Transmittal Letter (rfp 1)

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  Chair, People and Organizational Issues Working Group, American Medical Informatics Association (2001- )
  
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  National Science Foundation, grant reviewer (2001)(2002)
  
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  Member, Library Committee, Arizona School of Health Sciences (1999-2001)
  
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  Chair, Research Committee, Arizona School of Health Sciences (1999-2001)
  

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  University of Missouri – Columbia, MO – College of Education – PhD, Higher and Continuing Education
  
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  University of Missouri – Columbia, MO – School of Business – MPA, Public Administration
  
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  University of Missouri – Rolla, MO – College of Arts and Sciences – BA, Psychology (Magna Cum Laude)
  

Armer (JM), Harris, KD, and Dusold (JM). Application of the Concerns-Based Adoption Model

to the Installation of Telemedicine in a Rural Missouri Nursing Home. Journal of Nursing Staff Development, 19(4), 17-20, 2003.
Harris, KD, Campbell, JD, and Donaldson, JF. Issues of computer-based telemedicine in three rural Missouri counties. Journal of End User Computing, 13(4):26-35, 2001.
Campbell JD. Harris KD. Hodge R. Introducing telemedicine technology to rural physicians and settings. Journal of Family Practice. 50(5):419-24, 2001 May.
Harris KD, Campbell JD. Internet by proxy: how rural physicians use the Internet. Social Science Computer Review, 18(4):502-7, 2000 Winter.
presentations/panels

Harris, KD., Parsons, J., Jimenez, R. (2001 November) Implementing a Methodology for the Customization of an Electronic Medical Record in a Rural Healthcare Setting. A panel presentation at the AMIA '01 Fall Symposium. A Medical Informatics Odyssey. Washington, DC.

Harris, KD, Campbell, JD, and Donaldson, JF. Issues of computer-based telemedicine in three rural Missouri counties. Book chapter in: Mahmood, MA (ed.). (2002). Advanced Topics in End User Computing: Volume 1. Hershey: Idea Group Publishing.

RESUME for

Anil Kumar is a Technical Analyst with extensive experience analyzing existing information systems and developing technical requirements for new or enhanced systems. His qualifications include expertise in all aspects of HIPAA, creation of bridge application programs, and programming. He is also a skilled Business Analyst and has more than five years of project and team leadership experience working with large-scale project implementation and planning.

Mr. Kumar has expertise in:

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  Technical Analyst on the FOX team performing a technical analysis and assessment of the current MMIS, documenting prospective business and technical needs, identifying and evaluating MMIS replacement options through an alternatives analysis, preparing a Cost Benefit Analysis, and developing an RFP for the MMIS replacement
  
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  Assisted with the procurement of a new MMIS fiscal agent
  
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  Reviewed and evaluated existing system documentation
  
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  Evaluated functionality of the existing system
  
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  Assisted with development of the functional analysis area deliverables
  
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  Conducted Joint Application Requirements (JAR) sessions for requirements gathering for major subsystems
  
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  Created the Risk Evaluation and Analysis document for the new Mississippi MMIS
  
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  Loaded requirements into the RAMS tool for IV& Vpurposes
  

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  As Software Consultant, analyzed current ClaimFacts system to include new providers and health care plans
  
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  Created new data interface record that would be passed between Humana and ClaimFacts system
  
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  Developed claims editing and loading program that edits the data from the Humana system and loads it to the ClaimFacts system
  
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  Designed and developed claim number assignment module for all new claims that are passed from Humana system
  
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  Updated current documentation with system flow diagrams and flow charts to include the new process added
  
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  Software used included COBOL LE/370, CICS, VSAM, JCL, Expeditor, CA-Easytrieve, PANVALET
  

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  As Senior Technical Analyst on the Virginia MMIS Project, was a member of the EWO Emergency Work Order (EWO) group resolved emergency fixes and enhancements to the VAMMIS including adding new claim edits, modifying current edits, creating new provider and recipient subsystem reports for CMS certification process, and updating reference subsystem tables
  
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  As Senior Technical Analyst on the Nevada MMIS Project, was a member of the PEND-RESO team which helped to provide resolution on pended claims in the NVMMIS including analyzing and documenting all claim edits in the system, provider resolution on resolving pended claims in the system, and creating reports for upper management regarding the daily status of the claim adjudication run.
  
