Business Analyst

Ghanshyam

Experience Summary:

*+ year of experience in Finance, Healthcare & Insurance as a Business Analyst 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.

Outstanding expertise creating Decision Memos, Service-Level Agreements (SLA) and Standard Operating Procedures (SOP).

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).

Extensive work with various Rational tools like RequisitePro- Requirement gathering/maintenance, Use Case document maintenance, Clear Case- version control and Clear Quest/Test Director for bug tracking, Rational Rose for Use case diagrams, Sequence diagrams and activity diagrams.

Familiar with file 834 and 5010 data transmission with health providers.

Proficient in creating Traceability matrixes for various system interactions.

Extensively used Microsoft Project, Access, 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.

Supported Integrations of deliverable with legacy mainframe systems.

Worked With the Project Manager (PM) in handling the whole Project

Familiar with CMM, SEI, Six Sigma compliances, ISO-9000 and Total Quality Management Principles

Extensive knowledge of claims submission using HIPAA X12 Version 5010.

Excellent Communication and Analytical skills.

Technical Skills:

Methodologies

RUP, UML, RAD, Agile

Change Management Tools

Rational Clear Quest, HP Quality Center, RequisitePro, Jira, Rally

Business Modeling Tools

Rational Rose, Microsoft Visio

Version Control Systems

Rational Clear Case

Project Management

Microsoft Project, Microsoft Office.

Databases

SQL Server 2000, 2005, MS-Access, Oracle

Web Technologies

Microsoft FrontPage

PROFESSIONAL EXPERIENCE

MEDai, Orlando, FL (LexisNexis)

November 14 to May 15

Business Analyst

LexisNexis is a leader in providing essential information to help customers across industry and government assess, predict and manage risk. MEDai provides health analytic solutions to Providers, Commercial Health Plans, Third-Party Administrators, Self-insured, ACOs, Medicaid, State Agencies, Medicare Plans. I worked with two different projects;

1.PPM Performance Provider Monitor which employs advanced analytics that identify utilization of cost trends across networks. Users are able to drill down to individual physicians and patient profiles for details on the factors that are driving costs and impacting quality of care.

2.PHM Population Health Monitor which uses sophisticated predictive modeling to translate data into meaningful, quality information for better population health management.

Responsibilities:

Identify the client/organizational needs and provide suitable agile system based solutions.

Communicate with clients and inform the organization about the customer business needs and specifications.

Make certain the user stories are good, comply with acceptance criteria, have sufficient business value and selling points.

Guide the development teams to break down large and complex user story into simplified versions for execution.

Test the user stories for accuracy and compliance to ensure undisputed acceptance and validation of stories.

Use agile systems and strategies to provide quick and feasible solutions, based on agile system, to the organization.

Interface with internal and external clients continuously to maintain effective communication and coordination.

Coordinate activities with software developers, stakeholders, project managers and software testers.

Prepare and send weekly and monthly progress reports and keep the clients updated about the software under development.

Environment: .NET, JAVA, Rally, Jira, Axure, MS Suites, Agile.

Florida Blue, Jacksonville, FL (BLUE CROSS & BLUE SHIELD OF FLORIDA)

March 13 – September 14

Business/Product Analyst

Florida Blue is a not-for-profit health solutions company in State of Florida. I worked with Ancillary Product Development team as analyst at corporate office Jacksonville. The Ancillary Product owns about 30 different products in different LOBs like Consumer, Commercial, and Medicare. I have worked with different projects; implementing health embedded Pediatric Dental/Vision plans in 2013. Also, worked with Medicare team adding Over-the Counter (OTC) product to Medicare Advantage plan. Other than implementing products, I’ve been engaged in different Ancillary Products Maintenance and Management effort within ancillary team. Other product management coursework with ancillary team includes; Vendor Co-ordination, Daily Reporting,

Product Research, Competitive Analysis, Cost Analysis, Revenue Forecasting, Defining Processes/SOP’s, Creating SLA’s, Statement of Works for Contacts, and Decks for Leadership.

Responsibilities:

Facilitated Ancillary Product in all phases from Idea Generation to Implementing new product.

Assisted defining Change Management Process for Release Management Team.

Mapped process flow; assess as-is process through user interviews, data collection and analysis, design and evaluation of to-be process solutions.

Prepared Business Object / Business Process Models that included modeling of all the activities of business from conceptual to procedural level.

Created Service Level Agreements for Dental and Vision service providers.

Defined complex process and documented Standard Operating Procedure.

Performed detailed Ancillary Products Research for different products in idea generation stage.

Implemented pricing tables for different products working with external underwriting vendors

Developed data conversion programs for membership, claims, and benefit accumulator data - converted thirteen corporate acquisitions. Developed data field mappings. Provided programming and support for claims processing functions and auto-adjudication.

