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Click here or scroll down to respond to this candidateCandidate's Name - US CITIZEN
Email: EMAIL AVAILABLE
Mobile: PHONE NUMBER AVAILABLE
Summary
Diverse experience of 8 years in implementing IT projects. Proven ability to work cooperatively and
effectively with business, teams, and systems partners. Strong communication skills, both verbal and written,
with emphasis on gathering clear and detailed written Business Requirements, Test Plans, and Functional
Specification documents
Provider related experience in healthcare.Contract End- to End process that involves Enrollment,
credentialling, Contract Validation.
Understanding of Claims processing, membership, billing.
Collaborating with Quality Control, Project Managers, and Technical Leads to ensure Business acceptance.
Business Analyst with healthcare providers & part of Salesforce communities for the new Implementation
project , for Clients, that enable, spaces that work to facilitate collaboration and connection for employees,
business partners, and customers.
Tasks performed at most of the projects included translating requirements, producing reports and design
solutions to improve productivity and efficiency by maintaining regular contact with clients.
Develop use cases as a key communication tool between the business and technical teams.
Create and maintain functional models, process flows, and wire-frame diagrams.
Experience in documenting AS IS & TO BE States of the process.
Proven IT knowledge of business analysis process and functions.
Strong analytical and project management skills, including thorough understanding of how to
interpret customer business needs, model business functions, and translate them into application and
operational requirements
Demonstrating Strong collaboration, multi-tasking and organization skills in projects worked until now.
Strong oral and written communication skills, Leading lcommunication across different IT and business
teams, taking a lead role in coordinating efforts, utilizing proven knowledge of IT and roles and
responsibilities within the organization.
Creating Dashboards for tracking UAT Status & reports in Salesforce as needed
Strong experience working in Software Development Life Cycle (SDLC) using Agile, Scrum, Waterfall and
other client specific internal methodologies for various projects with large corporates.
Experience with Healthcare business applications with emphasis on the HC Delivery Life Cycle
With strong documentation skills performing tasks of writing business requirements specification, and
worked on Page layout field data definitions and maintaining the Requirements definition documents
that included Business requirements and Functional requirements.
Well versed with Building Salesforce In-App Guidance & Sales Enablement for LOB end users.
Hands on experience Gathering Requirements, interviewing senior level company officials, developers
and other Project team members to elicit requirements for documenting functional specification.
With excellent communication skills well versed in conducting Backlog grooming using Kanban board
for Sprint cycles.
Using Sharepoint to upload / share documents for access by team members.
Solid understanding of CRM centric business process, CRM best practices and ERP business process.
Remarkable experience, throughout, in supporting CRM applications Exceptional knowledge of
Salesforce.com, Microsoft CRM in healthcare domain
Strong organizational and presentations skills, thorough knowledge of Salesforce.com and CRM tools.
With strong project management and IT skills, comfortable with multi-tasking, & adept at understanding
how to interpret customer business needs, model business functions, and translate them into application
and operational requirements.
Extensive experience in using MS-Visio, Balsamiq creating Use Case diagrams, Swim-Lane Flow charts for
explaining end-to-end workflow to the non-technical audiences.
Experience in different sectors, planning and implementing large-scale enterprise data center migrations,
consolidations, build outs and operations.
Experience working with Web and Enterprise Content Management Systems (CMS) acting as Liaison among
the business, development and testing teams.
Strong experience working in Software Development Life Cycle (SDLC) using Agile, Waterfall, and other client
specific internal methodologies.
Well versed with SMART-SHEET ,Confluence tools to Update project status, add Project details in Pipeline
Matrix & make meeting notes .
Accelerate customer Business Transformation by leveraging Salesforce.com Innovations
Experience in of the following:
o Management Consulting o Atlassian JIRA user /
o Experienced end user of administrator
Salesforce
o Implementing custom Education
Salesforce solutions for Bachelors in Commerce, Mumbai University. India
Marketing, Tech Support teams 1988
o Data visualization and
reporting Working on CBAP & PowerBI Certification
o Working on a Scrum team Scrum Master Certified
o Experience
AmeriHealth Caritas
Philadelphia PA
May 2022 June 2023
Senior Business Analyst
Working on LIFT ( Leveraging Information For Tomorrow) project which is a CRM solution being
built to create a single enterprise-wide source of truth for end-to-end stakeholder and provider
relationship data management
As a Salesforce BA I support the business with strong customer focus on delivery with a solid
understanding of Salesforce s full functionalities and capabilities I help the team use the platform to
its full potential.
