Healthcare Business Analyst Resume Sample

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Anissa Hoeger
3510 Amie Views,  Boston,  MA
+1 (555) 150 5423

Work Experience

Lead Healthcare Business Analyst
12/2015 - PRESENT
Phoenix, AZ
  • Hands-on experience in a business analyst role or equivalent position in the healthcare space
  • Worked in any software development life cycle or product development life cycle for a health care or non-health care company
  • Facing with clients and users to gather requirements
  • Development of standard business process templates for the Clinical Systems Group
  • Create foundational documentation of high level key applications and business processes
  • Facilitation of requirements sessions and prototyping for business partners
  • Trouble shooting, testing, and training to support project implementations
  • Contributes to functionality and process design for new systems
Healthcare Business Analyst
09/2012 - 06/2015
Houston, TX
  • Work with developers and business representatives in the resolution of testing incidents
  • Responsible for communicating status, issues and risks to management and the relevant project teams
  • Responsible for tracking and escalating incomplete issues to closure
  • Develops implementation plans, training plans and user documentation as needed
  • Ensure team’s adherence to team methods and standards
  • Able to design customer solutions that include various Transcend Insights’ products
  • Serve as the Transcend Insights Technical Subject Matter Expert, and create solution architecture plans to ensure the environments adhere to Transcend Insights’ technical best practices, client requirements, sandbox testing results, and Transcend Insights’ business and strategic objectives
  • Re-architect existing architectures to better suit Transcend Insights’ business practices and strategic objectives (for example, EMR Hub Connection versus Individual Connection)
  • Train other high potential HBAs to scope and architect solutions for future prospects, demonstrating how to maintain the fine balance between customer requirements, EMR capabilities, and Transcend Insights’ business objectives
Junior Healthcare Business Analyst
04/2007 - 04/2012
Boston, MA
  • Supports in user acceptance testing and coordination of implementations
  • Provides direct support during initial rollout of systems
  • Functions as a liaison between Production Technology, Account Management teams and business clients in gathering, defining and understanding client’s needs
  • Collaborate with Supervisor, Subject Matter Experts, Product Managers to find the best approaches to address the client’s requirements
  • Development of business process and technology to support Medicare Claims, Care Management and Medicare Risk Adjustment
  • Experience in developing requirements and performing system analysis
  • Medical Management projects
  • Professional work experience in a professional environment
  • Experience with managing and or implementing Claims systems and technology


Trinity University
2001 - 2006
Bachelor's Degree in Health Care Administration

Professional Skills

  • Strong computer skills, especially advanced skills in Excel, PowerPoint, and report building
  • Analytical skills and problem solving- experience with working through a software defect and resolution
  • Excellent verbal communication skills – clear, concise and appropriate
  • Utilizes strong analytical skills to troubleshoot and resolve configuration errors
  • Excellent quantitative and analytical skills with the ability to interpret findings graphically, verbally, and in written format
  • Strong organizational and time management skills, with the ability to work with minimal supervision in a team environment
  • Outstanding writing and editing skills for accurate and concise communication of information

How to write Healthcare Business Analyst Resume

Healthcare Business Analyst role is responsible for software, analysis, reporting, automation, advanced, health, analytical, healthcare, finance, training.
To write great resume for healthcare business analyst job, your resume must include:

  • Your contact information
  • Work experience
  • Education
  • Skill listing

Contact Information For Healthcare Business Analyst Resume

The section contact information is important in your healthcare business analyst resume. The recruiter has to be able to contact you ASAP if they like to offer you the job. This is why you need to provide your:

  • First and last name
  • Email
  • Telephone number

Work Experience in Your Healthcare Business Analyst Resume

The section work experience is an essential part of your healthcare business analyst resume. It’s the one thing the recruiter really cares about and pays the most attention to.
This section, however, is not just a list of your previous healthcare business analyst responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular healthcare business analyst position you're applying to. The work experience section should be the detailed summary of your latest 3 or 4 positions.

Representative Healthcare Business Analyst resume experience can include:

  • Well defined problem solving and decision-making skills
  • Work and communicate effectively with all project stakeholders including the client, vendors, peers and Conduent management
  • Advanced Access, Excel and/or reporting and automation skills required
  • Experience working on multiple projects of a complex nature with proven success
  • Understand and process complex information concisely and effectively
  • Demonstrated experience with requirements analysis and documentation

Education on a Healthcare Business Analyst Resume

Make sure to make education a priority on your healthcare business analyst resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your healthcare business analyst experience. For example, if you have a Ph.D in Neuroscience and a Master's in the same sphere, just list your Ph.D. Besides the doctorate, Master’s degrees go next, followed by Bachelor’s and finally, Associate’s degree.