Teamed up with both internal and external software development groups to provide functional requirements specifications in form of use cases, business process flows, and prototypes and management reporting requirements

Created the business process model using MS Visio for better understanding of the system and presented it to Project Manager and other team members for validation.

Assisted the Project Manager to develop both high-level and detailed application architecture to meet user requests and business needs.

Assisted creating MLRT training deck for new product market launch for agent, vendors, internal employee and sales department.

Performed detail business migration analysis for Stand-alone Group-Vision product.

Co-ordinated with marketing creative services developing sales collaterals materials for new and existing ancillary products.

Co-ordinated work with Medicare Team on implementing Compliance changes to Medicare Advantage embedded Dental and Vision products.

Defined roles and responsibilities of participants in the business process.

Developed Customer Service Inquiry chart for Dental and Vision providers.

Led and conducted JAD sessions for requirements gathering, analysis and design of the system.

Created context and workflow models, information and business rule models, Use Case and Object Models during the analysis using rational tools.

Designed and developed project document templates based on SDLC methodology

Environment: InfoBank, eRate, Adobe Pro, Requisite Pro, Rational Rose, PL/SQL, HTML, MS Office, MS Visio, EDI, Rational Clear Quest, Rational Clear Case, UML, RUP.

Flagstar bank, Troy, MI

September 11 – March 13

Business Analyst

Flagstar Bank is a Michigan based financial institution that provides residential mortgages throughout the country and also provides banking services for customers in Michigan, Indiana and Georgia through retail bank branches. Additionally the bank provides consumer and commercial banking services to its existing customers thought the country. I worked as analyst assisting implementation of LPS (Lender Process Services /MSP (Mortgage Services Platform). I worked with Financial Functionality stream as well as General Ledger Interface stream. This project was about how loan service platform will work after customization of MSP.

Responsibility:

Defined and developed business functional requirements and participate in technical walk-through meetings to develop the functional design for the implementation.

Facilitated requirement gathering sessions with the business team to collect the business reporting standards, security and service level requirements, and documented them using RequisitePro.

Documented Requirement Traceability Matrix in RequisitePro for traceability of requirements through test cases.

Prepared Business Requirement Document (BRD), Functional Requirement Specification (FRS) document and Data Dictionary containing functional definitions and process details.

Conducted sessions with business users and technical units and (JAD) sessions with IT Group.

Worked closely with project management to keep track of the status of project and draft strategies for the near future.

Delivery of business requirements for all interfaces into a commercial lending origination and servicing system for a large straight through processing implementation and conversion project

Met with client groups to determine user requirements and goals. Utilized Rational Unified Process (RUP) to configure and develop process, standards, and procedures and create a Business requirement Document.

Developed RUP Analysis Model that included entity classes, use case diagram, sequence diagrams that provided a view of the requirements.

Analyze business requirements and segregated them into high level and low level Use Cases, Activity and Sequence using Rational Rose according to UML methodology.

Understand and articulate business requirements from user interviews and then convert requirements into technical specifications.

Wrote clear, concise detailed system requirements specification (SRS) documents and user documentation in accordance to guidelines and standards of a level where developers can interpret, design and develop the application with minimum guidance.

Designed Use Case Diagrams and wrote their specifications in the Use Case Specification documents based on the Requirements gathered.

Involved in walk-through meetings with development team to discuss related issues.

Used Rational Rose to visually determine the proper structure, key elements and optimal design for your database and to aid efficient creation of tables, stored procedures.

Analyzed the existing system and process gaps in context of new business changes (Gap Analysis).

Designed Use Cases, Use Case diagrams, Class diagrams, Activity diagrams, Sequence diagrams in UML methodology using Rational Rose.

Held group meetings, walkthroughs and supervised/trained other analysts.

Developed and maintained relationships with clients on all on-going projects.

Extensive interactions with the client and the management teams to understand the requirements and report the status of the testing efforts on their applications.

Environment: Oracle, HTML, and Windows, Rational Rose, RUP, UML, Gap Analysis, Lotus Notes, Change Point, Rational RequisitPro.

Assurant Health, Milwaukee, WI (FORTIS Health)

February 09 – August 11

Business Analyst/Systems Analyst

FORTIS insurance is one of the oldest companies that provide health insurance at a very minimal rate. I worked on web-based application that is known as Affordable Health Insurance. It is an online feature that finds valuable low cost health insurance plans. As this is an online system, you can get instant quotes, check benefits, apply online, be approved and be issued online right from the website. A combination of Microsoft Active server page (ASP) technology was used for an online application. An Oracle server was used as the database server for this web application.