Working closely with business partners and other key stockholders to clearly document
requirements, gather and understand problems to identify solutions and validate business
process within an Agile environment.
Coordinating and reporting on project progress, obstacles and accomplishments during
weekly team meetings & Managing requirement changes.
Collaborating with Quality Control, Project Managers, and Technical Leads to ensure
Business acceptance.
Developing use cases as a key communication tool between the business and technical
teams.
Documenting current and future state assessments.
Managing requirement changes.
Create and maintain functional models, process flows, and wire-frame diagrams
I demonstrate project management skills, including thorough understanding of how to interpret
customer business needs, model business functions, and translate them into application and
operational requirements
Creating supporting Excel documents with current page layout/ fields for refinement sessions, for
PNM functionality merge April release.
Responsible for conveying the vision and goals at the beginning and throughout the sprint.
Engaging developers and quality assurance resources throughout the build cycle,
identifying blockers to implement solutions & addressing ambiguity.
Managing Agile framework and creating building of user stories in Agility.
Coordinating and Managing UAT testing in ALM application from both a technical and business
perspective.
Understanding Ops Config group configuration for Facets claims systems and provider contracts for
correct pricing and eligibility, etc. as these systems are integrated with the Salesforce platforms.
Screen field analysis for fields in the page layout of current LIFT Application build for MVP/
PRODUCTION release, for adding/elimination of the same as per functional use for Provider Contract
Initiation/Validation/Approval/ CRM case/CRM Events.
Involved in the effort for Building Salesforce In-App Guidance & Sales Enablement by creating
trails/modules/units , content writing for LIFT Application in collaboration with training teams for
end users.
Meetings with COE team for our team access requirements & writing of US for the same for Business
Admin profile in Salesforce.
Gathering requirements from New markets in the review meetings to know their current process &
Demo. of what we have to offer in the LIFT Application for Contracting & CRM.
Getting familiar with New Market current processes & giving them a Demo of how LIFT Application
could leverage the functions & workflow between the Provider Network Management & Provider
Network Operations team.
Schedule meetings to gather requirements after defects Identified & converting the same to US as
per market requirements.
In charge of Change Champion meetings with Market SME s to address after release issues/incident
ticket raised in Sharepoint Hypercare ( for LOB queries/concerns)
Involved in the maintenance of the growing Salesforce organization & work directly with Operations
teams to manage business through learning and evolving the product.
Safe Guard Products
International Sandy Springs
Atlanta
September 2021-April 2022
Senior Business Analyst
As a Sr.Business Analyst on the EDW team, I identify & communicate with users to first understand their goals
& Challenges, understand & define Scope of work, thereby recommending the best possible process & system
solution, define proper test plan & scenarios & finally produce requirement documentations & technical
specifications for those solutions that are detailed, clear & complete, which involves interaction with both
internal & external project stakeholders.
Worked on their Rates & Forms POD & New Launches DaVinci POD, Enhancement projects that involves
Rates & Forms to be updated as per client /dealer requirements.
Cox Automative project is a new launch for AutoTraders account for New dealers with the Limited warranty
product that Safe Guard offers
Portal enhancement projects for BMW & Projects involving integrations of existing database EAS/Legacy
with CMS
Business Analyst for Salesforce Communities requirement with Stakeholders & internal Salesforce team
for the claims raised by Customer or Dealership( Cox Automative) , that enables communication between
teams & helps resolving the same.
Responsibilities:
Eliciting recommending solutions & document detailed business requirements including technical
specification for any given assignments& leverage user stories & process flows as needed.
Working with multiple stakeholders (internally & externally) to coordinate & gather requirements
for reporting or project related tasks.
Serving as a Liaison between IT & other functional departments on behalf of the client &
communicating business needs to development team.