Additional details to include:

  • School you graduated from
  • Major/ minor
  • Year of graduation
  • Location of school

These are the four additional pieces of information you should mention when listing your education on your resume.

Professional Skills in Healthcare Business Analyst Resume

When listing skills on your healthcare business analyst resume, remember always to be honest about your level of ability. Include the Skills section after experience.

Present the most important skills in your resume, there's a list of typical healthcare business analyst skills:

  • Communicating effectively with internal development teams to ensure that the technical requirements and the business objectives are clear
  • Experience as a Business Analyst, experience working with end users and gathering requirements
  • Experience in healthcare industry (including experience with HEDIS, NCQA, and CMS quality reporting)
  • Demonstrated experience with the structured testing of systems and business processes
  • Advanced data analytics/data mining skills
  • Intermediate skills that allow employee to adapt and meet some complex or non-routine situations

List of Typical Experience For a Healthcare Business Analyst Resume


Experience For Lead Healthcare Business Analyst Resume

  • Solicit, develop, document and manage requirements and provide detailed design and business rules to support the requirements throughout project life cycle up to and through change control
  • Assist product management with scoping and prioritizing requirements
  • Experience in Microsoft Office including Excel, PowerPoint, Word, Access
  • Experience; Microsoft Office, Including Excel and PowerPoint; Basic SQL statements; Knowledge of Claims/837; Health Insurance systems
  • 1) Three or more years of experience working as a Business Analyst
  • Healthcare insurance payer systems experience (Pegasystems, Visiant (ikaSystems), Facets, QNXT, Xcelys, Amisys etc)
  • Experience with data workflows

Experience For Senior Healthcare Business Analyst Resume

  • Proven track record in analysis and implementation of business software applications
  • Experience in a private sector role
  • Experience in RxClaim and benefit plan design
  • Experience with healthcare data and analytics
  • Experience with Medicaid/Medicare/Healthcare data and analytics
  • Demonstrated ability to understand industry issues and problems, relate them to clients'' needs, and propose appropriate solutions
  • Demonstrated ability to convey complex ideas in an easily understood manner to guide audience through written or verbal communications
  • Unique combination of business experience and technical knowledge
  • Experience with Blue Health Plans

Experience For Junior Healthcare Business Analyst Resume

  • Knowledge with communicating analysis including
  • Provide high level data analytics and data mining support to Star Ratings department, Revenue Management department, and all relevant business units
  • Work closely with BI/IT in automating department reports
  • Create metrics for Dashboard reporting
  • Share information with staff and management including any CMS regulation changes that need to be incorporated into department operations
  • Monitor ticketing system for specific release management and infrastructure Change Requests (CR)
  • Prepare and deliver both written and verbal reports on Release Management status as part of the project status reporting activities
  • Assist team members in developing documentation that is clear and understandable, and follows established guidelines

Experience For Public Sector Healthcare Business Analyst Associate Resume

  • Process Improvement planning – drafts objectives
  • Involved with story definition; assist team with their story estimates and sequencing
  • Highly business owner involved and client-facing role
  • Perform various levels of system functionality and process testing, document and present test results
  • Perform system configuration updates in the new system based on approved business requirements using system wizards and data entry screens
  • Provide analytical and consulting support
  • Act as a Subject Matter Expert for the development of user guides, release notes and training materials
  • Fee Schedules: create and update fee schedules, utilizing Access to create build templates

Experience For Healthcare Business Analyst, Junior Resume

  • Facilitates sessions for information gathering or document review and revision with Healthcare Account staff, vendor representatives, or both
  • Understands the basics of healthcare data and can use it for solving problems
  • Read and interpret medical records, including handwritten records
  • Conscientious problem solver, willing to learn, takes personal pride in their work performance/accuracy
  • Knowledge of interfaces/data sharing standards such as HL7, IHE,FIHR, 837/835

Experience For IT Healthcare Business Analyst Resume

  • Identify, coordinate and ensure integrity of data, including patient demographics, utilization, physician and hospital services and locations
  • Liaise with IT department regarding the report automation
  • Knowledgeable in technology, specifically data warehousing
  • Fundamental working knowledge of concepts, practices and procedures and ability to apply in varied situations
  • Awareness and understanding of current Healthcare industry with ability to convert data and findings into understandable tables, graphs, and written reports
  • Coordinate the benefit design, configuration and implementation effort
  • Creation of business process workflows
  • Healthcare Knowledge – Basics of how US healthcare works and the terminology related to healthcare benefits