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  As a Senior System Analyst working on the Alaska MMIS Deployment Team, involved with the Provider, Recipient, EPSDT and Reference subsystem development for the new AKMMIS including analyzing and creating impact analysis documents to reflect the impact of new RFP requirements on the current AKMMIS system, creating business analyst requirements documents which summarize the State’s requirements by grouping all affected components identified from the impact analysis; and creating program specifications and test cases in accordance with business requirements
  
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  Software Used included COBOL LE/370, DB2, CICS, VSAM, JCL, Princeton, CA-Easytrieve, Visio and OWL
  

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  Business Analyst/Team Leader for ACS New Mexico Medicaid Project
  
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  Created mapping documents for the X12N 837, 835, 276/277 and 278 transactions to the current New Mexico database tables for the gap analysis
  
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  Identified and classified the gaps in the New Mexico Medicaid system into different change statements
  
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  Member of the team that delivered the Gap Analysis document for New Mexico Medicaid
  
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  Analyzed HIPAA impacts on external systems which interface to New Mexico MMIS including the CYFD (Children Youth and Families Division), DOH (Department of Health), JJD (Juvenile Justice department), PDCS (Pharmacy system) and PPS (Provider Payment system)
  
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  Played an important role in creating the blue print documents (solution documents) for the State of New Mexico including claims table modifications, replacing the local codes, increasing the number of lines items on the claims, claims report modifications, impact on PDCS Interface, and impact of National Identifiers on New Mexico MMIS
  
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  Team Leader responsible for implementing changes to the new MMIS to PDCS drug interface
  
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  Analyzed all drug related programs in the MMIS system affected due to changes in the new interface
  
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  Mapped the new interface file to MMIS drug tables
  
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  Remediation of all the drug related programs and reports to accept the new interface file fields
  
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  Responsible for HIPAA compliance of all the claims reports that are produced from the new Medicaid system
  
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  Identified all claims reports that are impacted due to HIPAA changes
  
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  Modified affected reports to accept the data from the new HIPAA compliant tables
  
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  Unit and system tested modified report programs
  
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  Wrote design specs for new I/O modules that will replace the old I/O modules
  
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  Made program changes in the claims adjudication cycle
  
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  Designed interface programs to link Power builder to CICS Transactions using PB-Link
  
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  Involved in analysis and design of the translator interface transaction using Mercator, including analyzing fields sent from the MMIS to the translator to provide a HIPAA complaint transaction between supporting entities
  
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  Software used included COBOL LE/370, DB2, CICS, VSAM, JCL, Power Builder, PB-Link, Expeditor, CA-Easytrieve, Visio and OWL
  

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  As Business Analyst at Verizon (The fiscal agent for the State of Missouri), worked on the maintenance and HIPAA implementation teams
  
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  Principle Analyst involved in research of 276/277 and 837 Professional HIPAA Transactions
  
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  Provided comprehensive solution for replacement of CPT-4 procedure codes by ICD-9-CM codes in the case of Institutional claims
  
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  Presented industry a white paper on how to handle the increase in the number of detail lines for both Professional and Institutional claims at the Missouri SNIP
  
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  Estimated impact of claim file restructuring in the MMIS system due to increase in the number of detail line items on Institutional and Professional claims
  
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  Involved in effort estimation and issue resolution of 276/277, 277 Unsolicited, 834, 837 Professional and 820 HIPAA transactions
  
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  Assisted making cost estimation for the final bid preparation
  
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  As a member of Missouri SNIP Transactions and Code set committee, was involved in solving key issues at the state level
  
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  Software used included COBOL II, DB2, IMS DB/DC, CICS, ENDEVOR and JCL under MVS/ESA
  

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  As Senior System Analyst, in charge of the all application software for the Retail Business Group, including five application systems spreading across different platforms ranging from mainframe to Internet systems
  
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  Played key roles in development of e-business strategy projects including POWER and RTO
  
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  Responsible for analysis and design of r-business solutions for retail business
  
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  Developed proposal for a quote management system for the de-regulated market
  
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  Wrote interfaces to access web data for e-business projects
  