Supporting business functions daily for ad hoc requests (report analysis, SQL queries).
Manage deployments/monthly activities across multiple development teams.
Backlog grooming , sprint planning & BRD Documentation for various portal / new implementation/
enhancement projects.
Create and maintain functional models, process flows, and wire-frame diagrams
Demonstrate proven IT knowledge of business analysis process and functions.
Demonstrate strong analytical and project management skills, including thorough understanding of
how to interpret customer business needs, model business functions, and translate them into
application and operational requirements
Coordinate and report on project progress, obstacles and accomplishments during weekly team
meetings.
Manage requirement changes.
Collaborate with Quality Control, Project Managers, and Technical Leads to ensure Business
acceptance.
Develop use cases as a key communication tool between the business and technical teams.
Document current and future state assessments.
Creating JIRA Tickets for new Projects & linking to SMART-SHEET Project Pipeline Matrix, Scrum
activities.
SMART-SHEET ,Confluence tools to Update project status, add Project details in Pipeline Matrix &
make meeting notes
Analyzing existing/new processes & database models to make recommendations on potential process
improvement
Creating reports/dashboards with BI tools MS BI tools.
Build an understanding of new technologies and managing implementation as they arise.
Serving as a representative for the Company & IT function while in front of the client (internal &
external).
Dissecting problems using analytical skills & develop viable solution that supports the business needs.
Blue cross Blue shield of Michigan Detroit - MI
May 2020 - September 2021
Senior Business Analyst
BCBS is a leader in healthcare innovation & supports the nations s largest healthcare network
providing coverage to nearly one in three Americans.
GroupCRM in Salesforce for BCBS handles the business needs using Salesforce Technology & creating
objects as per agents / customer requirements, enhancement of the existing tools by creating Objects
& workflows for easier Sales operations
Performed tasks as a Business Analyst for enhancement Projects as follows:
Replacement of BOMA the Current ABR tool application for ABR ( Account Benefit Review) request
with enhancements by creating an Object called ABR Plan Mod in Salesforce Group CRM for Benefits
& Sales department operations.
RFP Project : MVP implementation of the RFP App to replace the share point functionality
Products & Quotes, Workflows & notifications
ACR/NCR project : Moving ACR & NCR functionality into Group CRM to support KLG & retirement of
the non-IT BOMA Application
Responsibilities :
Gathering requirements from Benefits team , scheduling meetings for the same on a daily basis &
working as a liaison between technical team & Users/stakeholders.
Being a part of the multiple enhancement projects for Replacing & integrating tools used in existing
software into Salesforce Group CRM project, coordinating team meetings with Benefits
Administration & Sales operations.
BA for enhancement project of Advance Paid To date forms & workflow for Group billing
Creating VISIO Workflow diagrams as per the discussion for project meetings & all the Necessary
documentation like minutes of the meeting required for the same.
Updating all the existing Future State Workflow Visio diagrams as per current Workflow for BCN &
BCBSM groups.
Data Validation by pulling reports from Salesforce after Implementation of the Project.
As a part of the maintenance project, Business Support Analyst for Data Mapping from FACETS
system to Salesforce
Created User Stories for Change Control and continuous improvement efforts within the Team.
Developed Custom Reports and Dashboards as per given requirements.
Making reports for up to date Project UAT test cases as per changes in user stories.
Created workflow rules and defined related tasks, time triggered tasks, email alerts, field updates to
implement business logic.
Developed Custom Reports and Dashboards as per given requirements.
Business Readiness : Created Project test scenarios/ test scripts & testing all those in UAT
Environment, raised defects in SaaS environment, conversion of some of those defects to User stories
for next phase.
Assisting the business users with defining and/or reviewing the test plans and related quality
reviews to conduct User Acceptance Testing (UAT). Assist the IT testers with defining and/or
reviewing the test plans and related quality reviews to conduct the Quality Assurance testing (QA).
Verifying that system requirements are traceable, consistent, complete, and testable
Writing checklist and tracking all the components involved in application changes
Provide business requirements within an AGILE software development AGILE SCRUM environment
Business Training documents
Used the sandbox for testing and migrated the code to the deployment instance after testing.