Experience For Healthcare Business Analyst Resume

  • Provide business support in the expansion of DataMart subject areas
  • Standardize reports across product line
  • Work closely with business and IT to improve data quality of submissions
  • Monitor and oversite of Vendor reports and processes
  • Keep abreast of changes in guidelines and regulations to government programs

Experience For Lead Healthcare Business Analyst Resume

  • Provide management analysis & reports required by CMS/HHS for the MA business, timely
  • Ensure all activities are CMS/HHS compliant
  • Provide support to Corporate initiatives
  • Acts as backup to Lead Participant in CMS webinars and calls
  • Maintain the Configuration Management and Release Management Plans and Procedures

Experience For Senior Healthcare Business Analyst Resume

  • Perform Release Management activities throughout the SDLC
  • Participates in appropriate change management activities to ensure changes to baseline functionality are correctly packaged and scheduled for release
  • Heavily involved in program backlog refinement
  • Contribute to the program Vision, Roadmap, and content presentations
  • Deliver functional specs, design documents, business process workflow and documentation for new development, modification and enhancement projects
  • Perform functional, integration, and regression test plans
  • Review 3rd party specifications and documentation for systems integrations
  • Play the role of scrum master for select projects
  • Regular use of Microsoft Word, Excel, PowerPoint, etc. in support of project documentation and communication needs

Experience For Junior Healthcare Business Analyst Resume

  • Contribute to all phases of the new system implementation including Analysis, Design, Configuration, Testing, Training, Documentation and post-implementation support
  • Analyze and document existing processes and data
  • Perform gap analysis between current system and new system functionality
  • Identify, clarify, and document business requirements
  • Facilitate discussions on various functionality challenges and design issues between client, vendor and internal teams

List of Typical Skills For a Healthcare Business Analyst Resume


Skills For Lead Healthcare Business Analyst Resume

  • Strong interpersonal skills and demonstrated ability to work effectively with team members and clients
  • Strong analytical capability as demonstrated by prior experience and or academic projects
  • Excellent communication skills, verbal and written, with a superior command of English
  • Military Health Systems experience strongly desired
  • Related business analysis experience, or any combination of education and experience, which would provide an equivalent background
  • Understanding and previous experience of working through the full software development life cycle (SDLC)

Skills For Senior Healthcare Business Analyst Resume

  • Testing experience- created scenarios and performed some level of hands-on testing
  • Collaborating with clients, internal analytics, IT development and data warehouse teams to inform and validate business and technical requirements
  • Three (3) to Five (5) years of experience developing, analyzing, interpreting & trending data
  • 2) Experience working in an IT environment specifically creating and developing reports/manipulating data within Excel
  • Experience in gathering and documenting requirements as well as business and process analysis or business process reengineering
  • Maintain flexibility when handling multiple projects with competing or changing priorities

Skills For Junior Healthcare Business Analyst Resume

  • Experience as a Business Systems Analyst, involved in gathering requirements, creating specifications
  • Experience with mapping processes or work flows using a tool such as Visio
  • Experience facilitating requirements gathering or Joint Application Design (JAD) session
  • Two (2) years of Accounting/Finance business related experience; Two (2) years managing projects and initiatives designed to improve business operations
  • Experience with setting up/developing a standard for benefit administration
  • Client facing- experience with client presentations and training
  • Good data understanding (run basic SQL queries and work with Dev/QA teams)
  • BA experience- requirements gathering that includes changes to software
  • Experience handling intricate database with knowledge of PC-based applications used for data management

Skills For Public Sector Healthcare Business Analyst Associate Resume

  • Two to three years of professional work experience with an understanding of areas such as Medicare and Medicaid
  • Experience performing data analytics
  • Two years Medicaid or Health Care experience, or, working knowledge of Medicaid/Medicare regulations, standards, and processes
  • Experience working in Healthcare
  • Experience with SQL Developer and GQL reporting tools

Skills For Healthcare Business Analyst, Junior Resume

  • Healthcare experience in a payer setting
  • Multi-task and prioritize competing responsibilities
  • Strong Healthcare Industry background
  • Recent experience with business and requirements analysis within the healthcare industry
  • Demonstrated knowledge of healthcare software as it relates to clinical workflow
  • Professional demeanor and good work ethic; Self-motivated
  • Professional work experience that includes business process modeling with Visio or other tools
  • Experience, preferably in healthcare industry

