Product Manager Business Analyst

Garima Gupta 937-***-****

Healthcare BA-Product Manager linkedin.com/in/garima-gupta-msit-b134a646

*** ****** *****, **** *** York, USA, 07093 ******.****@*****.***

Professional summary

Experienced Healthcare Business Analyst & Product Manager with 13+ years in healthcare technology & systems. Skilled in bridging business & tech, optimizing EHRs, & leading cross-functional teams. Proficient in Agile, SQL, & UI/UX design, with a strong track record in stakeholder engagement, product strategy, & system enhancements.

Expert in Power BI, business insights, & crafting end-to-end user stories. Known for excellent communication & stakeholder management.

Skill/Tools:

Business Analysis & Documentation:

JIRA, Confluence, Agile, Scrum, BRD/FRD, Visio, Process Mapping, Microsoft Office suite, SharePoint, Whiteboard

ERP integration Tools:

Data Loader, XML.

Data Management & Reporting:

SQL, Excel Macros Clarity PPM, JIRA, Confluence, SharePoint, EHR

Cloud :

AWS, Azure.

Testing & Automation:

Test Plans, UAT, Bug Tracking (JIRA, HP ALM), Automated Test Scripts.

Business Intelligence & Analytics:

Power BI, Tableau, flowcharts, & process mapping using MS Visio.

Professional Experience

Easicient / Product Manager / New Jersey / Feb 2022 – Present

Spearheaded the launch of a new product, securing buy-in for the product vision both internally & with key external partners.

Contributed to the development of product pricing & positioning strategies.

Leveraged AI-driven analytics tools to extract insights & forecast market trends.

Used AI to summarize stakeholder feedback & identify trends.

Translated product strategy into detailed requirements & prototypes for seamless execution.

Managed all aspects of project management, including time & resource allocation, financial planning, scope management, risk & issue resolution, & overall project execution.

Collaborated with project stakeholders to gather business requirements & validated project reports using Tableau, ensuring transparency & accurate progress tracking.

Participated in stakeholder meetings to define go-to-market (GTM) strategies

Leveraged Google Trends to identify effective marketing channels for GTM strategies.

Facilitated in-depth market research, translating insights into actionable product features that led to increased customer satisfaction.

Verified healthcare provider licenses, certifications, peer references, & education records using credentialing databases like CAQH ProView & NPDB.

Managed credentialing for providers across diverse entities including ASC, Medical Groups, MRI & CT facilities, & Urgent Care centers.

Expert in collaborating with healthcare providers, administrators, & third-party organizations to gather & verify all necessary documentation.

BLUE CROSS BLUE SHIELD (HCL- Implementation Partner) / Healthcare Business Data Analyst / Durham, NC / Oct 2021- Jan 2022

Collaborated with business users to review Post Payment cases & conducted claims research in Teradata to facilitate refunds.

Generated monthly savings reports for refund processes across various Lines of Business (LOBs), identifying key trends opportunities for improvement.

Applied specialized knowledge of medical claims to resolve complex business challenges.

Conducted thorough root cause analyses to identify payment issues & implemented effective solutions to resolve them.

Developed SQL queries, created detailed end-to-end user stories, & utilized diverse analytical methods to tackle business problems & optimize processes.

Managed the product backlog & created detailed user stories.

Oversaw business processes & systems to ensure alignment with industry standards, maintaining integrity & compliance in billing &claims payments.

CARESOURCE / Healthcare Business Data Analyst / Dayton, OH/ Jun 2021- Sep 2021

Developed test designs in ALM to enhance efficiency & effectiveness of business capability testing.

Reviewed & refined business requirements in ALM, collaborating with SharePoint notes, whiteboard discussions, & regulatory foundations for clarity & accuracy.

Created & executed UAT test plans ensuring alignment with project objectives & timelines.

Established &F maintained a Requirement Traceability Matrix for defect tracking & project status reporting, helping secure approval of test deliverables.

