Business Analysis with Healthcare Online Training
Business Analysis with Healthcare domain knowledge combines with Business Analyst skills to give a customized skillset for an individual looking to make a career as a Business Analyst in the Healthcare domain. This explores many business processes, use cases at every point of contact where the patients interfaces with the healthcare professionals. A Business Analyst should equipped with clinical trial knowledge and with various tools usage like SAS, HPQC- ALM, MS Visio, etc.
After the completion of this course, Trainee will:
1. Determine the primary role of a Business Analyst in a business
2. Understand project scope and project plan in a real business scenario
3. Learn Insurance Life Cycle and Healthcare Insurance products
4. Master in determining and analyzing business requirements document and business requirement Tools
5. Create a test plan as per the requirements using various testing methodologies
6. Learn different software development methodologies (waterfall, Agile, Spiral, RAD, Scrum)
7. Gain Knowledge on Prototyping and JAD [Joint Application Development], types of requirements (Business, Functional, Non-Functional, Transition, UI etc).
- Candidates should have education or background in some aspect of the life sciences, healthcare, IT, pharmaceutical, medical devices, or related areas
2. Basic knowledge on Healthcare processes and concepts
Unit 1: BA Basics
- 1. Introduction to Business Analysis
- 2. Importance of Effective Business Analysis
- 3. Business Composition and Architecture
- 4. Roles and Responsibilities of a Business Analyst
- 5. Need for a Business Analyst
- 6. Standardization and Adaptability
- 7. Importance of Communication/Collaboration
- 8. Project Team
- 9. Importance of Business Analyst in the Project Team
- 10. Business Analyst Career Path
Unit 2: Business Analysis Deliverables Part 1: BRD & Process flows
- 1. Requirements
- 2. Data Flow Diagrams, As-Is Process Flow, To-Be Process flows, Common Mistakes made by new Business Analyst, Wireframes, UI mock-ups
Unit 3: Business Analysis Deliverables Part 2: Use cases
- 1. Use Cases
- 2. User Scenarios and
- 3. User Stories
Unit 4: BA Tools & Healthcare Tools
- 1. HPQC – ALM
- 2. Visual Use Case
- 3. MS-VISIO
- 4. Enterprise Architect
- 5. FACETS Overview
- 6. EMR System Overview
Unit 5: Industry Overview, Healthcare Reform, Healthcare Acronyms
- 1. Healthcare in USA
- 2. What are the major sectors of the industry, where are the jobs , MCD, MCR, MMIS
- 3. What is healthcare reform – basics
- 4. Health Insurance Concepts: Premium, Deductible, Co-pay, Co-insurance, Exclusions, MLR, OOPMax, EHBs, Capitation versus FFS, In-network, OON, Prior-Auth, Pre-cert, EOB, AV-Values, etc.
- 5. What are the common short-forms in healthcare interview, what each one means, when to not use which short-forms.
Unit 6: Types of Insurance & Healthcare Insurance Exchange (HIX)
- 1. The biggest provision of the healthcare law is HIX, THIS is where the jobs are
- 2. What is an Exchange, how does it work, who do exchange people work with
- 3. What is a state-run HIX, what is a Federal HIX
- 4. What are the different functions of the exchange – eligibility, enrollment, plan management, risk, re-insurance & risk corridors
Unit 7: EDI & Claims
- 1. What are EDI transactions, different types, ANSI, ASCX12, EDIX12, Meanings, Uses and Formats of the following: HIPAA EDI 837, 834, 835, 820, 270, 271, 277, 278
- 2. What are EDI implementation guides, what are EDI Companion guides? How to read them? How to write EDI requirements? What business rules do EDI transactions follow?
- 3. What is an EDI transaction? What are the parts – loops, segments, delimiters, etc?
- 4. What is claims lifecycle? Who pays for claims & how is payment transmitted? What is Revenue Cycle Management
Unit 8: Healthcare Small Topics
- 1. What is ICD? Why ICD-10? What are CPT Codes, What are HCPCS codes? What is HCFA-1500? What is UB04 Form?
- 2. What are NCQA standards?
- 3. What is MMIS of CMS? What do they do?
- 4. Conversion means what? What is data mapping? What is ICD-9 to ICD-10 crosswalk? What are the online conversion tools?
- 5. ICD-CM versus ICD-PCS à Clinical Unit versus Procedure Coding System
- 6. Medical Loss Ratio
- 7. Pharmacy Benefit Management
Unit 9: Provider Sector
- 1. BPMN Basics – Pools, Lanes, Event, Activity, Gateway, Sequence, Group, Annotation!
- 2. EMR/EHR
- 3. EMR Implementation Projects
- 4. Revenue Cycle Management Projects
Unit 10: JAD Session
- 1. JAD Session, Verifying Requirements after a JAD Session. One-on-One Meetings for Requirements: JAD Session Homework, Writing a JAD Session Agenda, JAD session inputs, Conducting a JAD Session, JAD Session Outputs, Recording draft requirements in Requirements management tool.
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