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MOUNI - HEALTHCARE BSA CONSULTANT

[email protected]

Location: Edison, New Jersey, USA

Relocation:

Visa: GC

Employer : [email protected]; [email protected]; (609) 778-4215 ext 1000 Mouni BSA PROFESSIONAL SUMMARY 12+ Years of experience as Business System Analyst, Product Owner, Process Modeler in Healthcare and Banking industry. Expertise in Cross-functional Team Leadership, Vendor Management, Software Development Life Cycle (SDLC), Agile and Waterfall methodologies, Solution Architect, Product Management, Software Project Management, Production Planning, Project Implementation and Scaled Agile Framework along with Strong computer expertise with MS Office; Excel; Word; Project; PowerPoint; Visio, MSP, Agile Methodologies (Kanban-Rally-Jira-Confluence), wireframes, Data visualization tool (Power BI), Smart-sheet and SharePoint Interpreting customer business needs and translating them into application and operational requirements. Extensive Conceptual Knowledge on all stages of the Software Development Life Cycle (SDLC) including Planning, Analysis, Design, Development, Testing, and Implementation of software applications, utilizing project life cycles such as Agile and Waterfall. Expertise in Project Management using Agile methodology to implement best practices, promoted, and facilitated Agile ceremonies for the development team, including sprint planning, daily scrum, sprint retrospective, Capability review, story refinement, backlog grooming and Demo sessions to facilitate collaboration and communication across roles. Experience in assisting internal and external work groups through documenting and reviewing the BRD/FRD documents creating AS-IS to the TO-BE cross functional business process modeling with the core team, business owners and SME s. Handled business requirement documents (BRD s) and translated them into functional requirements (FRD s) across the deliverables of a project. Documented the project AOD s (Architecture overview diagram), TDD s (Technical Design documents), project task lists and maintaining the documents for leadership reviews. Experience in conducting impact analysis to enable organizations and customers abilities to efficiently understand and implement the lean organizational changes in the Risk Management and Risk Adjustment area. Experience in Agile framework project management tools such as Rally for creating the user stories by defining the user acceptance criteria and assigning the tasks to the dev team with the estimates and release schedules. Planning the features of the project in Rally, assigning them to the required deliverables and tracking the project initiatives. Coordinated with the Product Managers and BSA s on the Product Release Management activities and performed User Acceptance Testing (UAT). Interacted with SMEs to capture business requirements and involved in the requirement gathering and data analysis for developing the artifacts. Performed initial business analysis to determine scope and document review for the operational and technical teams. Created executable project plans based on the requirements gathered. Expertise in Project Coordination for the E2E Project Implementation. Expertise in handling Change Management and Release Management. Developed Business requirements for the Web portals/mobile and mapping documents specific to Restful API s. Coordinated with Product Managers and Stakeholders on the product release management activities and maintained thorough documentation of all the business requirements and findings. Coordinated Joint Application Development (JAD) sessions, project meetings, reviews, walkthroughs, customer interviews, focus groups. Object Oriented Analysis and design with experience in creating use cases, class diagrams, activity diagrams, state diagrams, sequence diagrams, using MS Visio to extract business process workflows. Experienced in handling Change Management and Release Management. Insightful knowledge of business process analysis and design, domain, and technology expertise with strong integration skills. Expertise in working with consumer applications like Member Portals, Provider Portals, Broker (Vendor) Portals Experience in multiple projects handling - claims, Member, Provider data loading and extracting to multiple vendors. Knowledge of Medicaid, Medicare (Part A, B, C and D), Procedural and Diagnostic codes. Excellent knowledge of STARS, HEDIS, DDDS AND Reporting initiatives in BlueCross. Knowledge on Health Insurance Portability and Accountability Act (HIPPA4010 and HIPPA 5010, Affordable Care Act (ACA), and Current Procedural Terminology (CPT). Experienced in scheduling meetings and running large-scale meetings presenting deliverables. Excellent interpersonal skills in listening, mentoring, negotiation, conflict resolution and strong communication skills in verbal, written and presentation skills. Technical Skills: Project Methodologies SDLC, Waterfall, Agile Business Modeling: MS Visio, MS Project, Snagit Project Management Tools MS