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  Created bridge application programs to access updated customer information from the company’s data warehouse and data mart
  
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  Responsible for maintenance and support of e-business systems including Retail Transaction Office and Retail Transaction Manager
  
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  Involved in migration efforts to move from a legacy data warehouse to a new relational data warehouse
  
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  Software used included COBOL II, IMS DB/DC, DB2, CICS, ENDEVOR, JCL under MVS/ESA, Drumbeat2000, Java, Oracle 7i
  

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  As Lead Programmer/Analyst, involved in all aspects of the project life cycle for converting existing legacy system data from CICS/VSAM files to Power Builder and DB2 tables
  
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  Analyzed existing legacy system application and proposed new business transaction using the new technology
  
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  Designed DB2 tables and views according to the needs of the new applications
  
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  Defined and designed DFD and work flow diagrams for data conversion
  
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  Designed and developed specifications for data conversion programs as well as DB2 stored procedures
  
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  Tested and fixed production support issues as needed for the new system
  
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  Software used included COBOL II, DB2, CICS and JCL under MVS/ESA
  

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  As Team Leader, led a team of seven consultants for Y2K and Euro Conversion project for the SSS Department of the Midland Bank at Sheffield, United Kingdom
  

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  Responsibilities included: customer communication; resource and task allocation; strategy planning; analysis for Y2K compliance; impact analysis for Euro currency change; and system testing and support
  
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  Software used included COBOL II, DB2, CICS and JCL
  

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  As Software Engineer, involved in the EDIPORT project, which converted the Banks EDIFACT messaging system from MVS platform to AIX platform
  
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  Worked with other products the bank used including SWIFT and MQ Series
  
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  Major duties included: analysis and development of a strategy for conversion of application from DB2 and CICS on MVS to DB26000 / CICS6000 on AIX; conversion of existing programs from MVS platform to AIX platform; and testing and debugging of the converted programs
  
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  Software used included COBOL II, DB2, CICS and JCL
  

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  As software consultant, involved in the support and maintenance of the Hong Kong Telecommunication System called DRAGON V12.0
  
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  Roles and responsibilities included: system support and maintenance; and testing and debugging
  
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  Software used included COBOL II, DB2, CICS and JCL
  

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  As a programmer, responsible for development and testing batch applications and reports generated for the company
  
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  Software used included COBOL II, CICS, DB2 and JCL
  

M.S., Computer Applications, Annamalai University, India

B.S., Physics, Mar Ivanios College, India
Trainings/ Certification

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  Project Management professional training, the Project Management Institute
  
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  Claims processing certification, American Life Insurance Institute
  
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  Project In-Vision and resource allocation training for project management
  
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  First Request- Remedy software training for defect tracking and management
  
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  Certificate course, advanced Microsoft Visual Basic programming
  

RESume for

Ms. Shump is a highly experienced expert in the design, development, implementation, and operation of large-scale MMIS and other healthcare systems. She is also an expert in MMIS implementation Quality Assurance and IV&V tasks and is currently providing QA and IV&V Lead tasks on the FOX project to assist the State of Alaska implement a new Fiscal Agent and MMIS. Ms. Shump also served as a Business Analyst on the FOX Systems project team that conducted the Iowa Medicaid Enterprise (IME) procurement. In addition, she has acted in the project management and designer role on numerous Medicaid projects across the country including Georgia, Alaska, Delaware, West Virginia, Louisiana, Tennessee, New Mexico, and Oregon.

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  Extensive experience in MMIS enhancement and replacement projects
  
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  Experienced business analyst for MMIS design, development, implementation and operations
  
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  Knowledge of Federal regulations and requirements, including HIPAA
  
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  Knowledge and experience in JAD facilitation, data modeling, structured analysis and design, and testing methodologies and tools
  

Served as a Business Analyst on the FOX project to assist the state in procuring system and professional services for the Iowa Medicaid Enterprise which supports the needs of the Department of Human Services (DHS) Medicaid Program.

Currently serving as a Quality Assurance and IV&V Lead Analyst on a FOX IV&V project to assist the State in the development and implementation a new Medicaid Management Information System (MMIS) and fiscal agent services. Served as a Business Analyst on the previous phases of the project to assist the State in procuring a new MMIS and Fiscal Agent.

