Summary of Qualifications:

• Over 7+ years of extensive experience as a Business Analyst with a solid understanding of Business Requirements Gathering, Business Process Flow and Business Process Modeling in diverse domains like Health care, Risk Management, Technical Financial Analysis.
• Demonstrated skills in critically conducting the GAP Analysis throughout the projects in evaluating/ analyzing the existing standards and policies to determine the improvements
• Urbanized and simplified the existing procedures, business processes to document the business requirements and to assist the application development team in writing analysis, to design documents and translate into system solutions through Standard / Structured Systems Life Cycle, RUP and UML.
• Proficient in authoring Business Requirement Document, Narrative Use Cases, creating Use Case diagrams, Sequence Diagrams, Activity Diagrams and other UML based diagrams using MS Visio, Rational Rose.
• Extensive experience in conducting Joint Requirement Planning (JRP) sessions, Joint Application Development (JAD) sessions with committee of SME’s, senior management and IT groups to converge early towards a goal acceptable to customers and feasible to a designer to complete.
• Experienced in Smoke testing and Functional Testing to ensure the software meets the system requirements and specifications.
• Excellent Knowledge in Electronic Medical Record (EMR) / Electronic Health Records (EHR) modules and process flow.
• Expertise in Healthcare Data warehousing, MS BI tools (Sequel server Reporting/Analytical tools).
• Adept in developing and writing Test Plans, Test Cases and Test Scripts using manual and automated testing tools such as Rational Suite and Mercury Interactive to perform User Acceptance Testing (UAT).
• Expertise in reviewing Test Procedures, creating Test plans, defining System & Integration Test Cases, executing Test Cases, Test Data reviewing and maintaining and executing detailed Test scripts for User Acceptance Testing (UAT), analyzing bugs, interacting with team members in fixing.
• Expertise in Client site coordinator that involves understanding business requirements,day to day client interaction, offshore knowledge transfer (KT) activities, onsite status call coordination, project deadline keeping and worked as a team with business partners and end data customers

Proficiency & Expertise:

• Extensive experience in client management. Flexible to adapt to the changing needs of the performing organizations and their clients.
• Managing a diverse set of stakeholders for the project deliverables and meeting project objectives. Gained management experience and skills through numerous on the job training exposures in the areas of project management and client management.

Languages: SQL

Healthcare Domain specific experience:

• Experience with Healthcare systems, HIPAA compliance applications and electronic exchange guidelines.
• Experience with Medicare, Medicaid and commercial insurances in HIPAA ANSI X12 formats including 270/271, 835, 837, 997
• Experience with claims process and adjudication in the Medicare, Medicaid & Private Insurance Sectors.
• Experience in configuration of claims adjudication systems, i.e., WMG-EHR, Criterions etc.
• Experience in providing US Health Insurance domain and system training, mentoring to other internal Business Analysts and Entry level fresher’s including knowledge of conversation.
• Was responsible for developing and documenting the clinical & non-clinical areas of the project and in deriving integrations for the modules.
• Was involved in Implementations of Hospital Information Systems to major facilities with 600+ bedded.

Education/Qualification:

• Masters in Business Administration
• Bachelors in Science
• Diploma in Computer Application.

Professional Experience:

Confidential, IL Jan 2009 – Present

Role: Sr. Business Analyst
Project Description Presently working as a Sr. Business Analyst in a product development data warehousing project that is based on onsite/Offshore model. The project is all about applying Specialty restriction for the Xponent data coming from different data sources like IMS, MAX, Caremark etc.
The main activity includes the creation of business flow diagrams, functional design specifications and conceptual data models for key IT processes.
Project Achievements:

• Worked with the Stakeholders, Project Manager and senior Business & SQA (Software Quality Assurance) Analysts in defining, documenting and diagramming the business needs and Business Process flow.
• Used the guidelines and artifacts of the Rational Unified Process (RUP) to strategize the Implementation of Rational Unified Process effort in different iterations and phases (Inception, Elaboration, Construction and Transition) of the Systems Life Cycle methodologies. Prepared various artifacts for all the phases of RUP.
• Involved in requirement gathering, analysis and design which helped in determining the functional specifications, writing use cases and creating screen prototypes.
• Managed the workflow process using SDLC methodology and Iterations.
• Worked extensively to write use cases and functional requirement Case diagrams, Activity diagrams, Sequence diagrams, State diagrams based on UML Methodology and business process flow diagrams using MS Visio.
• Worked extensively with the QA (Quality Assurance) team for designing Test Plan and Test Cases for the User Acceptance testing- Defined test cases, creating test scripts, analyzing bugs, interacting with QA / development teams in fixing errors and User Acceptance Testing (UAT).
• Coordinate project teams, including reviewing deliverables and providing technical guidance.
• Trained Internal Users on applications mainly in Visual Studio 2003
• Applied project management knowledge and expertise to gauge system performance and assess risk.

