Sr Business Analyst available for c2c roles.... REMOTE Only
Name : Anusha
Skill : . Business Analyst
Visa : H1B
SUMMARY
· Expert knowledge in Medicaid, Payor Systems and Managed Care Organization business including Pharmacy Benefits Management System, Claims Processing and Prior Authorization.
· 6 years of business systems analyst experience in gathering techno – functional user requirements, requirements analysis and documenting them to Business Requirement Documents (BRD), System Requirement Specifications (SRS).
· Worked on all phases of SDLC possesses expertise to validate and test multi-tier, scalable, web-enabled business applications include Regression Testing and User Acceptance Testing.
· In depth knowledge of UML in visualizing and documenting the artifacts using Use Cases diagrams, Class diagrams, Sequence diagrams, Swim-lane Diagrams, and Collaboration diagrams in MS-VISIO.
· Experience communicating with Subject Matter Experts (SMEs) and Clients (business users) in performing requirements gathering, business analysis, data analysis and documentation.
· Experience in facilitating Joint Application Development (JAD) sessions and White Board Sessions with end-users, Subject Matter Expert (SMEs) team, Data and System Architects.
· Hands on experience in working with Cross Functional teams, converting the data requirements into business requirement documents (BRD’s), Functional Specification Documents (FSD) and Technical Requirement documents (TRD).
· Experience in SQL queries for data validation at backend in SQL.
· Experience in using SOAPUI and Postman for testing SOAP API’ for REST API’s.
· Strong understanding of Gap Analysis, Requirement management, Risk analysis and project plans.
· Efficient in Share Point Server for managing documentation for the project.
· Excellent experience with Data Mapping, Data Analysis and Data Profiling.
· Used SQL Assistant, TOAD to write SQL and query the Teradata database table.
· Solid experience in backlog grooming, Project Story board, capacity planning, tracking burn-down charts with business and technical teams.
SKILLS AND EXPERTISE
Microsoft Office
Word, Excel, Access, Visio, Outlook, PowerPoint
Project Management Tools
Microsoft Project 2016/2019 and other tools
Project Methodologies
SDLC, Agile, Waterfall, SAFe Agile
Requirement Management Tools
Rational Requisite Pro, Team Foundation Server, Wiki, Jira, Kanban, Rally
Databases
SQL Server 2008/2012/2016/ 2018, DB2, Teradata, Oracle11g/10g
Languages
TSQL. Teradata, Oracle, IQL
Operating Systems
Windows 10/7
Business Modeling Tools
MS Visio, Rational Requisite Pro, Rational ClearQuest
Certifications:
Scrum Master Accredited Certification
License: 29113000695593
PROJECTS
Indeed,
Austin, Texas(WFH) Nov 2021- Present
Business System Analyst
· Lead and conduct business analysis to elicit requirements and create governance as the foundation for IT solutions to meet business needs (e.g., workshops, focus groups, interviews, observation, brainstorming, and JAD Sessions) and organize into traceable, testable, and verifiable data and business formats.
· Facilitate change management and manage expectations effectively to identify, track and escalate constraints/risks and communicate timely to appropriate stakeholders using standard RAID processes.
· Advisor to business stakeholders regarding proposed solutions for IT applications.
· Created workflows and complex process flow diagrams during the requirements gathering phase.
· Experienced in business process mapping, Data Flow Diagram, Context Diagram, Business Process Model, Root Cause Analysis, Gap analysis, preparation of functional and technical specifications.
· Worked closely with our UX and Designing teams to update our web-based applications, products and define multiple surveys and survey distributing tools.
· Worked with Qualtrics team to define the current state and design future state for surveys that are distributed to Internal and External customers of Indeed.
· Involved in writing SQL queries and joins for retrieving variables, response rates and page views/clicks that are hosted in various databases and servers to support Developers in their tasks.
· Worked on the requirements for Data Profiling, Data cleansing and Data reporting
· Validate and verify requirements throughout the system development life cycle (SDLC) to ensure systems perform to the required specifications and can achieve target goals for various IT interfaces.
· Lead and define efforts to ensure test plans (Unit testing, Functional Testing and End to End) and scenarios are created, as well as review and signoff on test results.
Environment: SAFe Agile, Google Suite, Lucid Chart, Jira, IQL, Teradata, MS Excel, Miro, Salesforce
Aetna, Jan2021 – October’21
WFH Columbus, OH
Business Systems Analyst
· Facilitated Requirements Sessions (gathering & analysis) to seek current Data Mart schemas with data table layouts. Analysis included validation of active and obsolete data fields.
· Collaborate with Product owner and Architecture team for Solution Sessions to ensure gaps are filled with technical/business solutions and future state system is complete with requirements. This include detailed evaluation of current functionalities to establish whether enhancement is required or to implement same in future development.
· Created workflow rules and defined related tasks, time triggered tasks, email alerts, field updates to implement business logic.
· Developed Data Transformation and Data Validation Rules for reconciling data ensuring togetherness of historical and current data, consistency in synchronized data across transactional Provider System and Enterprise Data Warehouse.