Office Suite, MS Project, MS SharePoint, JIRA, Rally Documentation Tools PPT, Wireframes, MS Word, Smartsheet DB Mongo, Postgress, SQL server Professional Experience BCBSFL November,2021 Till Date Senior Business Systems Analyst Project Description: Business System s Analyst and a SME with focus on gathering Business requirements for Connect of Connects in integrating a low code/no code solution (tooljet) into Florida Blue s eco system. Analysis on Low code tool solution strategies. Software development Integration in building new platform, called AppLab that enables faster delivery of technology through streamlined process. AppLab is an enterprise Low-Code open source, self-hosting platform used to build and deploy custom applications with less coding and efficient development time capability with Drag and drop UI approach that aligns with Florida Blue security permission to facilitate and promote small applications. Constant analysis, documentation and lead initiatives for Product management and End users. Constant collaboration with design and product development groups and interfacing with Business stakeholders to conduct/manage meetings, identify scope of work, workshops, conduct gap analysis and leading overall business priorities and deliverables. working closely with multiple application teams for identifying In-Scope elements, standardizing components for feature enhancements and document processes, storybooks, Analysis matrix and Data Extraction. Experience in defining the BRD s and converting them to Functional requirements collaborating with the developers in understanding the backend logic and UI. Responsibilities: Detailed analysis and research work on open-source self-hosting tools for a low code software development approach to enable faster delivery of technology through streamlined process to build and deploy custom applications with minimal coding aligning with FB security and controls. Analysis and review on more than 30 open source, REACT, self-hosted Low Code tools to build an integrated platform to host smaller applications in compliance with the security systems aligning the Florida blue policy. Documenting the Mongo DB collections that are used to service the AppLab platform by defining the Key collections, Data queries and Aggregations. Gathered requirements for user security protocols such as Authentication and Authorization process via JWT token system. Assessment of Connect of Connects (CoC) portal, which is part of gwOS platform with many Internal integrated applications to review each of their Intents and propose Best Practices Recommendations for better User Experience and efficient operational results. Developed and modified user stories, facilitating daily scrum in tracking the project status and updating/maintaining Rally and involved in monitoring the defects. Documented AppLab User guide, for any new on boarding applications, documented/maintained Project task lists, planning documents and reviewed with the management to obtain approvals for business use. Developed and maintained AppLab manual application intake form to initiate a request from requestor (App teams) to build an application or enhance an existing app in the platform. On-going interaction with Business partners and End users to understand the product/project scope and document customer requirements. Interacting with the development teams to convert the business requirements into functional/operational by understanding the backend logic, Front end/UI to build the code. Working closely with Multiple application portals/teams on documenting and proposing standardization of the Top Navigation header components, feature enhancements and their functionalities, and capabilities for connect portal. Constant collaboration with developers assisting with the translation of Business requirements into System requirements for AppLab. Closing working with the design team to follow and propose design and brand standard to avoid impacts on user experience. Working on the Claims, Customer Connect, Care Connect, Provider Connect portals extracting the data and identifying the duplication of Member demographics. Analysis on the multiple app portals and proposing a standard Top navigation Icons and Menu. Expertise in Claims data analysis including the HCCID, Member card elements, Health benefit plan data, Member dependents list, Care journey and propose new communication preferences. Experience in Extracting and loading the Member, Provider and Claims data for data management. Worked closely with design team for the Architectural and UI/UX design documentation. Expertise working on the POC, CoC/Manifest & Intent Integration, Testing and Implementation documentation. Worked on the Claims Diagnosis/Procedure codes data. Ongoing collaboration with the Design team to develop a Design standard and pattern library to create visual and functional consistency and efficiency. Identified and communicated business needs and worked on the process improvement for various platforms. Analyzed the BRD s and FRD s to identify