Onboarded new offshore team members by providing an overview of the project status & ensuring timely access setup, improving ramp-up efficiency.

Supported UAT for ANSI X12 Version 5010/EDI transactions (HIPAA) related to Claims Status & Eligibility, ensuring compliance with HIPAA regulations across various modules in the Facets system.

Performed comprehensive testing on Facets applications, focusing on Provider, Group, Subscriber/Family, Membership, & Billing modules to ensure system accuracy & functionality.

Utilized SQL & Tableau dashboards to analyze patient data, enabling informed decision-making & business insights.

Miami Valley Ambulatory Surgery Center / Business Analyst / Dayton, OH/ Feb 2020- Jun 2021

Managed the full lifecycle of Electronic Health Record implementation, aligning templates with practitioner needs & enhancing clinical workflow efficiency across various departments.

Provided training for Surgery Center staff on EHR system usage, optimizing login processes, user roles, & modules to ensure smooth adoption & operational readiness.

Acted as liaison between Subject Matter Experts (SMEs) & development team, ensuring alignment & clear communication throughout all phases of the Software Development Life Cycle (SDLC).

Contributed to MMIS, HIX, EMR, & system projects, applying knowledge of healthcare reforms such as Patient Protection & Affordable Care Act (PPACA) to ensure compliance.

Assisted end users in performing UAT, verifying that the development effort met business needs by testing the resulting files & ensuring the system functioned as required.

Demonstrated extensive knowledge of various health insurance programs, including Medicare (Parts A, B, C, & D), PPO, HMO, POS ensuring that all project requirements were well-covered.

Ohio Institute of Allied Health / Business Analyst / Dayton, OH /Apr 2013- Jan 2020

Collaborated with the school team to create an online platform using the Diamond D tool, enabling students to access grades, schedules, attendance, & payment details through a web portal.

Facilitated senior management's understanding of the technology behind the online school.

Utilized Diamond D software to track student progress & manage new potential leads for college

Worked closely with management to ensure the clarity, accuracy, & quality of written materials, including policies & procedures supporting the online educational program.

Analyzed impact of current legislation & board-directed initiatives on IT systems

Led Joint Application Development (JAD) sessions with business & technical units to gather comprehensive business & functional requirements for the online education system.

Defined & validated data requirements to implement necessary elements for distance learning.

Created use case documents to elaborate on the user experience

Pearson / Business Analyst / Iowa City, IA / May 2012- Dec 2012

Defined & prioritized requirements based on user feedback

Updated user manuals after successful implementation of new features, ensuring accuracy.

Led client meetings during the inception phase to gather requirements & assisted technical leads in the analysis & design of architecture using UML & the Rational Unified Process (RUP).

Played an integral role in the planning, testing, & implementation of system enhancements, supporting an Agile development environment.

Analyzed & addressed user-reported issues in ePEN 0.5, optimizing resolution processes to enhance system performance & user satisfaction.

Education

Master of Science in Information Systems / Stratford University / Virginia / 2011

MBA in IT & Finance / Apeejay University / India / 2009

BE in Computer Science / Gandhi Institute of Engineering / India / 2006

Additional information

Volunteer Experience I Credentialing Specialist

In-depth understanding of HIPAA regulations & Payers (Medicare, Medicaid, BWC etc.)

Successfully implemented CAQH ProView to streamline provider data collection, reducing application processing time by 20%.

Ensured full compliance with NAMSS credentialing standards, maintaining a perfect audit pass rate.

Developed & implemented best practices, policies & procedures related to the credentialing process.

Managed the credentialing process for a network of over 200 providers, across multiple Payors.

Primary Contact for Credentialing Inquiries: Served as the main point of contact for all credentialing-related inquiries from providers & payers.

Successfully achieved AAAHC hospital accreditation for ASC, ensuring compliance with strict national standards for equipment, operating room safety, & personnel/physician credentials.

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