Jignesh Patel
Business Analyst @EmblemHealth
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WORK HISTORY
Business Analyst @EmblemHealth
Project 1Worked on the project to prepare Emblem Health to review and build/enhance enrollment, billing, claims and customer services process that are required to participate in the Health Insurance Exchange (HIX), Since Emblem Health made the business decision to participate in the NYS Public Health Insurance Exchange (HIX) in2014, which is the result of Patient Protection and Affordability ActProject 2Worked on the initiative to migrate existing care management, disease management and utilization managementsolutions to solutions providers like Trizetto for Utilization management, case management and casenet for disease management
EDUCATION
Monroe University
Master of Business Administration (M.B.A.), Information Technology, Finance, Management
SKILLS
ABOUT JIGNESH PATEL
Business Analyst over 3 years of Information Technology experience in business analysis, deployment, and developing business processes and system solutions for the Healthcare, Pharmacy, Health Insurance industries. Strong knowledge of Scrum and Software Development Life Cycle (SDLC) methodologies, including Agile and Waterfall models and RUP methodologies. Adept at creating and transforming business requirements into functional requirements and designing business models using UML diagrams. Excellent facilitation skills in conducting JAD sessions. Expertise in developing the master validation test plan, validation protocols, Requirements Traceability Matrix (RTM), gap analysis. Experienced in User Requirement Specifications (UR’S) and Functional Requirement Specifications (FR’S). Proficient in Medicare (Parts A, B, C and D) and has been exposed to Sarbanes-Oxley (SOX) and HIPPA/ EDI transaction codes (270, 271, 276, 277, 278, 834, 835 and 837). Experienced with Epic Clinical Systems and working with SQL and EDI environments and on RSA processes. Has extensive experience in gathering, managing and documenting business and functional requirements, and communicating effectively with upper management, Developers and QA Engineers.
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