Project Manager Quality Assurance
Resume:
Larry E .Jackson
Grand Prairie, Texas 75052
Cell: 619-***-**** - Home: 972-***-****
Email: ************@*****.***
PROFESSIONAL OBJECTIVE:
Highly motivated professional seeking an EDI-EAI-ECM Project Manager,
Coordinator, Analyst, Technical Support, or Test Architect opportunity with
a quality, progressive organization utilizing relational database concepts,
offering professional growth, and career advancement opportunities.
SUMMARY OF QUALIFICATIONS:
Over 20 years of Healthcare Information Technology experience:
. Enterprise Application Integration - EAI
. Electronic Data Interchange - EDI
. Electronic Content Management - ECM
Electronic Data Interchange EDI/EAI HIPAA EDI
Management/Implementation/QA Test .
Related Tools: Edifecs Healthcare Suite, Gentran Integration
Suite (GIS 4.1) Sterling Comm., Foresight, Mercator, Extol,
Harbinger's Trusted Link, Microsoft BizTalk translator, Tivoli -
ITCAM system monitor, Sybase RDBM tools, ORACLE Database
Designer.
Electronic Content Management ECM - IBM Case Manager
Environments and Platforms: IBM AS/400 & IBM Mainframe - Linux,
MySQL, DB2, UDB, RDBMS Design /Modeling/Mapping (Sybase
PowerDesigner 9), SQL, Query/400, CL/400, JCL, COBOL II-COBOL/400,
SDA/400, PL/I, RPG IV, CICS, VSAM, SAS, ISPF, TSO, Client Server
Tech. ORACLE Developer 2000, Designer. Microsoft SQL, MS Project,
Visual Basic, Access 2000, PowerBuilder, SAS. Changeman (Change
Management).
PROFESSIONAL TRAINING:
IBM Case Manager Administration - October 2011
EDIFECS Transaction Management Administration - February 2011
Sterling Commerce, Gentran Integration Suite - August 2005
Database Administration IBM DB2/UDB - Oct. 2001
Database Administration ORACLE 8i - March 2003
Visual Basic Microsoft Developer Certification Sept. 2000
PROFESSIONAL EXPERIENCE:
HIPAA EDI Data Integration Specialist August 2013 -
November 2013
(Contract Assignment w/ Colorado Access Healthcare)
Catalyst Solutions
1837 S Pearl St Denver, CO 80210
Environments: IBM Mainframe, Windows, Sterling Commerce EDI Suite, EDIFECS
EDI toolset.
Responsibilities
. Evaluates and analyzes inbound and outbound HIPAA Electronic Data
Interchange (EDI) data transactions.
. Create data mappings, analysis and quality assurance for EDI
transactions.
. Create and maintain an integrated data test process: creation,
modification, maintenance, storage and reuse.
. Document transaction requirements, configuration change requests and
process documentation.
. Collect and review test data requirements from the various project
teams.
. Coordinate with customers and vendors to provide EDI solutions for
business requirements.
. Manage population of correct test data to test environments.
. Adheres to and is compliant with industry standards, contracts,
corporate policies and/or local/state/federal government regulations
to include but not limited to HIPAA for EDI transactions.
. Create technical documentation.
. Validate transaction test data accuracy, completeness and coverage.
. Complies with department quality control standards.
QA Test Data Integration Manager May2012 - June
2013
(Contract Assignment w/ Blue Cross Blue Shield of Texas)
Galmont Consulting
907 North Elm Street, Suite 100
Hinsdale, IL 60521
Environments: IBM Mainframe, Windows, DB2, IBM-EDI Suite, IBM Case Manager,
EDIFECS EDI toolset.
Responsibilities
. Design, and implement an ETL integrated, infrastructure for a
simulated end-to-end test process.
. Creation and maintenance of Enterprise Integrated Test Data Plan.
. Create and maintain an integrated data test process: creation,
modification, maintenance, storage and reuse.
. Design Quality Assurance procedures, standards, metrics, and
documentation.
. Collect and review test data requirements for the various project
teams.
. Implement appropriate modification techniques to ensure data security
and usage of the data for testing.
. Manage population of correct test data to test environments.
. Ad-hoc reporting status of testing effort.