Documentation of Requirement Traceability Matrix & Business Readiness, Job aides for training
purposes.
Resolving CRM tickets raised by users in SaaS Environment
Next-Gen Healthcare-
Horsham,
Jan 2018 April 2020
Sr. Business Analyst
Next-Gen healthcare management system is presented where the management system can include a
data routing engine configured to route patient data to various authorized providers as a function of one or
more
trigger rules. Next Gen guideline integration engine imports medical guideline information from disparate
sources based on various guideline standards into a knowledge base. This project handles patient s value-based
reimbursements. We ll automate tasks, streamline workflows, optimize resources, reduce claim denials, speed
and increase payments. Demonstrate value-based measures and accomplish more in less time, with less
overhead by using RCM Services, Practice Management & EDI.
Contributions:
Analyzed organization processes, converting business workflows into Salesforce.com workflows and
configuring Salesforce.com to meet business requirements.
Gathered information and researched on the Business model of PACSGEAR and building requirement to
accommodate customization of Salesforce accordingly.
Experience on End to End Legacy Salesforce to new Salesforce migration/implementation that includes
Sales, Marketing and Support.
Lead the Data Migration/Implementation effort from the Legacy System to target system.
Coordination 3 Way integration of Salesforce with MDM (Master Data Management), WM (Web Methods)
and SAP.
Written and maintained test plans based on software requirements and design documents
Verified that software applications performance is in accordance with system requirements and
specifications
Verified if the function, performance, integration, and acceptance test results are in accordance with
application and departmental standards
Data Validation by pulling reports from Salesforce after Implementation of the Project.
Created User Stories for Change Control and continuous improvement efforts within the Team.
Performing the role of Salesforce Administrator in the organization including working on the DEV
and QA instances of Salesforce.
Created mock up screens (GUI's) for developers and SME's using Balsamiq
Participated in requirements Gathering and definition of ER (Entity Relationship) diagrams using MS
Visio. Also used Schema builder within Salesforce to import an ER diagram representing the data
architecture of Perspective s instance of Salesforce
Involved in Salesforce.com Application Setup activities and customized the apps to match the
functional needs of the organization.
Provide business requirements within an AGILE software development AGILE SCRUM environment
Provided AGILE project management controls, project plans, timeline schedules, facilitate JAD
sessions, and review software defects
Queried and Imported and Exported data using Data Loader and Workbench.
Created page layouts, search layouts to organize fields, custom links, related lists, and other
components on a record detail and edit pages
Implemented pick lists, dependent pick lists, lookups, master detail relationships, validation and
formula fields to the custom objects, Web to case, Email to case, queues for Case
Management/Opportunity Management.
Created workflow rules and defined related tasks, time triggered tasks, email alerts, field updates to
implement business logic.
Developed Custom Reports and Dashboards as per given requirements.
Created test scenarios on Sandbox environment, testing and implementing UAT.
Established detailed knowledge of Lead to Customer/Partner, CRM, Opportunity Management,
Campaign Management, Lead Management and Case Management.
Worked in Agile Methodology with adherence to meeting quick deadlines and providing expertise on
multiple projects
WellCare
Tampa, FL Jun 16 to Dec 17
Senior Business Analyst
WellCare provides managed care services exclusively for government-sponsored health care programs,
focusing on Medicaid and Medicare. Headquartered in Tampa, Florida, The Salesforce CRM Application is
implemented to consolidate sales management for all the regions. Online Sales force CRM Application was
developed to leverage some key business functionalities of the legacy application and provide customized
solutions to the Sales team to keep track of their customers, their contact information and their opportunities
in Pipeline.
Responsibilities:
Interacted with various business team members to gather the requirements and documented the
requirements.
Developed sales and marketing apps on Salesforce.com platform using CRM Process.
Involved in Salesforce.com Application Setup activities and customized the apps to match the
functional needs of the organization.
Designed and developed SFA based Application on Force.com Platform in Salesforce.com environment
with Apex programming language at backend and Visual-Force pages as user interface.
Used Sales Force Automation (SFA) for Sales Lead Management, Account and Contact Management and
Approvals and Workflow.