Skills For IT Healthcare Business Analyst Resume

  • Experience with feasibility studies and gap analysis
  • Experience with configuration design and execution of benefits
  • Experience with the Microsoft Office Suite (Word, Excel, Outlook, PowerPoint) and SharePoint
  • Provide leadership and direction to lesser experienced Business Analysts
  • Experience in life cycle management
  • Operate in a fast-paced environment with tight deadlines and make key decisions
  • Experience
  • Experience working with and developing reporting requirements for output from MicroStrategy or similar business intelligence systems

Skills For Healthcare Business Analyst Resume

  • Strong interest in health care and health reform
  • Assisting in the development of a training plan, training materials, and initiation of training for the end user training on reports
  • Translating moderately complex and varied business needs into reporting requirements and supporting documentation of technical specifications
  • Participating in the in testing efforts, including test scenario development, execution of test scripts, and documentation of results
  • Translating client needs and requirements to internal CVS teams such as Benefits Coding, Testing and Quality Analysis
  • Looking to join a dynamic and agile company

Skills For Lead Healthcare Business Analyst Resume

  • Working with internal and external stakeholders to proactively identify opportunities to leverage data and information to support business and client needs
  • Identifying areas of opportunity to add value to the client and Evolent team
  • Analyzing business processes to determine how to measure and report on key operational and performance metrics
  • Working with other Technical, Business and Clinical Lead/ Analysts to address interface and domain overlap issues and conflicts and resolves disputes
  • Managing projects independently
  • Understanding, elicitation and documentation of clients business needs around prescription benefit plan design

Skills For Senior Healthcare Business Analyst Resume

  • Building relationships with key client stakeholders through a consultative approach to fully understand client benefit plan design needs
  • Understanding on Formulary Management, Drug Utilization Management, and Claims Adjudication
  • Understanding of both technical and business process MITA requirements
  • Acting as the link between our clients and our technical team
  • Ensuring customer satisfaction as the primary deliverable
  • Lead configuration effort including other Business Analysts, meeting including the customer and other project team members
  • Presents data sharing documentation to Healthcare Account data sharing review sponsor for acceptance
  • Maintains Healthcare Account data sharing review inventory for the IS department, based on data sharing reviews conducted

Skills For Junior Healthcare Business Analyst Resume

  • A ''people'' person, motivated by finding solutions and creating consensus
  • Update policies & procedures, and provide input on strategies for maintaining and implementing additional activities as they arise
  • Supports Lead in training, oversight and monitoring of team staff
  • Prepare materials and supporting schedules and reports to support operational leadership including the verification of completeness and accuracy
  • Develop automated applications, eliminating duplication, and coordinating information requirements
  • Define project requirements by identifying project milestones, phases, and elements; forming project team
  • Sound knowledge of functional areas such as Claims, Enrollment, Billing, Medical Management (not all for one person),

List of Typical Responsibilities For a Healthcare Business Analyst Resume


Responsibilities For Lead Healthcare Business Analyst Resume

  • Knowledge of accounting and financial reporting principles and business functions
  • Manage requirements using the HPQC/ALM requirements management package
  • Assists Data Modelers and Data Analysts in assuring requirements are traceable between the source data and target tables/entities in the respective data models
  • Completion of Advanced Access, Excel, GQL, or SQL training
  • Proficiency with SQL and understanding of data extraction from relational database systems

Responsibilities For Senior Healthcare Business Analyst Resume

  • Protect operations by keeping financial and patient information confidential
  • Coordinate across multiple teams, both internal and external, to facilitate timely and quality implementations of project initiatives
  • Create detailed documentation of system incidents/defects
  • Create flow diagrams and project documentation
  • Recommend solutions to business problems
  • Develop and analyze business and user requirements for clarity, completeness, scope, and technical feasibility

Responsibilities For Junior Healthcare Business Analyst Resume

  • Decompose business and user requirements into system and software functional requirements
  • Define system quality and operational attributes, external interfaces, constraints, rules, and other non-functional requirements
  • Develop system use cases that describe the system's intended functional behavior and serve as SME
  • Develop supplementary specifications that capture system requirements that are not readily captured in use cases
  • Perform requirements modeling and develop UML diagrams which depict various perspectives of the system's functional behavior, to include, activity diagrams, sequence diagrams, and state diagrams
  • Develop software requirements specifications that capture the software requirements for the complete system and serve as the "build-to" specification for development
  • Manage requirements traceability to include development of requirements traceability matrices
  • Support requirements triage to select the right requirements to include in a specific software release. Activities would include identification of relationships and dependencies between requirements, and estimation of technical effort