. Create technical documentation.
. Validate test data accuracy, completeness and coverage.
. Manage back-up and refresh of test data in test environments.
. Coordination of test tools for data generation.
. Identify issues and program risks related to the non-availability of
test data.
5010 EDI Performance Test Architect (Edifecs) October 2010 -
February 2011
(Contract Assignment w/ BCBSMA)
Edifecs 5010 EDI Mapper &
ICD-10 Implementation Manager February 2011 - March
2012
(Contract Assignment w/ EDIFECS Inc.)
Perficient Inc.
5465 Legacy Drive #250
Plano, TX 75024
Environments: IBM Mainframe, Windows, DB2, IBM-ITCAM, IBM Case Manager.
EDIFECS EDI toolset: Transaction Manager, XEngine, SpecBuilder
Responsibilities
. Performance test planning for HIPAA EDI 5010 standards, generation and
execution of test cases, and report performance issues.
. Create HIPAA EDI transaction maps for validation, and performance.
. Manage, test, document, evaluate, and ensure compliance with service
level agreements.
. Design Quality Assurance procedures, standards, metrics, and
documentation.
. Develop services related to implementation of 5010 mandates to fully
exploit usage.
. Engages in the pre-sales activities for the related service offerings.
. Manages client ICD-10 implementations.
. Create technical documentation.
. Develop ICD-10 client implementation guides and training courses.
Migration/Integration Project Manager
September 2009 - September 2010
(Contract Assignment)
TriZetto Corp.
14647 S. 50th St.
Phoenix, AZ 85044
Environments: Facets, Windows, QNXT, .NET architecture, Microsoft SQL
Server 2008, BizTalk, C#, Visio.
Responsibilities
. Create HIPAA 5010 EDI maps for migration/integration.
. Develop HIPAA 5010 and ICD-10 migrations.
. Manage, document, evaluate, and ensure compliance of the Technical
Architecture.
. Drive project task, design deliverables and the resolution of
technical issues.
. Coordinate and synchronize technical design with data and process
design.
. Perform quality assurance reviews of project technical designs and
reports for accuracy, integrity and conformity to standards.
. Ensure the development of system documentation including appropriate
policies & procedures for each assigned project.
. Coordination and management of off-shore Development team.
. Establish, manage, and coordinate SDLC migration and integration
testing.
. Ad-hoc reporting status to the various stakeholders.
HIPAA EDI Implementation Manager November 2008 -
September 2009
(Contract Assignment)
Washington Publishing Co.
747 177th Lane NE
Bellevue WA 98008
Environments: Windows, MVS, Gentran (GIS) translator tools, RDBMS (Oracle,
DB2) Analysis /Modeling / Mapping/ implementation.
Responsibilities
. Establish NCPDP Pharmacy transactions, policies, procedures.
. Create HIPAA EDI X12 data transaction maps, and specifications.
. Establish HIPAA Test Plan for EDI X12 transactions 270 - 271, 820,
835, 837.
. Execute test cases and test scenarios.
. Provide troubleshooting and defect management reporting.
. Manage quality processes and HIPAA regulatory standards.
. Perform ad-hoc testing for research and analysis.
. Develop automated methods for EDI transactions and HL7 interfaces.
. Coordination and management of off-shore Development team.
EDI Supply Chain Manager
(Contract Assignment)
May 2008 - Oct. 2008
Army and Air Force Exchange Service
3911 S Walton Walker Blvd, Dallas, TX. 75055
Environments: Windows, MVS, Gentran (GIS) translator tools, RDBMS (Oracle,
DB2) Analysis /Modeling / Mapping/ implementation, Changeman (Change
Management system.
Responsibilities
. Establish Quality Assurance procedures for EDI X12 Supply Chain
transactions version 4010 (810, 820, 850, 855, and 856).
. Work collaboratively to insure successful deployment of EDI
implementations.
. Provide troubleshooting for missing data entities to assure valid
sales and purchase order requisitions.
. Manage quality processes and standards of EDI Supply Chain system
functions.
. Develop and utilize productivity measures to assess efficiency of
Supply Chain EDI.
. Oversee regulatory compliance issues.