the dependencies and impacts to operations and product delivery. Coordinated with the Product Mangers and BSA s on Release Management Activities, performed UAT and communicated with the testing teams of any Bugs/Issues within the functionality of the tool. Acted as a (CoC) Product Owner to ensure timely delivery of artifacts and took necessary actions to raise change controls (CC) and RAID items to comply with Project deadlines (Estimated completion dates- ECD). Experience working closely with vendor Enrollment application called MembersEdge and implementing their sso link in CoC portal. Experience working closely with multiple team members interacting with all levels of management throughout the organization. Environment: Rally, MS SharePoint, MSP, MS Word, MS Office, Office 365, Web Applications, Postgress, Mongo db, SQL server Neutrino Advisory June,2021 October,2022 Senior Business Analyst/Project Coordinator Project Description: Senior Business Analyst with focus on driving Business requirements, analysis, project coordination and stakeholder management. Ongoing collaboration with design and product development groups and interfacing with Business stakeholders to conduct/manage meetings, workshops, and overall business priorities. Working closely with technical teams and client s knowledge management groups to document processes. Experience in defining KPI s and reporting to support business drivers. Responsibilities: Functioned as SME, Senior Business Analyst and Project Coordinator. Worked as a subject matter expert in connecting with the client stake holders and application owners to analyze Project/Product In-Scope and identify the business use cases. Responsible for creating and evaluating KPI s (Key performance indicators), Metrics and translating them into Customer Experience Level Agreement (CXLA) scores, a project to track and improve the efficiency of service desk (Incident management, Application performance, Platform Performance) for building the Dashboards. Translated stakeholders requirements and business standards into executable project plans. Identified/Communicated business needs and worked on the Process Improvement for various platforms and products likes CONTROL-UP. (a tool that helps in tracking the application performance). Developed presentations to communicate analysis, findings, recommendations, and process improvement results. Facilitated and participated in Scrum ceremonies using Agile methodology. Communicated with developments teams on data analysis and data mapping. Expertise in handling Change Management for timely Deliverables. Actively participated in the GO/ No-Go decision making of the release. Scheduling and facilitating the Daily standup calls/Weekly/Monthly review meetings with business stakeholders, Application owners, Development and Testing teams for the Project Deliverables. Prepared and maintained meeting minutes/documents /decision log tracker in Excel with constant tracking of action items and issue resolution. Documented User stories in JIRA and Smartsheet. Performed gap analysis to identify and document the gaps between the existing current and future systems. Ability to work under pressure, both individually and in a team-based environment. Coordinated work between different teams at different locations. Environment: JIRA, MS Visio, MS SharePoint, MSP, MS Word, MS Office, Office 365, Web Applications, Smartsheet, Power BI, Access Data. BlueCross BlueShield (BCBSM) March 2016 March 2020 Senior Business Analyst/Business Process Modeler Project Description: BCBSM is a nonprofit health maintenance organization that offers a nationally recognized PPO and other group and individual health insurance plan options. The purpose of the project was to deliver healthcare services and documentation for Commercial Medicare Advantage Arkansas Blue Cross Blue Shield (ABCBS) , and Blue Cross Blue Shield of Nebraska (BCBSNE). Responsibilities: Responsible to understand customer strategies and goals and congregate requirements to develop process flows. Experience working closely with various departments to capture step by step processes and desk levels needed to perform and execute identified capabilities. Attended and contributed qualitatively to Joint Application Development (JAD) meetings with the associated project manager along with various members from multiple departments. Responsible for creating process flows, desk levels, communication, and training documents to obtain Swim Lane Owner s (SLO s) approvals as needed. Facilitated collaboration between the affected groups to gain acceptance of the process changes and complete assigned tasks by the due dates. Conducted impact analysis on the requirements gathered in the BRD/FRD and Use cases and provided the key findings to the Subject Matter Experts for further analysis. Worked closely with Risk Management, Risk Adjustment, Stars quality departmental managers to develop more efficient ways to complete collaborative end-to-end business processes. Translated stakeholders requirements and business