· Integrating Health care Application data under HIPPA and PCI compliance guidelines staging and hosting on Cloud Servers.
· Performed Gap Analysis between the “AS-IS” system and “TO-BE” system to identify technical and business gaps.
· Document System Design Procedures, Data Flows, Business Requirements, Technical Specifications, User Acceptance Criteria (references to Quality Standard Acceptance).
· Develop User Stories with use cases that include main flow and alternate flow of business logics that a developer uses to code them to future state system.
· Used Postman to test Web API functionality
· Develop Test Cases with Test Procedure to ensure Quality Analysts perform system testing per agreed procedures and with provided test scenarios and test data.
· Resolve system program issues and defects ensuring normalcy of system is restored.
Environment: SAFe Agile, Rally, SharePoint, MS Visio, MS Excel, MS SQL 2018, Postman.
Cardinal Health, Dublin, OH Jun2020-Nov2020
Business Systems Analyst
· Writing user stories for IDS Conductor workflow models with the help of wireframes using iRise.
· Followed agile methodology for acceptance criteria based on user stories associated to each sprint
· Developed stories and documented alternate scenarios for bringing the catalog and Service Contract
· Wrapped up the technical documentation for integration points such as customer data, Service Contract data and pricing.
· Facilitating meetings with SMEs to gather requirements to enhance, build and support existing/new applications.
· Facilitating sprint, daily scrum stand-up & sprint retrospective meetings.
· Creating/updating (Epics, Stories and Tasks) in JIRA Agile application.
· Performing GAP analysis by the AS-IS process. Create strategic approaches that to facilitate a focused discussion which involves different business segments.
· Performed Risk Analysis on identified requirements and checked for their feasibility and created an approach and raised an issue log for the billing and the logistics of OPAL.
· Develop detailed functional specs through sessions, interviews, on site meetings with business users & development team.
· Create end to end Business Process workflow for high level and detailed scenarios.
· Working with developers on proof of concept to make sure application design as per the requirements.
· Translate business and functional requirements and user expectations into detailed specifications employing use cases and user stories, sequence and activity diagrams using MS Visio.
· Understand functionalities of existing applications by working in test environment.
· Ensured issues were quickly identified, tracked, reported on, and resolved in a timely manner
· Developed, documented, the User Acceptance testing as a means of measuring customer satisfaction and improvements to internal process
· Report all the issues related to the newly implemented system/ application and perform additional task as required for the project.
Environment: Kanban Agile, JIRA, Google Cloud Platform (GCP), Microsoft Suite (MS-Project, MS-Visio, MS-Access, MS-Share Point, MS-Excel), iRise
State of Illinois Department of Health Care and Family Services May 2018 – June 2020
Springfield, IL
Business Systems Analyst
IMPACT project is a comprehensive replacement and enhancement project of Illinois’s Information Technology Infrastructure. This project is currently focusing on replacing Illinois’s over 35-year-old Medicaid Management Information Systems (MMIS) with web-based Advanced Cloud Technology which includes Provider Enrolment System, Pharmacy Benefits Management System, Integrated Eligibility System and Core MMIS Applications.
· Determine operational objectives by analyzing business functions and eliciting requirements from State Departments/Bureaus. Analyze elicited business requirements, conducting requirements analysis (gap analysis, feasibility analysis, impact analysis, decision matrix and acceptance criteria) and identify gaps between As-Is and To-Be systems and working towards deriving solutions using results from requirements analysis.
· Provide Subject Matter Expert services with Medicaid and Medicare business knowledge and associated technical expertise on Claims & Encounters Processing System, Pharmacy Benefits Management System and other associated MMIS upgrade/replacement systems (ex. Prior Authorization, Cognos Reporting System).
· Configured Benefit Plans for the Eligibility Enrollment by having brain storming sessions with the business. Updated the benefit plan matrix as per the changes for every fiscal year.
· Perform Systems Analysis on current program logics (referred as Edits), data mappings to establish reliability, reusability and identify potential accommodation capabilities into new computer program logics. (additions/deletion/amendment and test for system integration for potential defects on test environment. Current system is COBOL programmed on IBM Mainframes environment and web-based User Interfaces with .NET environment.
· Perform Database Administration using Teradata SQL Assistant tool including data extraction, generating data reports depending on requirement, create data crosswalks using multiple data models, perform data conversions, validate application interface data file layouts and EDI file layouts (270/271, 276/277, 837/835, 834/820, 278).
· Extract, Analyze and reconfigure ‘edits’ for loading and adjudication of claims using IBM Mainframes and RuleIT code engine.
· Converted mainframes health records to ‘Electronic Health Records (EHR) and implemented them in a phased approach using IBM Mainframes.
· Perform Data Analysis on historical data using Teradata SQL Assistant and BI Query to create/update business rules, write data conversion/transformation rules, set data indicators, modifiers, create new data file layouts, and write/update stored procedures and data flows.
· Write Use Cases, User Stories and Epics with functional and non-functional requirements.