Responsibilities For Public Sector Healthcare Business Analyst Associate Resume

  • Manage changes to base lined requirements through effective application of change control processes and tools. Analyze SCRs for impact of change, etc. Support CCB meetings. Track requirements status throughout the project
  • At the end of each iteration or release, produce a lessons learned report which summarizes the effectiveness and efficiency of the requirements practices and resources employed on the project
  • Serve as primary liaison between the technical team and the product team and end-users for the purpose of establishing a common understanding of requirements and the as-built product
  • Lead the customer through steps of Agile/Iterative Methodology associated with the delivery of BI solutions; Requirements, Design, Development, System Test, User Acceptance Test and Operations
  • Responsible for facilitating customer Requirement Analysis Sessions (RAS) and is responsible for capturing and documenting customer business process models (BPM)

Responsibilities For Healthcare Business Analyst, Junior Resume

  • Clarify issues relating to scope and business requirements for project team (including technical implementation team, project management and client management)
  • Acts as a representative from the business area and to identify and refine their requirements for information, informing the creation of a warehouse data model
  • Interacts with functional users and data stewards/SME to ensure that all the proper questions have been identified and answered satisfactorily
  • Assists Quality Assurance team with development, execution, and documentation of test cases
  • Works to identify and document data quality issues

Responsibilities For IT Healthcare Business Analyst Resume

  • Leads RAS sessions with clients
  • Works with Implementation and Development leads to translate and map business requirements to technical requirements/specifications
  • Defines scope of work for work proposed to meet business requirements
  • Define business requirements for change requests, investigate issues/defects and define remediation requirements
  • At least a beginner level proficiency with MC Access, SQL, SAS and/or other statistical programs

Responsibilities For Healthcare Business Analyst Resume

  • Report to StrataCare’s management any use or disclosure of protected health information not permitted by StrataCare's policies related to state or federal laws such as HIPAA
  • Experience with Medicare Advantage, Medicare Part D, Medicaid or Qualified Health Plans
  • Experience in health care finance
  • Affordable Care Act (ACA) experience or knowledge
  • Support Transcend Insights’ management and executives on architectural and implementation related discussions

Responsibilities For Lead Healthcare Business Analyst Resume

  • Strong working knowledge of relational database principles including SQL Server Management Studio, SAS PROC SQL, and Microsoft Office (Outlook, Word, Excel, Power Point, and Access)
  • Proficient at using various data sources to develop relevant reporting tools, and to use those tools to enhance processes and procedures
  • Research, analyze, interpret, trend, and implement process improvement initiatives
  • Collect and prepare data for written/oral presentation
  • Knowledge of EDW or similar
  • Knowledge of EDI processes

Responsibilities For Senior Healthcare Business Analyst Resume

  • Knowledge of Facets or other Health Insurance Claims/Membership systems
  • Knowledge of Medicare and/or Medicare Advantage processes
  • Proficiency with data manipulation and analysis in Excel is required
  • Possesses full technical knowledge of most phases of systems and business analysis and is able to consider the business implications of the application of technology to current and future business environments
  • Willingness to develop and explore new approaches, adapt, and execute quickly
  • The ability to work in a very detail oriented environment is essential for this role
  • Desire to grow into opportunities related to initiative development and cross market performance improvement projects
  • Demonstrated ability to critically evaluate information gathered from multiple sources, produce requirements documents, develop use cases and process flow charts, create presentations, and to capture, track and report statistical data

Responsibilities For Junior Healthcare Business Analyst Resume

  • Demonstrated aptitude at using advanced computer software including databases, OLAP tools and statistical software
  • Elicit requirements using interviews, surveys, client site visits, business process descriptions, use cases, scenarios, task and workflow analysis
  • Knowledge of clinical terminologies such as ICD-10, ICD-9, CPT, HCPCS, DRG and NDC
  • Document the requirements and specifications to address the client’s needs
  • Be recognized & rewarded – our client values their employees, recognizes talent, encourages growth and rewards contributions
  • Work with team of subject matter experts, clients, analysts, engineers, QA and product management
  • Excellent verbal and written communication skills and the ability to interact professionally with a diverse group of executives, managers, physicians and other medical personnel, and subject matter experts
  • Use of requirements, Vision documents, UI Storyboards, Use Case diagrams

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