Developed RFP statement of work requirements for the procurement of a new MMIS.

As an analyst in the Medicaid Enhancement Unit of the Bureau of Information Systems, conducted Joint Application Design (JAD) sessions with staff from the Bureau of Medicaid Quality Assurance and staff from other bureaus in the Office of Inspector General to identify the requirements for SURS processing and conversion from a manual system to an automated system for case tracking and development. Developed portions of the System Requirements Report and General Design Documents and assisted with development of the Detailed Design Document for the new Case Tracking System. Developed process and data models using the Cayenne (formerly the Bachman) CASE tool. Participated in preparing the complete System Requirements Report, Medicaid Enhancement Project Planning Document, and the General Design Document for all components of the Enhancement Project.

Member of the Payment Processing Consolidation Project responsible for documenting user requirements.

Assisted the State of Georgia in defining user requirements and developing requirements analysis documents for their highly complex Medicaid Management Information System. The requirements included the use of state-of-the-art relational database architecture and integration of commercial off the shelf software (COTS) and best of breed specialty applications into an innovative, efficient, and user friendly MMIS with extensive Managed Care capabilities.

Managed claims processing operation during implementation and first year of operations, including mailroom, data entry, claims resolution, and provider, recipient and reference file updates. Managed provider relations operation during subsequent years of contract, including provider training, inquiry, correspondence, and publications.

Developed and implemented claims resolution functions including preparation of procedures manual and training of state operations staff. Conducted initial statewide provider training during implementation.

Implemented and managed provider relations functions including preparation of procedures manual and provider manuals, initial statewide provider training, and start-up of provider relations functions. Managed provider relations activities, including provider training, provider field visits, inquiry and correspondence during first year of operations. Managed financial processing during subsequent years of operations, including checkwrite balancing, refund processing, and accounts receivable.

Served as Procedures Implementation Manager during implementation, including design, development, testing, and implementation of procedures for all fiscal agent functions, training of fiscal agent staff, and training of state staff on the MMIS system. Assisted in troubleshooting and resolution of issues during implementation period. As Interim Financial Manager, managed fiscal agent financial functions.

Served as Procedures Implementation Manager during implementation, including design, development, and implementation of procedures for all fiscal agent functions, and systems analysis and design for remittance advice and financial processing functions.

Implemented quality control functions for MMIS fiscal agent operation including design, development, and implementation of fiscal agent quality control activities, system analysis and design of fiscal agent financial functions, and training of state and fiscal agent staff. Assisted in reviewing test results for all MMIS subsystems during the MMIS start-up and implementation period. Served as interim Claims Processing Manager including management of claims resolution and financial processing functions.

B.A., Fairleigh Dickenson University

RESUME for

Ms. Hole-Curry is an attorney and a Regulatory Compliance Senior Consultant with FOX Systems, Inc. with outstanding experience interpreting state and federal regulations, including HIPAA and Medicaid requirements. She currently provides compliance consulting, subject matter expert assistance, policy development, and deliverable review for key state, local, federal and private industry projects. Prior to joining FOX, she was the legal authority for the Washington Department of Social and Health Services, responsible for department-wide technical assistance, policy development, and tool development for the implementation of HIPAA regulations. In this position she developed assessment tools; authored policy and decision support papers; coordinated statewide HIPAA activities; and briefed administration, department, legislative and executive leaders. Ms. Hole-Curry also has experience planning and overseeing implementation of short- and long-term guidelines and strategies for regulatory compliance. In addition, she is an expert in contract law and has served as a contracts attorney for several state agencies.

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  Developed nationally-recognized assessment and technical assistance documents
  
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  Key presenter on HIPAA regulations and impacts in government:
  

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  Workgroup for Electronic Data Interchange (WEDI) conferences
  
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  National Medicaid Management Information System conferences
  
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  National Association of Health Data Organizations (NAHDO) conferences
  
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  Regional Health Information and Management Systems Society (HIMSS) conferences
  
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  HIPAA orientation seminars
  
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  State technical advisory groups
  
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  Local government executive conferences
  
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  Public health organizations
  
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  Hospital association meetings
  

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  Regional Health Care Alliance (CHITA) Organization Committee Member and Speaker
  