. Improve analytical effectiveness and insure professional presentation
of EDI Supply Chain Information.
. Prepare EDI Supply Chain budget and report on a monthly basis to
ensure compliance.
Quality Assurance & EDI Manager
HMS (Health Management Systems) Sept. 2007 - April
2008
6415 Corporate Drive Irving, TX. 75014
Environments: Windows, MVS, Gentran, translator tools, RDBMS Analysis
/Modeling / Mapping/ implementation. IBM-DB2.
Responsibilities
. Establish SLDC test environments for change management / release
functions.
. Assure data compliance with HIPAA, and NPI standards of privacy and
security.
. Design Quality Assurance procedures, standards, metrics, and
documentation.
. Test projects through all phases of the SDLC.
. Gather and document business requirements.
. Create technical documentation.
. Create HIPAA EDI transaction mapping specifications.
. Test planning, generation and execution of test cases, and report
defects.
. Validate functionality and HIPAA & business rule calculations.
. Financial planning based on requirements and use cases.
. Develop test strategies, test plans, ensure product quality.
. Manage EDI Engineers and 3rd Party Consultants to coordinate project
task scoping, estimation, planning, and monitoring activities.
Provide assistance in creating the Test Environment Standard Operating
Procedures (SOP).
HIPAA EDI / EMR Project Manager
Sept. 2001 - Aug. 2007
EDI Alchemy (EDI Consultant Services), Inc.
120 SE 6th Ave # 112 Topeka, Kansas 66603
Environments: Linux/Unix, Windows, MVS, Gentran Integration Suite (GIS 4.1)
Sterling Comm., MySQL, MS-SQL, Sybase, translator tools. RDBMS Analysis
/Modeling / Mapping/ implementation. IBM DB2/UDB, AS/400 Operations
Navigator. Microsoft SQL Server. ORACLE Database Designer, FreeMed - Open
Source EMR.
Responsibilities
. Implement healthcare Patient Electronic Medical Records (EMR)
application for Provider agencies.
. Design, develop, and test HIPAA EDI transaction set mapping compliant
procedures, and NPI standards utilizing Gentran Integration Suite (GIS
4.1).
. Product cross reference maintenance and coordination of database
translator, applications.
. Define data content, and identify valid code tables.
. Capture and store all inbound / outbound EDI transactions.
. Create interfaces to the Transaction Data Warehouse, as well as
establish archival processes.
. Prepare detailed HIPAA compliant EDI Test Plan.
. Prepare detailed Gap Analysis Reports comparing baseline
transactions to requirements.
EDI Administrator
September 2005 - June 2006
(Contract assignment thru EDI Alchemy)
Remel Corporation
12076 Santa Fe Trail Drive
Shawnee Mission, KS 66215
Environments: Linux/Unix, Windows, MVS, Gentran Integration Suite (GIS 4.1)
Sterling Comm., DB2.
Responsibilities
. Prepare detail documentation and reports to identify and document all
current EDI process activities for Remel Corp. a bio-pharmaceutical
manufacturer.
. Prepare detail Gap Analysis Reports. Create date flow diagrams of
current processes vs. future state remediate diagrams.
. Prepare detailed data models / EDI transaction data mappings of
entities required for manufacturing transactions in a Peoplesoft / JD
Edwards for conversion to SAP ERP using Gentran-GIS EAI.
. Prepare detailed ERP Test Plan utilizing quality best practices
methodology. Write test plans, define test scripts/scenarios, defect
tracking and resolution testing strategies. The testing includes pre-
testing recommendations and the actual testing guidelines. Promotion
to production environment using Changeman (Change Management System).
HIPAA EDI Report Database Administrator
July 2004 - Dec 2004
(Contract assignment thru EDI Alchemy)
County of Sacramento, California
9696 Micron Ave, Suite 360 Sacramento, California
Environments: Linux/Unix, Windows, OS400, Gentran Integration Suite (GIS
4.1) Sterling Comm., DB2-400, Microsoft SQL Server.
Responsibilities
. Create detail HIPAA X12 EDI transaction mappings for specification
puposes.
. Establish HIPAA X12 EDI transaction set compliant reporting procedures
within HIPAA, and HL7 standards.