Responsibilities:

Gathered business requirements by driving user-group meetings and working with various global, cross-functional and virtual teams by using Rational RequisitePro.

Consulted with healthcare third-party Administrator Company to develop conversion specifications for member, enrollment, and authorizations.

Responsible for business system analysis of customizing the BPS Risk Management product with involvement through the whole SDLC.

Teamed up with both internal and external software development groups to provide functional requirements specifications in form of use cases, business process flows, and prototypes and management reporting requirements.

Designed a claim processing system for the healthcare management client system. It allowed the user to inexpensively capture information regarding patient, summary of medical history, symptoms (ICD-9 codes), and treatment (CPT).

Used Test Director and Mercury Quality Center for updating the status of all the Test Cases & Test Scripts that are executed during testing process.

As a part of RUP process, involved in peer reviews of data architecture team and data models.

Utilized corporation developed Agile SDLC methodology. Used ScrumWork Pro and Microsoft Office software to perform required job functions.

Generated server side SQL scripts for data manipulation and validation and created various Snapshots and materialized views for remote instances.

Establish documentation for agile methodology for implementation with a very water-fall-centric development team.

Prepared Business Requirement Documents (BRD’s) after the collection of Functional Requirements from System Users that provided appropriate scope of work for technical team to develop prototype and overall system.

Worked on creating Functional Specifications, UI specifications and UI prototypes.

Involved in interactions with Subject Matter Expert, Project Manager, Developers, and the end-users in more than one JAD sessions. MS Project proved useful in coordinating activities with project manager and various other teams

Involved in setting up different configuration environment for compatibility testing and manual testing.

Managed workload, schedules and coordinated status review meetings with project managers, business managers and team members.

Authored progress and completion reports which were then submitted to project management on a weekly basis in MS project.

Worked in mainframe environment and used SQL to query various reporting databases.

Extensive experience in using collaborative tools like Mercury Quality Center to facilitate development across disparate teams

Developed business process models in RUP to document existing and future business processes.

Established RUP (Rational Unified Process) methodology and provided assistance in developing Use cases and project plans.

Provided management support to the off-shore End to End Integration / Regression Test Team

Prepared UAT Materials UAT Test Cases to include various steps involved for UAT and to have proper coverage of requirements

Interacted with the users and logged any defects, enhancements from the UAT and communicated them to the development team

Environment: MS Word, Excel, Visio, RUP, Access, and Project, MS SQL Server 7.0, HTML, XML, UNIX.

MetLife, Jersey City, NJ

February 08 – February 09

Business Analyst

This Project was developed for the users to purchase Unit Trusts, Insurance products, Investment products online. This also keeps track of their portfolio depending on the information provided by the user. They can do their retirement planning, education planning for their children. The planning results show their amount they need to save for their happy future. Depending on their needs & their strategy, this provides the good products they can buy online. Provides product analysis & keeps track of their Portfolio. From the administration side, it keeps track of all the policies information that was purchased & calculates the commissions accordingly.

Responsibilities:

Gathered Business Requirements through brainstorming sessions on global calls.

Documented the business logic and associated validation logic.

Designed and developed Use Cases, Activity Diagrams, Sequence Diagrams, OOAD using UML and Business Process Modeling.

Represented the business requirements in various alternative views such as analysis models, process flow diagrams and user stories.

Acted as a liaison between the development team, QA team and the Business team and resolved any conflicts due to change in requirements.

Consulted with healthcare insurance company to develop conversion specifications for other insurance Coordination of Benefits (including Medicare).

Involved in mentoring specific projects in application of the new SDLC based on the Agile Unified Process, especially from the project management, requirements and architecture perspectives

Worked on following applications Business Objects, Enterprise Architect, Microsoft Suite (Word, Excel, PowerPoint, Visio, Access, Project)

Introduced Agile and RUP methodologies to reflect liquid nature of front-office improving time-to-market

Provided suggestions and ideas more from a strategic and long term perspective.

Created Requirements Specification Document that translated business requirements into Technical specification including business and validation logic for ease of understanding to the development team.

Used MS-Visio for flow-charting, process model and architectural design of the application.

Designed and developed project document templates based on SDLC methodology

Analyzed and translated business requirements into system specifications utilizing UML and RUP methodology

Developed SQL queries using SQL Navigator to extract data from the target tables to prove the data mapping.

Involved in creating business processes and modeling diagrams using Rational Unified Process (RUP).

Ensured that all Lines of Business specifications were consistent in form and function to the Diamond Base System.

Environment: MS Office, SQL Server, MS Project, MS Access, Rational Clear Quest, Rational Clear Case, Rational Requisite Pro, Rational Rose, UML, RUP, MS Visio.

Education:

Bachelor of Business Administration, Gujarat University.

Masters of Business Administration, S.I.U.

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