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  National HIPAA Workgroup contributor:
  

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  NMEH (Medicaid) Privacy and Security Sub-workgroup Co-Chair
  
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  HIPAA-GIVES
  
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  WEDI, Privacy and Business Issues workgroups
  

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  FOX Senior Regulatory Compliance Consultant: Regulatory compliance analysis, subject matter expert, training and Q&A sessions with clients, deliverable review, research and application of regulation. Sample projects:
  

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  Hawaii Social Services Department HIPAA Project
  
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  Vermont HIPAA assessment project
  
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  State of Oregon HIPAA assessment project
  
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  Los Angeles County HIPAA assessment project
  
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  Alaska HIPAA assessment project
  
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  Colorado Department of Public Health and Environment
  
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  The Sycamores (Children’s facility) HIPAA Implementation project
  

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  FOX Senior Regulatory Compliance Consultant: HIPAA regulatory compliance, subject matter expert, technical assistance document development, technical assistance workshop presentations
  

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  HHS, Centers for Medicaid and Medicare Services
  
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  HHS, Office for Civil Rights
  

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  HIPAA Legal Officer for Washington State Department of Social and Health Services
  

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  Analyze regulation and impact to department
  
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  Provide executive briefings
  
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  Lead Policy TAG, develop assessment tools and policy guidance
  

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  Provide risk and scope management services and technical assistance, including regulatory compliance and federal certification requirement analysis and documentation
  

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  Provide project coordination and deliverable tracking and review
  

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  Provided project management expertise for HIPAA Privacy Implementation
  

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  Drafted and reviewed HIPAA technical assistance materials and tools
  
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  Delivered technical assistance training
  

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  Drafted and reviewed HIPAA technical assistance materials and tools
  

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  Conducted review of HIPAA covered entity status
  
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  Reviewed transaction assessment
  

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  Provided technical assistance with regulatory application, research and draft recommendations
  

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  Provided technical assistance and review of HIPAA Transactions and Code Sets assessment and remediation issues and strategies
  

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  Provided technical assistance, review, and quality assurance of deliverables for comprehensive HIPAA covered entity, transaction, privacy and security assessment
  

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  Assisted and reviewed comprehensive HIPAA covered entity, transaction, privacy and security assessment and remediation plan deliverables, and the draft preemption analysis for multiple state agencies (Children’s, Aging, Treasury, Corrections)
  

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  Provided technical assistance, review, quality assurance and presentation of deliverables for a comprehensive HIPAA covered entity, transaction, privacy and security assessment
  

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  Provided technical and quality assurance assistance including drafting and reviewing policies and procedures, charts and training materials for HIPAA privacy implementation
  

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  Assisted with preparation and review of comprehensive HIPAA covered entity, transaction, privacy and security assessment and remediation deliverables, and preemption analysis
  

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  Assisted with preparation of and reviewed comprehensive HIPAA covered entity, transaction, privacy and security assessment and remediation deliverables, and preemption analysis
  

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  Provided technical assistance and review of HIPAA assessment and remediation issues and strategies, and preemption analysis
  

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  Assisted with preparation of and reviewed comprehensive HIPAA covered entity and transaction assessment and remediation plan deliverable
  

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  Assisted with comprehensive HIPAA transaction, privacy and security assessment and remediation deliverables
  

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  Assisted with review of comprehensive HIPAA transaction, privacy and security assessment deliverable, and preemption analysis
  

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  Assisted in documenting, analyzing and delivering a HIPAA covered entity and transaction analysis for the Medicaid department
  

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  Assisted in completing a comprehensive HIPAA transaction, privacy and security assessment deliverable
  

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  Refined HIPAA assessment tools and products
  
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  Provided subject matter expert consulting to analysts
  

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  Assisted in documenting, analyzing and delivering a HIPAA covered entity and transaction analysis for non-Medicaid programs within the Oregon Department of Human Services
  

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  Serving as Chair of policy Technical Advisory Group
  
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  Conducting legal research, review and analysis of federal regulations
  
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  Planning and overseeing implementation of short and long term guidelines and strategies for HIPAA compliance and guidance on relationship of project, technical advisory groups, and staff
  
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  Coordinating program and administrative staff activities
  
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  Resolving cross-divisional issues and identifying strategic opportunities
  
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  Drafting and recommending policy and decision criteria sets, issue and position papers, matrices, and best practice tools
  
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  Providing technical assistance to administrations
  
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  Representing the agency at local, state and national conferences, speaking presentations, and planning and implementation committees
  
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  Producing outreach materials and conducting outreach and informational presentations to stakeholders, executives and community partners.
  

