BA Healthcare Domain
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 equip with clinical trial knowledge and with various tools usage like HPQC- ALM, MS Visio, etc.
Duration:
Course Content:
Introduction to Business analysis
- Importance of BA
- Business architecture
- Role and responsibilities of BA
- Objective need and scope
- Project vs product based IT companies
- SDLC
Knowledge areas:
- Enterprise analysis
- Requirement planning and Management
- Elicitation, analysis and documentation
- ( Business, functional, nonfunctional requirements )
- Communication of requirements
- Solution assessment
JAD Sessions,
OOAD & UML
User stories in agile process
BA Tools:
- MS VISIO
- Enterprise Architect
- Rational rose
Basic health insurance terminology
- What is Health Insurance and why it is required.
- What is HIPPA?
- Indemnity Plans – All plans
- Managed Care( HMO, PPO,POS)
- Medicare
- Medicaid
Basic terms
- Subscriber/Member
- Provider
- Claims
- COBRA
- Capitation
- Co-pay
- Co-insurance
- Fee-For-Service
- Deductible
LIMIT
- COB
- EOB
- Procedure codes
- Diagnosis codes,
- Accumulator
- ICD with examples wherever possible.
FACETS OVERVIEW
- What is Facets, version of Facets and its modules?
- Extension
- What are Extensions
- Types of Extensions.
- Configuration of Extension
FACETS DATA MODULE
- Accounting
- Accumulator
- Application support
- Benefit Configuration
- Billing
- Hippa
- Capitation
- Claims Process
CLAIMS PROCESSING – ITS
- Commission
- Criteria
- Customer Service
- Dental Plans
- Dental provider agreement
- FSA Plan
- ITS Application Support
ITS PLAN
- Medical Plan
- Provider NetworkX
- Provider agreement
- Pricing Profile
- Provider
- Subscriber
- Utilization Management
- Workflow Configuration