strategy into executable project plans. Responsible to organize, coordinate and facilitate requirements elicitation sessions. Performed impact analysis on the process flows for operation teams to identify deliverables on the project plan. Working closely with multiple team members and interacting with all levels of management throughout the organization. Responsible for multi-tasking and prioritizing work to multiple deadlines. Responsible for creating and evaluating monthly key performance indicators (KPI) achievement and producing an end of month spreadsheets and graphs. Analyzed business process data and created KPI presentations and reports that were presented directly to the management. Responsible for moving the artifacts from shared drive to SharePoint library. Experience working with SMEs from Data Driven Delivery Systems (DDDS) in creation of artifacts. Demonstrated ability to multi-task and maintained an effective working relationship with quality operation Customers. Environment: JIRA, MS Visio, MS SharePoint, MSP, MS Word, MS Office, Office 365, Web Applications, Smartsheet, Power BI, Access Data. Priority Health, MI April,2014 January,2016 Business Analyst Project Description The objective of the project was ICD9 to ICD10 and claim system migration from the legacy system. Responsible for gathering requirements, GAP, Impact analysis and documentation using multiple tools. Responsibilities: Gathered and documented Business requirements from User groups, SME S, and Vendors via workshops. Expertise in MS Visio and UML for generating class diagrams, activity diagrams and Process flows. Worked in close collaboration with the Project manager, Vendor team, and Business users to gather the requirements, analyze and document the BRD s to Functional requirements. Designed and developed Use Cases, Activity Diagrams, Sequence Diagrams using UML and Visio. Identified, researched, investigated, analyzed, documented business processes and use case scenarios. Performed gap analysis to identify and document the gaps between the existing current and future systems. Functioned as a liaison between the business line, operations, and the technical areas throughout the project cycle. Assisted the QA team in developing the test plan, test conditions and test cases to be used in testing based on business requirements, technical specifications and/or product knowledge. Used Test Director with QA team for testing. Assisted in the development of training materials for new technology and process improvements. Interacted effectively with the internal and the external parties. Worked closely with the project manager in handling the whole project. Maintained a Traceability Matrix to ensure that all Functional Requirements were addressed at the Use Case Level as well as the Test Case Level. Environment: JIRA, MS Visio, MS SharePoint, MSP, MS Word, MS Office, Office 365, Web Applications. Health Alliance Plan (HAP), Detroit, MI May 2011 April,2013 Jr. Business Analyst &Process Modeler Responsibilities: Gathered and documented business requirements from SMEs, user groups and vendors via workshops, interviews, and JAD sessions Acted a s liaison between Business and IT Prepared a comprehensive functional requirement document and supplementary specification document (nonfunctional) from the gathered requirements. Involved in writing USE cases and prepared the business requirements documents for various requirements collected from the business users. Used MS Visio and UML for generating class diagrams and activity diagrams. Worked in close collaboration with the project manager, vendor team and business users to gather, analyze and document the functional requirements for the project. Facilitated and managed meeting sessions with committee of SMEs from various business areas including benefits administration, health claims group, HIPAA administration, health policy and program evaluation team and data management group. Created functional specifications for the provider tracks with their changed reimbursement and administration in the Medicare and Medicaid program. Worked on PCC and Referrals Benefit tiring. Gathered and documented requirements for CCS Benefit track for health insurance carriers. Participated in entering, tracking system defects in Rational ClearQuest Submitted change requests and worked with change request records in ClearQuest. Involved in configuration management, requirement management and analysis. Provided technical and procedural support for User Acceptance Testing (UAT) Created workflow diagrams, UML diagrams, process models, activity diagrams, use cases, swim lanes, for incorporating design changes in the order creation/management. Environment: Healthcare Payer, Oracle Data Warehouse, Crystal Reports, Web Applications, Test Director, SQL, MS Office, Visio, UML EDUCATION: Bachelor s in computer science Vishwa Bharathi University India - 2006 Keywords: cprogramm quality analyst user interface user experience business intelligence database information technology golang microsoft Michigan