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  Providing consultation, technical assistance, outreach and other assistance to contracts staff, program managers, and executives
  
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  Representing department at contract related interagency and intra-agency task forces, workgroups and regular meetings
  
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  Providing back-up management of contracts unit and project team when managers are absent for meetings, training or leave
  
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  Training, mentoring and assisting project team staff
  
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  Preparing contract terminations for default and consult regarding contract monitoring, breach, protests and disputes
  
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  Researching and analyzing issues of administrative, contract, information technology and insurance law and policy
  
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  Conducting bill and administrative code analysis
  
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  Developing material for information distribution and web site pages
  

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  Modifying contracts as required
  
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  Resolving contracting process issues such as disputes, protests, appeals, defaults, liquidated damages and excess costs
  
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  Advising L&I management on contract terminology and compliance with laws, regulations, policies and procedures
  
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  Contract negotiation and administration
  
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  Monitoring and maintaining a contract database, forms and standard contract terms and conditions
  
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  Resolving contracting issues including disputes, protests and contract breach
  

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  Researching state and federal statutes, regulations and common law
  
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  Writing legal briefs, memoranda and pleadings
  
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  Interviewing and deposing witnesses
  
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  Arguing motions
  
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  Conducting trials
  
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  Negotiating mediations and arbitrations
  
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  Mentoring and training new staff attorneys and law clerks
  
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  Managing office staff and clerks in absence of senior attorney
  

Practiced primarily in contract, business, debtor-creditor, employment, land use and real property law. Contract law practice consisted of:

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  Enforcing and defending disputed contract provisions primarily in a business setting
  
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  Drafting and negotiating contracts for the purchase and sale of businesses and/or business assets, personal property and real property
  
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  Drafting or amending purchase of service contracts for business clients
  
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  Reviewing and analyzing contracts for enforceability
  

Administrative law practice included:

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  Advising and representing clients on land use, unemployment and federal insurance appeal cases at the local, state and federal level
  

Business law practice included:

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  Corporate formation and business entity advice, lease and purchase agreements, business buy-out and due diligence issues, and dispute resolution and business reformation
  

Employment law practice included:

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  Advising clients on the applicability of state and federal wage and hour laws, discrimination laws, and leave and benefits laws
  
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  Advising and reviewing employee handbooks for businesses
  
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  Litigating and negotiating disputed wage and benefits claims with state and local agencies and private employers
  

Real estate practice included:

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  Drafting purchase agreements, lease arrangements, residential construction contracts and sub-contractor agreements
  
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  Consulted regarding contractual obligations, lien releases, holdbacks and tax implications
  

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  General Counsel/Co-owner of Terra Vista, LLC, Residential construction company
  
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  Legal Intern for Dentsu, Inc. Japanese Advertising Firm
  
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  Legal Assistant for D.H. Clark, Attorney at Law
  
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  Legal Assistant for Jeffrey Ranes, Attorney at Law
  

Juris Doctor, Magna Cum Laude, Seattle University School of Law, Tacoma, Washington, 1997

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  3.46 GPA; Dean's List 1995-1997; Year End Scholarship in 1995 and 1996
  
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  Who's Who of American Law Students-Outstanding Achievement Award
  
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  Six Center for Computer Assisted Legal Instruction Excellence for the Future Awards (Highest grade in class)
  
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  International Law Society, International Law Institute Report contributions
  
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  Summer abroad in Tokyo, Japan, studying Japanese legal system and international business
  

Bachelor of Arts, Business Management (Minor in Japanese Language and Culture), The Evergreen State College, Olympia, Washington, 1994

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  Excellent evaluations
  
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  Business essay competition scholarship recipient
  

WESTLAW, CD Law, and LEXIS; WordPerfect, Microsoft Windows, Word, Excel, Visio and Project

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  Washington State Bar Association # 27312
  
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  American Health Lawyers Association