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Profile of Qualifications

Hardworking and self-driven Business Systems Analyst with over five years of progressive experience in requirement gathering and business process management. Efficient, committed and detailed with strong proficiency in designing, developing and implementing innovative processes and system solutions within the healthcare Industry. Thrives as an independent contributor or cross-functional team member in fast-paced, deadline-driven environments. Seeking a senior-level Business Analyst role with an innovative and reputable healthcare organization.


Core Competencies

Teambuilding & Leadership Interpersonal Communication Time Management & Multitasking Strategic Planning & Analysis

Critical Thinking Problem Solving Government Sponsored Programs (Medicare, Medicaid, etc.) CDHP Requirements Documentation

Project Management Care Management & Transition Client Requirements Gathering Business Writing Process Modeling Data Flows

Workflow Analysis Sequence Diagrams Test Cases Ÿ Regulatory Compliance Cube Processing OLAP Databases

GAP Analysis Data Analysis Methods Data Warehousing Structures



SDLC Waterfall RUP Agile Healthcare Systems (ITS, QNXT) EDI transactions 837, 834, 835, 270/271

ICD9/ICD10 HCPCS, CPT ICD Codes ORU & OUL Messages UAT (User Acceptance Testing) OLTP/OLAP

HIPPA 4010 HIPPA 5010 EDI X12 HL7 SEC 326 USA Patriot ACT Windows Linux Ÿ MAC Ÿ Visual Basic 6 Ÿ UML

MS Office MS Access MS Visio SharePoint Rational Clear Case Rational Rose Rational SoDA Rational Clear Quest

SQL Server Object Explorer Version 11 Mercury Test Director HP Quality Center JIRA Ralley Oracle

Microsoft Visual Studio 2012 Balsamic Notes For Author Ÿ Data Mapping & Modeling

Professional Background

Allscripts, 2015-Present

Senior Business Analyst

Liaise with hospitals and eligible professionals to drive compliance with Meaningful Use Standards in order to help them join the CMS (Center for Medicare and Medicaid Service) E.H.R. Incentive Program. Develop and implement mapping documents via SQL and data manipulation, as well as access both source and target databases. Create and maintain meaningful use reports by accessing measures and documenting data points from the metadata database. Play an active role in Daily Scrum team meetings to review daily goals and discuss project scope. Devise design documents and attach wire frames to illustrate product changes and reporting standards. Craft user stories release notes to showcase capabilities within the current release, as well as solved bugs/defects.

         Worked with CMS subject mater experts and stakeholders to successfully submit QRDA 1 and 3 files electronically in alignment with relevant CMS standards

         Conducted independent research and worked with Scrum team to evaluate and document Allscripts user guide steps

o    Done in order to create a report in instances when a reporting model was not used as a data source and stored procedures were utilized instead

o    Shaped a comprehensive, updated list of stored processes by accessing the Allscripts report builder


UnitedHealth Group, 2014-2015

Business Analyst

Measured and analyzed discrepancies identified from enrollment/eligibility files (834 transactions) and payment files (820 transactions) to outline/initiate improvements and ensure control of the processing gaps. Collaborated with Development team to document requirements and automate files. Streamlined database process to make it more efficient using Agile Scrum. Managed software system development and integration projects through all lifecycle phases, e.g. analysis, design, development, testing, execution and post-production support. Liaised with various stakeholders to elicit key data points for enrollment; mapped the points within the system using documents that illustrated and matched source and target data. Conducted functional requirement reviews and walkthroughs with designers, developers and stakeholders. Met with IT teams to sign-off meetings, finalize requirements. Utilized JAD sessions to allow stakeholders to communicate perspectives with one another, resolve issues and construct an agreement. Tracked stakeholder-requested enhancements and changes using Requirement Traceability Matrix (RTM). Played a key role in gap and feasibility analyses to design and build the new application. Used Quality Center to log defects and manage defect history. Facilitated the User Acceptance Testing (UAT) for the application in conjunction with the QA team.

         Resolved functional concerns and internal systematic issues via weekly meetings with New York State Exchange (NYSE)

         Created high-level Use Cases from business requirements; created UML diagrams using MS Visio and Swim Lane Diagrams in order to separate and better illustrate data flows



Business Analyst, Continued

         Automated 834 enrollment files; worked to remove human intervention from enrollment processes

         Used SQL commands and queries to test the database for records that detect and submit functional acknowledgement and remittance advice within the enrollment application

         United with the Quality Assurance Team to design and execute test plans and cases using the Quality Center


Life Time Health, 2012-2014

Business Analyst

Enhanced existing EDI transactions in accordance with HIPPA transitions; project also involved ICD 9 to ICD 10 transition using RUP methodology. Partook in the initial Impact Analysis (ICD-10) for all critical functions, including membership/enrollment, claims, utilization management, medical policy, reporting, vendor relations, etc. Conducted working sessions to gather and document business requirements; detailed high-level requirements for different business units impacted by ICD10. Coordinated with Business Owner, Application Vendor, Business Project Teams, payers and clearinghouses to execute processes and mitigate impact to current revenue flow under 5010 compliance requirements. Conducted JAD sessions with stakeholders and system users to collect the software requirement specifications (SRS) and used Requisite Pro to maintain all requirements. Analyzed testing results to ensure that they followed Gap Analysis.

         Worked with an internal team to effectively document impact analysis on 5010 upgrades and ICD-10 conversions; defined the conversion mapping process using the GEM (General Equivalency Mapping) crosswalk file

         Diligently worked on ETL mappings, as well as analysis and documentation of OLAP Reports

         Developed data modules on Erwin and created databases using SQL

         Created use cases and data flows to analyze the impact of ICD-10 diagnosis codes embedded in different systems/applications

         Gathered and validated application inventory, interfaces, and reports that needed to be amended to comply with ICD-10

         Performed back-end testing using SQL queries; developed test scenarios and cases for testing functional requirements


InHealth Mutual, 2010-2011

Business Analyst

Focused primarily on the growth and enhancement of clients Health Insurance Correspondence Department. Served to boost the Correspondence Department s ability to incorporate Medicare compliance for insurance ID card generation and disbursement. Called on RUP methodology to arrange and refine processes and related standards. Gathered, documented and confirmed business requirements. Worked with the Project Manager to plan and organize project activities through intentional and effective communication with Managers. Communicated with key stakeholders to implement systematic changes when upgrading ID cards. Operated with the Correspondence Department to document logic for IDs and help understand the logic behind requirements. Conducted JAD sessions with Business Owners, SMEs (Subject Matter Experts) and marketing team, for requirement gathering in definition stage. Worked with SMEs to automate the company s internal system in order to resolve existing issues. Prepared business workflow diagrams using MS Visio

         Met with business partners to define requirements, determine solution alternatives and develop high-level designs and estimates

         Crafted Business Requirement documents; key elements included use cases, functional requirements and GAP analyses

         Established test scenarios and cases used to evaluate functional requirements; enhanced test cases and scripts by adding required functionality as per new requirements

         Checked in with the Development Team to generate error reports based on issues varying in scope and priority

         Worked in conjunction with clients as it pertained to the final signing process in the User Acceptance Stages



Bachelor of Arts, Economics, Rutgers University


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