Verified if the function, performance, integration, and acceptance test results are in accordance with
application and departmental standards
Implemented the requirements on Salesforce.com platform and Force.com IDE Plug-in using Eclipse.
Translate business and technical requirements into extensible, scalable, and maintainable
applications.
Worked with various salesforce.com objects like NFR, BRD, JAD, Accounts, Contacts, Leads, Campaigns,
Reports and Dashboards.
Developed various Custom Objects, Tabs, Entity-Relationship data model, validation rules on the
objects and tabs, Components and Visual Force Pages.
Created page layouts, search layouts to organize fields, custom links, related lists, and other
components on a record detail and edit pages.
Created workflow rules and defined related tasks, time triggered tasks, email alerts, filed updates to
implement business logic.
Designed, developed and deployed Apex Classes, Controller Classes and Apex Triggers for various
functional needs in the application.
Developed and configured various Reports and Report Folders for different user profiles based on the
need in the organization.
Developed Custom Objects, Custom Reports and configured the Analytic Snapshots to dump the data
on regular basis for the sales performance and lead generation statistics.
Used the sandbox for testing and migrated the code to the deployment instance after testing.
State of North Dakota (DHHS)
Bismarck, ND
Apr 14 to May 16
Business Analyst
Planned and designed MMIS business processes; assisted in formulating recommendations to improve and
support business activities Assisted in analyzing and documenting client's MMIS business requirements and
processes. Also worked on Medicaid policy, interpreting Medicaid policy to provider case management staff to
determine accurate utilization review decisions
Responsibilities:
Gathered business requirements by driving user-group meetings and working with various global,
cross-functional and virtual teams
Conducted assessment by aligning the core Medicaid business area and processes with the MITA
business model to establish an assessment standard.
Leverage Agile software tools such as JAMA and JIRA to manage requirements, test cases, test scripts
and manage software defect tracking
Designed workflows and allocated permissions within MS SharePoint
Working as project coordinator. Making timeline and project check points to achieve project deadline.
Manage and compile retrieved, collected and abstracted medical records to support reporting of HEDIS
measures.
Supported the development effort of an enterprise data warehouse for health insurance claims and
eligibility data. Validated the data in the Operational Data Store against historical report data.
Facilitated the User Acceptance Testing (UAT) with BPM System Administrators and Business Users,
documented any issues or defects and eventually got sign off from the right parties.
Responsible for configuration development and solution within the Facets system.
Used Curam framework to drive requirements, process flow documents, and subsequent design
estimation. Used Query Analyzer, Execution Plan to optimize SQL Queries.
Worked on Benefit Plans, Claims Payment Cycle, Waiver Programs and Reference, Applications, QNXT
configuration, billing applications, CCA and UM modules, Managed Care Organization system, MMIS,
Medicaid and Medicare claims and Eligibility processing systems.
Performed Gap Analysis by matching the requirements for managed care program.
Designed the online screens and reports for the Medicaid Online Electronic Claims Submission System.
Analyzed, designed, and coded several online subsystems for the Medicaid System.
Responsible for business system analysis of customizing the BPS Risk Management product with
involvement through the whole SDLC
Worked on migrating pages and data from old intranet to new SharePoint platform
Developed BRD for new MMIS system and conducted data mapping as well as developed Use
Cases/Activity Diagrams.
Used SDLC (System Development Life Cycle) methodologies like the RUP and the waterfall.
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
Extensive experience in using collaborative tools like Mercury Quality Center to facilitate development
across disparate teams
Documented & managed system requirements, change requests & test cases in HPALM, Jira & Jama
Designed and developed Use Cases, Activity Diagrams, Sequence Diagrams, OOAD using UML and
Business Process Modeling.
Developed business process models in RUP to document existing and future business processes.
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
Acted as the Project Coordinator on the implementation of Root Cause Analysis methodology.
Interacted with the users and logged any defects, enhancements from the UAT and communicated
them to the development team.
Non IT Work Experience:
2002 -2014 : USA
Pharmacy IV Technician at Hospitals & IV Infusion facilities
1988-2001 : INDIA
Accountant / Payroll
Accounts Controller for private organizations & outsourced department.
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