· Develop functional test plans, create test scenarios, write test cases, test scripts. Perform System Testing (system integration, regression and UAT).
· Coordinate Change Requests on new business rules/program logics/data validation and other associated as appropriate. Creating the hand-off documents for incremental code releases.
· Build Concept of Operations for applications including Business Continuity & Contingency Plan and prepare technical documentation required for Software System Certification by Federal Government Agency, Centers for Medicare & Medicaid Services (CMS).
Environment: 3M Core Grouper (v 2019.0.0), Rapphl – 2N (v Web server 1999), As-One ES (v 13.8), Teradata SQL Assistant (v 15.10.0.2), Open Text BI Query (v 10.5.1.1.18), IBM BlueZone Mainframes (v 6.2.2325), Sandbox (v 1.2.0.4), Archimate, Microsoft Suite (MS-Project, MS-Visio, MS-Access, MS-Share Point, MS-Excel).
Cigna Health, TN Jul 2016 – May 2018
Business Analyst
· Writing user stories for enhancements to existing claims processing workflow models for efficient edit processing and lowering adjudication turnaround times.
· Expertise in EDI 837 (I/P/D), EDI 270/271, EDI 278 (Prior Auth). Processed Encounter claims for reporting purposes and interacted with Ohio State Medicaid for reporting Capitation Program.
· Followed agile methodology for acceptance criteria based on user stories associated to each sprint.
· Developed stories and documented alternate scenarios for bringing the catalog and pricing online.
· Wrapped up the technical documentation for integration points such as customer data, store data and pricing.
· Cleaning of user story backlog and updating the project timelines and scope.
· Captured As-Is state of existing process through Visio.
· Facilitated workshops to capture complete and meaningful use cases.
· Developed functional specifications and system design specifications based on client wants.
· Ensured issues were quickly identified, tracked, reported on, and resolved in a timely manner.
· Developed, documented test cases for applying the art of User Acceptance testing as a means of measuring customer satisfaction and improvements to internal process.
· Applied change management where needed and logged CR’s accordingly.
· Worked as a liaison between technical teams and the business.
· Assisted in enforcement of project deadlines and schedules.
· Consistently delivered high-quality services to our clients.
Environment: Agile, JIRA, MS Visio, MS Share Point, Edifecs SpecBuilder, Teradata SQL Assistant, MS-Office 365.
UCare, Minneapolis, MN Jan 2015 – Jun 2016
Business Analyst (Offshore)
· Responsible to lead the unit as lead to reach the project timelines effectively.
· Identified stakeholders' requirements and validated them with implementation and Quality-of-Service requirements.
· Gathered and reviewed the Business Requirements Document (BRD) with the business users, Subject Matter Experts (SME) and included representations from the technical team as well and submitting RFP to external vendor.
· Gathered the requirements for Medicare products.
· Responsible for creating weekly/monthly/quarterly extracts and transmitted to a third-party vendor. Extracts like Medical Claims, RX claims, Member Data.
· Responsible for architecting integrated HIPAA, CRM, Medicare solutions, Facets.
· Gathered requirements, AS-IS and TO-BE for migrating the data source for HIPAA.
· Generated Data Mapping documents to define mapping sourcing from data warehouse.
· Responsible for Data Requirements/Mapping Documentation as related to the redirection or sourcing of the application to the Integrated Data Warehouse.
· Worked with the development team to make sure that they understood the user requirements and that the system developed met those requirements.
· Worked in a team with ETL developers and process analyst in preparing the requirements and writing workflows and process flows.
· Assisted the ETL Team during Data Mapping, Data Integration, Process Mapping and Process Integration.
· Wrote SQL Queries to analyze the data in the Data warehouse.
· Proficient knowledge of tools such as Jira with Green Hopper and Rally for backlog management.
· Worked with the Project Manager on various project management activities like keeping track of project status, deadlines and compliance issues.
· Responsible for cross coordination, communication, estimation, management and for the assigned deliverables with in-house and offshore leads.
· Coordinated with End users/clients about the File target location process.
· Validated the source date from IDW to Target Mappings.
· Performed source data quality assessments.
· Developed Complex SQL Queries using Teradata SQL Assistant.
· Assisted the Data Architect to ensure the Data Architecture is applied properly.
· Resolved the data type inconsistencies between the source systems and the target system using the Mapping Documents.
· Interfaced with marketing for product demonstrations and documented incidents and enhancement requests in IBM Rational ClearQuest.
· Responsible for final documentation reviews, approvals and sign offs.
· Responsible for the coordination of the SIT testing with testing team.
· Responsible for the coordination of the UAT/BAT testing with the end users of the deliverables.
Environment: MS SQL Server, Waterfall, Informatica, JIRA, Windows XP, MS-Office, XML, Teradata SQL Assistant, IBM DB2, IBM Rational Requisite Pro, IBM Rational ClearQuest, Crystal Reports.
Thanks & Regards
Naveen
Team Lead- Sales
TechSmart Global Inc.
666 Plainsboro Rd, Suite 1116, Plainsboro, NJ 08536.
