Naresh Reddy
Senior Business Analyst / Product Owner
Hyderabad
Summary
- Certified SAFe Product Owner / Product Manager, leveraging 11+ years of experience in the IT industry, specializing in Product Management and Business Analysis.
- Proven track record in managing complex IT projects, consistently exceeding expectations and delivering high-quality products.
- Expertise in healthcare claims adjudication (Payor & Provider), requirement gathering, and requirements documentation.
- Skilled in gathering business, functional, and non-functional requirements, and documenting specifications.
- Adept at manual testing, UAT, and writing test cases for various business scenarios.
- Proficient in SQL, with hands-on experience in writing complex queries and retrieving healthcare or business reports.
- In-depth knowledge of healthcare payer areas including membership claims, benefits, eligibility checks, ICD10, HIPAA, and HCPCS.
- Strong analytical skills with expertise in research, root cause error analysis, and data analysis on large data sets.
- Excellent communication skills, capable of engaging effectively with client executives and their teams.
- Strong interpersonal skills, adept at facilitating discussions and negotiations with stakeholders, and recognized for delivering complex projects on time.
- Perceptive Senior Business Analyst with [8] years driving successful business processes for [Type] companies. Dedicated to maximizing impact of key performance metrics to enhance and expand business operations.
- Known for leveraging both macro and micro-scale analyses to generate holistic images of ongoing business operations for immediate actionability.
Overview
11
11
years of professional experience
4
4
Certifications
Work History
Senior Business Analyst (Product OWNER)
Encora
6 2023 - Current
- Defined and communicated the product vision and strategy for the 340B contract pharmacy application, aligning with organizational goals and market needs
- Collaborated with stakeholders including pharmacy administrators, developers, and end-users to gather requirements, prioritize features, and maintain a product backlog
- Crafted detailed user stories with acceptance criteria, ensuring clear communication of requirements to development teams and stakeholders
- Identified and defined key features and functionality for the 340B contract pharmacy application, creating and maintaining a product roadmap to guide development efforts
- Perform Data Analysis to come up with requirement for loading the data and parameters to consider while updating it to data base
- Successfully delivered the Framework Starter Kit for the 'Contract Pharmacy' application, the first investment from Encora's DAP unit
- Recognized by the VP for seamless delivery, enabling Equiscript to become the first client to leverage the product
- Delivered all required features within the 12-month deadline
- 33% Increase in claim capture ratio
- Technologies used: C#, .NET, AWS, React.Js, Redis, MSSQL, Docker, Kubernetes, Jenkins & CI/CD Tools used: Jira, Confluence, Visio, MS Office, Figma & SharePoint
Senior Business Analyst
Optum Global Solutions (United health GROUP)
03.2018 - 06.2023
- Worked on Fax Transformation, initiating request for Drugs that require Prior Authorization and Provider Outreach Assistant, designed solution with RPA and hybrid solution of both Cognitive and RPA
- Analyzed existing business processes to identify areas of improvement and inefficiencies
- Interact with business stakeholders and investigate business problems and opportunities using root cause analysis and building relationships with all key stakeholders and experience in conducting interviews to gather customer requirements and provide all adequate information to Automation Director to create CBA and help to prioritize opportunity
- Identify and prioritize technical and functional requirements and help PO developing (user stories grooming sessions) of the business requirements to ensure that requirement specifications are correctly interpreted and conceptual customer requirements into functional requirements in a clear manner that is comprehensible to developers/project teams in the form of User Stories
- Understand and negotiate the needs and expectations of multiple stakeholders - Stay current with customer needs and strategies
- Engaging various stakeholder to understand the pain area with existing application and discuss features that they would like to see on the new application and onboard the stakeholder with new solution
- 42% increase in speed of clearing the fax backlog
- 24% increase in response rate from providers
- Technologies used: UiPath, UiPath Orchestrator, C#, DB Visualizer, Jenkins, CI/CD Tools used: Rally, Visio, MS Office, SharePoint
Pharma Benefit Analyst/Sr. Test Engineer/qa LEAD
Optum Global Solutions (United health GROUP)
06.2013 - 08.2016
- Responsible for preparing the test plan, testcases, test data and test execution and test results report and coordinate with Data analyst, development, BA and product owners (PO) on regular basis to track the automation requirements and presenting the business demo to stake holds (onshore partners)
- Communicated test progress, test results and other relevant information to project stakeholders and management, supported and identified continuous improvements within testing processes
- Worked closely with the program management and development teams to drive quality through design and implementation, ensured that appropriate quality metrics and goals were defined and tracked throughout the project lifecycle
- Able to lead test activities across all the different phases of testing from test planning to test execution to test reporting
- Performing testing on the data scripts provided by data analyst team to identify only required data coming through the quire designed
- Perform regression testing after each new build of the application
- Send the UAT test cases to business for approval
- Schedule call with clients and give the demo on the application developed
- Track the performance of Application post deployment as part of Hypercare and send the report daily for 3 to 10 days depends on process
- Responsible for the configuration of benefits and set-up of formularies, client and pharmacy pricing, and pharmacy networks in RxCLAIM to support of the adjudication of pharmacy claims
- Analysed existing business processes to identify areas of improvement and inefficiencies.
Education
MASTERS IN PHARMACY -
SAMSKRUTI COLLEGE, JNTUH, HYDERABAD
Skills
Agile Project Management
SAFe
SDLC/STLC
Requirement Gathering
Backlog refinement
User stories creation
Translating requirements
Product Roadmap
Decision making
Prioritization
BDD/PDD Creation
Data Analysis
US Healthcare Domain
Azure DevOps
Technology architecture analysis
User Acceptance Testing
Stakeholder Management
Business Process Mapping
Business process improvement
Certification
Certified SAFe Product Owner / Product Manager
Personal Information
Name: Naresh Reddy
S/O: Sammireddy
Marital Status : Married
Nationality: Indian
Languages
English
Hindi
Telugu
Timeline
Senior Business Analyst
Optum Global Solutions (United health GROUP)
03.2018 - 06.2023
Pharma Benefit Analyst/Sr. Test Engineer/qa LEAD
Optum Global Solutions (United health GROUP)
06.2013 - 08.2016
Senior Business Analyst (Product OWNER)
Encora
6 2023 - Current
MASTERS IN PHARMACY -
SAMSKRUTI COLLEGE, JNTUH, HYDERABAD