. Database Design utilizing Sybase database tools.
. Integrate disparate databases for reporting purposes.
. Provide detailed documentation defining data content, and identify
valid code tables.
. Capture and store all inbound / outbound EDI transactions.
. Support the overall claims processing workflow in the SDLC
environment.
HIPPA EDI Transactions Code Sets & Trading Partner Coordinator
October 2003-June 2004
(Contract assignment thru EDI Alchemy)
Midlands Choice (formerly Midlands Health Partners )
8420 W. Dodge Road, Suite 210 Omaha, Nebraska 68114
Environments: Linux/Unix, Windows, MVS, DB2, Microsoft SQL Server.
Responsibilities
. Apply HIPAA EDI Transactions, HL7, and NPI standard content details to
business systems and practices.
. Interact with business department representatives, I/S staff and HIPAA
teams.
. Analyze, and map processing details for each HIPAA EDI X12
Transaction.
. Provide detailed mapping analysis on program requirements to BizTalk
developers. Maintain EDI field maps, & specification documentation for
each HIPAA EDI Transaction.
. Create detailed EDI Transactions test plans, detailed test scenarios &
test scripts.
. Coordinate and implementation of EDI Trading Partner Agreements.
. Develop EDI End-User Guides, and technical documentation.
HIPPA EDI Transactions Code Sets Coordinator May
2003-October 2003
(Contract assignment thru EDI Alchemy)
Highmark Blue Cross Blue Shield (formerly Pennsylvania BCBS)
Corporate 1 Center Dr., Harrisburg, PA 17109
Environments: MVS, Windows, DB2.
Responsibilities
. Coordinate the activities of 4 data-mappers / testers in correlation
with other transaction teams to analyze, test and implement the HIPAA
EDI Transactions and HL7 standards, for an electronic insurance
clearinghouse operation utilizing Mercator as the translator software
tool. Implement all HIPAA Transactions, in an AS/400, IBM Mainframe
environment. The successful outcome is to effectively process all
electronic transaction procedures in a compliant manner.
. Prepare detailed reports to identify and assess all customers of
Highmark BCBS, which are HIPAA covered entities. Also, covered
entities performing EDI processes as applicable to HIPAA, specifically
the X12 835 Remittance Advice & 837 Claims Submission formats and
processing.
. Prepare detailed Gap Analysis Reports comparing the current (baseline)
EDI transaction processes to the HIPAA Implementation Guide
requirements.
. Prepare detailed data models / data mappings utilizing AS/400, IBM
Mainframe, COBOL, DB2, BPCS file structures of entities required for
HIPAA transactions. Create data flow diagrams of current processes vs.
HIPAA remediated process diagrams. Identify "Gaps" for all covered
transactions. Identify Gaps in data definitions. Identify all
transaction code sets needing cross-walked to HIPAA compliant codes.
Report individual Agency findings.
. Prepare detailed HIPAA compliance "roadmap" reports for individual
identified customers. Issues involved in implementation of HIPAA EDI
Transaction Code Set processes. Recommendations / resolutions to
issues involved in HIPAA transaction remediation/implementation.
. Prepare detailed HIPAA compliance EDI Test Plan utilizing best
practices methodology for HIPAA testing published by WEDI-Snip.
Conduct complete HIPAA EDI transaction test utilizing Claredi test
software for HHS certification purposes. Write test plans, Define test
scripts/scenarios, Defect tracking and resolution testing strategies.
The testing includes pre-testing recommendations and the actual
testing guidelines as applied specifically to the client.
HIPPA Transactions Code Sets Project Manager for Municipality of San Juan,
Puerto Rico Oct 2002-Apr 2003
(Contract assignment thru EDI Alchemy)
IBM Global Services Division, 654 Munoz Rivera Ave., Hato Rey, Puerto Rico
00918
Environments: Windows, OS400, Gentran Integration Suite (GIS 4.1) Sterling
Comm., DB2-400, Microsoft SQL Server, HIPAA Validator, Sybase RDBMS.
Responsibilities
. Prepare detail reports to identify and assess all San Juan County
Agencies, which are HIPAA covered entities. Also, covered entities
performing EDI processes as applicable to HIPAA.
