Summary

5+ years of Healthcare industry experience as Business Analyst in Healthcare with solid understanding of Business Requirements Gathering, Business Process Flow, Business Process Modeling and Business Analysis. Adept at Business Requirements Gathering and expertise in the documentation of Business Requirement Documents, Use Case Specifications, Functional Specifications, System Requirement Specification (SRS), Workflow and UML Diagram such as Activity Diagrams, Class Diagrams and Sequence Diagrams. Solid Experience in developing Scope/Vision Documentation and Project Plan, as well as tracking Project Process, and manage resources to ensure successful delivery Strong understanding of Rational Unified Process (RUP) using Rational Rose, Requisite Pro, Unified Modeling Language (UML), Object Modeling Technique (OMT), and Object Oriented Analysis (OOA). Extensively used Microsoft Project, Word, Excel and Visio. Extensive experience in the development, implementation and integration strategies within a team oriented environment, utilizing quantitative and qualitative analytical skills. Involved in conducting GAP analysis and User Acceptance Testing (UAT). Involved in creating, editing, and coordinating extensive communication networks (facilitation of Joint Application Design (JAD) sessions and interviews, written correspondence, reports, implementation requirements, project status reports, oral presentations and email), to keep executive staff and team members apprised of goals, project status, and resolving issues and conflicts. Sound knowledge of Project management principles. Very good knowledge of HIPAA rules & procedures.

• Well versed with 4010A and 5010 Versions of HIPAA Transactions.
• Knowledge of HIPAA Certification process CMS Certification.
• Excellent communications and interpersonal skills.

Professional Experience

Confidential,Boston MA

Confidential,Health Department is developing NewMMIS system for centralizing the all Healthcare related transactions all over the state. They are replacing old & cumbersome system to the NewMMIS.

Responsibilities:

• Coordination between all HIPAA transactions workgroups for various activities.
• Assist with the Development and Validation of MMIS documentation. i.e. HIPAA Companion Guides, Implementation Guides, HIPAA EDI Transactions etc.
• Coordinate with the SME & BA to evaluate proposals and make recommendations to the Procurement Management Team & Trading Partner Agreement Team.
• Lead, facilitate, and support workgroups and other activities to address key project issues. i.e. Notices workgroup, Documentation Workgroup, HIPAA, PAG, etc.
• Assist with the validation of Functional Requirements with the NewMMIS Vendor.
• Participate in systems design (i.e. Joint application design [JAD]) sessions.
• Maintain liaison with SMEs & BAs to coordinate and facilitate key project issues.
• Review specific project documents as required (i.e. Detailed Systems Design, communication, etc.) and coordinate the functional teams’ response to the vendor.
• Review & support the development of test scenarios, cases, and outcomes as required.
• Participate in User Acceptance Testing and coordinate related issues with SMEs and BAs.
• Support the Development of Training Curriculum, Approach, and Review of documentation as required.
• Coordinate with SMEs, BAs (as required), and the Business Process Re-engineering (BPR) vendor to Develop and Implement new/revised Business processes as required.
• Coordinate with the SMEs and BAs to support the development and implementation of interfaces with key business partners.
• Coordinate with the SME and Change Management and Implementation Manager to Plan, Develop, and Implement key strategies and approaches.
• Coordinate with the SMEs and BAs to Identify, Track and Resolve key Project Issues for each functional area.
• Facilitate, Lead, Participate in, and Support other related project activities as required.
• Working with 4010A and 5010 Versions of HIPAA Transactions.
• EDI X12 Transactions Mapping from Legacy to new MMIS Systems.

Business Analyst – hipaa

Nov 2007 – Till Date

Confidential,

Responsibilities:

• Participates in driving out business, functional, and technical requirements.
• Creates detailed design specifications for technical requirements which are delivered to offshore vendors for coding and testing.
• Participates in leadership a group which coordinates all phases of testing, monitors requested requirement changes and takes responsibility to accept or reject proposed changes depending on impacts to all associated projects.
• Use of MMIS for claim processing services.
• Use of HIPAA procedures for Claims processing.
• Key contact point for internal and external vendor relations; acts as an IT Liaison, contributes to third party business impact analysis.
• Represents projects as application lead through all phases of the project life cycle.
• Collectively works with several project team leads to ensure all requirements are met, cross project milestones are identified, and testing is completed on time, within budget, and meeting the quality guidelines.
• Prepares knowledge transfer plans of all new work being transitioned to an internal department for future questions, maintenance, and/or enhancements.
• Leads project management tasks including, scope definition, project resource allocations, project planning using Microsoft Project, provide and monitor weekly status, ensure the project is within the allocated budget, and track all changes determining if escalation to upper management is needed.
• Work with implementation and testing teams to ensure the products are delivered within expected time frames and meet all enterprise quality standards.