Environment: Windows XP/2000, SQL, Oracle, MS Office Suite, MS Visio, HTML, XML, Win Runner, Load Runner, MS BI tools, Visual Studio

Confidential, WI July 2007- Jan 2009

Role: Sr. Business Analyst

(Feb 2008- Jan 2009):

Project Description:
American Family is a leading insurance company in the field of Health, Housing, Auto and finance.
This project is initiated to reduce the volume of paper going to the claims central scanning center by sending all medical bills to an outside vendor for scanning ,indexing and storing. The project is all about the Arbitration of billing sent to Amfam in a hard copy format, which includes per-use charges for the types of services provided and identifies the claim number and other pertinent information. Arbitration Forums provide this billing in electronic format as an automated billing process. This process benefits in eliminating most of the manual reconciliation process and produces timely, accurate billing reconciliation and payment with minimal human intervention.
Technologies: Visual Studio Team Foundation Server 2008, Visual Studio Team Build 2008, Visual Studio 2008 Team Suite
Project Achievements:

• Collect and Analyze Requirements
• Prepare a written recommendation for a standard suite of development tools based on the Visual Studio Team System
• Developed new Use Case Specification guidelines for the project to facilitate specific business rules at Amfam
• Developed use case flow diagrams using MS-Visio
• Facilitated security review assessment with the security team
• Developed front-end application mock-up screens for a better understanding and removing all the ambiguities between developers and clients
• Worked with developers to create/review program authorizations
• Assisted business clients in updating BRD, Business Rules, and User Summary outlines
• Developed and managed Issues Log using MS-Excel and Track Record
• Facilitated brain-storming session with the team to discover risks associated with the project and risk assessment sessions to mitigate them
• Worked closely with Education department to develop instruction manuals and job-aid for the end-users
• Design and developed Configuration Management Plan, Project Plan, Deployment Plans, Statement of Work, and Software Development Plan
• Developed Phase Plan and Iteration Plan to introduce RUP on the project
• Worked with Software Engineering Specialist to design MS-Project Schedules and resource allocation
• Designed higher level testing plan by developing Test Strategy, Test Plan, Test Suites, and Test Data files
• Conducted system, functional, regression, and capacity testing
• Reviewed testing/performance results with the clients for their sign-off

Environment: Windows XP/2000, SQL,Oracle, MS Office Suite, Rational Suite, HTML, XML, Win Runner, Load Runner, Oracle, Visual Studio

Project: National Provider ID (NPI) for Life/Health ( July 2007-Jan 2008)

Project Description: Electronic Health Records systems (also known as Electric Medical Records, or EMR) have proven to be a far better approach to documentation than conventional, paper-based systems and is designed and built on HIPPA compliance. The project involved building intelligent and customer user-friendly interface to Simplify calls for a standard unique health identifier for each individual, employer, health plan, and healthcare provider for use in the healthcare system.More Efficiently Patient information is available with a few keystrokes. Records are electronically stored in a database, not taking up space in an office or storage facility. Customized dashboard which comprises of Templates, workflow, secured messaging, referrals, charts, and more are all customized to fit the way you work. .With complete and immediate access to patient records, providers are able to provide better, faster. Patient information is readily available, saving time and effort. Additionally, much less office space is required to store the records.

Project Achievements:

• Assisted project manager with the development of project schedules. Develop requirements and preliminary design for client applications.
• Worked with production staff to identify and map detailed current processes, identify gaps and failure points, perform root cause analysis and develop functional requirements that supported overall strategy, goals and objectives.
• Conducted JAD sessions to gather all the requirements from the Life/Health applications.
• Developed Use Case diagrams, behavioral diagrams (sequence, collaboration, state-chart, and activity diagrams), and class diagrams using MS-Visio.
• Performed GAP analysis for the modules in production, conducted feasibility study and performed impact analysis for proposed enhancements.
• Interacted with data architects for data mapping, data modeling, and entity relationship.
• Prepare metadata architecture for database design of the central repository for query enhancement, clarification of data relationships, data conversion, and reporting features as per the business requirements.
• Developed Software Requirements Specifications (SRS), Use Case Specification, Supplementary Requirements Specifications.
• Designed and developed Test Plan and Test Suites documents.
• Conducted manual testing of NexSys system in Integration.
• Worked with UI team to create the User Interface screenshots to be presented to the end-users and stakeholders.
• Coordinated and prioritized outstanding defects and enhancement/system requests using Track Record, allowing sufficient time-frame to ensure accuracy, and meet project deadlines

Environment: Windows XP/2000, SQL, MS Office Suite, MS Visio, HTML, XML, Win Runner, Load Runner,Oracle, Visual Studio

Confidential,CA Feb2006 - June2007
Role:Sr. Business Analyst

Project description:
Pfizer Inc is a leading drug manufacturing pharmaceutical company and global leader in health care Industry.
Project involved Web-based application called EDR (Electronic Data Reserve) database for storing user files.
Key Roles and Responsibility:

• Reviewed business process, URS, and functional requirements.
• Aided documentation of computer system validation lifecycle per FDA regulations.
• Assisted in process modeling; conducted and participated in JAD sessions with system users; helpe with design walkthroughs with stakeholders for base lining architecture.
• Involved in detailing project mission, data process flow diagrams, and timelines.
• Worked with SQL queries for data manipulations.
• Participated in Design walk-through with SME’s to baseline the business architecture.
• Prepared Logical Data Models that contains set of diagrams and supporting documents containing the essential business elements, detailed definitions, and descriptions of the relationships between the data elements to analyze and document business data requirements.
• Coordinated with the development team, database team, data warehousing team and QA team throughout all phases of the RUP methodology.