and customized Tableau reports and dashboards to meet the specific analytical needs of stakeholders, enhancing data-driven decision-making processes within the organization. Business Data Analyst September 2016- October 2017 Dexcom Health - San Diego, CA

Responsibilities:

● Maintained sizable collections of patient data in well-organized spreadsheets in Excel.

● Completed upgrades, data migrations, backups, and recovery tasks for databases.

● Participated in the analysis, creation, and documentation of data specifications and business requirements, FRD and BRD.

● To store the data, tables were made in the SQL database using facts and dimensions.

● Examined the effects of the remote patient monitoring system, a connection to a SQL database was established using Tableau.

● Expertise in designing star and snowflake schema and ETL data migration procedures.

● Used RPM system devices to analyze patients with specific conditions like diabetes and hypertension.

● Performed reporting and performance analysis on complex patient data.

● Skilled in performing data mapping, creating comprehensive data dictionaries, and defining data structures to support data analysis and enhance data quality across diverse business systems and analytical initiatives.

● Collected and arranged patient medical information from RPM devices.

● Collaborated with team members using Git for version control, aiding in the tracking of changes and contributing to the organization of code and project files during analytical tasks.

● Recognized patterns, trends, and anomalies in the patient data to spot potential medical problems.

● Examined the patient's vital signs and medical history to provide any necessary health warnings.

● Utilized Python for basic data analysis tasks such as data cleaning, manipulation, and visualization, under the guidance of senior analysts, contributing to the team's analytical efforts.

● Reviewed basic SQL queries and edited inner, left, and right joins in Tableau Desktop.

● Created dashboards and visualizations in Tableau to track the usage of the system by patients and evaluate the results.

● Designed dashboards in Power BI and Tableau to examine how the system performs under various conditions.

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