Business Analyst

Jan 2007 – June 2007

Confidential,Haskell NJ

Responsibilities:

• Utilized Rational Unified Process (RUP) and developed business process flows;
  system flows; validated object-oriented design methodology.
• Determine reengineered, ideal business processes.
• Conducted GAP analysis with the current systems and desired functionality.
• Developed business rules.
• Reverse engineered code, develop naming conventions; perform data analysis.
• Facilitated JAD/JAR discussion sessions with users, analyzed information from users,
• Including oral and written feedback, customer responses and user behavior.
• Performed Use Case Requirements Gathering, Use Case, Collaboration, Sequence Diagrams, State Diagrams, and Class Diagrams along with Test Architecture at all levels throughout the software development life cycle (unit, functional, feature and system) per RUP/UML/J2EE component service based structure methodology.
• Performed Requirements Analysis to understand user needs for US Donor Blood Bank data &Toxicology/LAR/Pharmacology n-tier system.
• Facilitated the development of Business and System Use Cases.
• Performed/mentored in systems analysis design and architecture activities.
• Performed/mentored in object-oriented modeling and design using the UML.
• Produced/mentored in Domain Models, Class Models, Activity Diagrams, Sequence Diagrams, State Diagrams and key process flows.
• Developed system requirements based on user & functional needs.
• Supported the design of user interface for web-based applications.
• Functioned as the Team Leader in the development of a requirements gathering and requirements management process.
• Developed Requirements and maintained traceability throughout all documentation by using Requisite Pro, Rational Rose, Rational and Clear Case.
• Involved with ETL process for extracting data from outside sources, transforming it to fit business needs and ultimately loading it into the data warehouse

Business Analyst

Nov 2005 – Dec 2006

Confidential,VA

Responsibilities:

• Over all Project Management, preparing project plan, risk analysis, resource allocation, timely delivery in terms of milestones.
• Involved in Business Process Assessment, Requirements Gathering, Gap Analysis and converting these into technical document and briefing it to tech lead of the team.
• Assisted in defining and creating proprietary formats.
• Developed several Test Scripts for testing EDI transactions.
• Involved in Quality Assurance.
• Master Patient Index Creation & operations.
• Design, Analyze and Test customized industry standard type to suit the needs of the client.
• Evaluate and correct Test plans, Test cases and Test Requirements.
• Prepared methodology design functionality specification.
• Involved in system testing & acceptance testing.
• Involved in creating flow charts and record layouts for 271 transaction sets.

Business Analyst

Sept 2004 – Oct 2005

Confidential,India

Responsibilities:

Assisted client in development of business requirements, including identification of opportunities for improvement and optimization of business processes.

• Utilized Rational Unified Process (RUP) and developed business process flows, system flows, validated object-oriented design methodology.
• Determine reengineered, ideal business processes.
• Conducted GAP analysis with the current systems and desired functionality.
• Developed business rules.
• Facilitated JAD/JAR discussion sessions with users, analyzed information from users, including oral and written feedback
• Performed Use Case Requirements Gathering, Use Case, Collaboration, Sequence Diagrams, State Diagrams, and Class Diagrams at all levels throughout the software development life cycle (unit, functional, feature and system) per RUP/UML/J2EE component service based structure methodology.
• Facilitated the development of Business and System Use Cases.
• Performed/mentored in Object-Oriented Modeling and design using the Unified Modeling Language (UML).
• Developed system requirements based on user & functional needs.
• Supported the design of user interface for web-based applications.
• Validated & verified the satisfaction of requirements in system design.
• Functioned as the Team Leader in the development of a requirements gathering and requirements management process.
• Developed Requirements and maintained traceability throughout all documentation by using, Requisite Pro, Rational Rose, Rational and Clear Case.
• Created Test strategy and a Test Plan document to define the coverage of testing to be performed during the testing phase.

Business Analyst – Healthcare Management System

Jan 2003 – Aug 2004