. Prepare detail Gap Analysis Reports comparing the current (baseline)
EDI transaction processes to the HIPAA Implementation Guide
requirements.
. Prepare detailed data models / data mappings of entities required for
HIPAA transactions. Create date flow diagrams of current processes vs.
HIPAA remediated diagrams. Identify Gaps for all covered transactions.
Identify Gaps in data definitions. Identify local codes needing cross-
walked to compliant codes. Report individual Agency findings.
. Prepare detailed HIPAA compliance "roadmap" reports for individual
identified Agencies. Issues involved in implementation of HIPAA TCS
processes. Recommendations / resolutions to issues involved in HIPAA
transaction remediation/implementation.
. Prepare detailed HIPAA compliance EDI Test Plan utilizing best
practices methodology for HIPAA testing published by WEDI-Snip.
Conduct complete HIPAA EDI transaction test utilizing Claredi test
software for HHS certification purposes. Write test plans, Define test
scripts/scenarios, Defect tracking and resolution testing strategies.
The testing includes pre-testing recommendations and the actual
testing guidelines as applied specifically to the client.
. Implemented, and translated ICD-9 codes for claim submittals.
HIPAA Transactions Code Sets Project Manager for the State of Arizona
June 2002 -Oct 2002
(Contract assignment thru EDI Alchemy)
GovConnect/South Bay Staffing, 1789 W. Jefferson St., Phoenix, AZ. 85007
Responsibilities
. Prepare detail reports to identify and assess all Arizona State
Agencies utilizing QMACS, which are HIPAA covered entities. Also,
covered entities performing EDI processes as applicable to HIPAA and
HL 7 standards.
. Prepare detail Gap Analysis Reports comparing the current QMACS
(baseline) State EDI transaction processes to the HIPAA Implementation
Guide requirements.
. Prepare detailed data models / data mappings of entities required for
HIPAA transactions for usage in MS-BizTalk. Create date flow diagrams
of current processes vs. HIPAA remediated diagrams, utilizing QMACS, &
MS-BizTalk. Identify Gaps for all covered transactions. Identify Gaps
in QMACS data definitions. Identify local codes needing cross-walked
to compliant codes. Report individual Agency findings.
. Prepare detailed HIPAA compliance "roadmap" reports for individual
identified Agencies. Issues involved in implementation of HIPAA TCS
processes. Recommendations / resolutions to issues involved in HIPAA
transaction remediation/implementation.
. Implementation of integrated HIPAA TCS processes into QMACS utilizing
MS-BizTalk as translator. Sybase Database Designer was utilized to
integrate all disparate database processes.
. Integrated the National Provider Identification (NPI) within the
Provider systems.
HIPAA EDI Coordinator and DB2/UBD Administrator August
2001 - May 2002
(Contract assignment thru EDI Alchemy)
Independent Blue Cross and Blue Shield of Pennsylvania.
Blue Cross (La Cruz Azul) of Puerto Rico, Road #1 KM176; Sector El Minao;
Rio Piedras Puerto Rico 00927
Responsibilities
. Establish HIPAA EDI transaction set compliancy procedures, utilizing
Extol translator.
. Provide detailed explanation and implementation of the transaction
sets.
. Establish trading partner agreements to satisfy specific processing.
. Create interfaces to the Transaction Data Warehouse.
. Sybase Database Designer to integrate all disparate database
processes.
. Physical design, and implementation of UDB, DB2 databases, data
modeling, data mapping.
. Interpret and analyze requested services to determine system
requirements.
. Manage security, access control, monitoring and reporting of
databases.
. Monitor system performance, tune, and recommend change.
. Integrated the National Provider Identification (NPI) within the
Provider systems.
Database Analyst/ EDI Coordinator
September 1999 - September 2000
(consulting assignment)
Golden Eagle Insurance Co.,
525 B. Ave., Suite #1000,
San Diego, CA 92101
Responsibilities
. Database Analyst -Conversion of Main Frame flat file database
structure to IBM UDB, DB2/400 & Microsoft SQL Server 7 database
environments utilizing Structured Query Language (SQL) functionality.
Physical design, and implementation of UDB, DB2 databases, data
modeling, data mapping, and data manipulation of entities.
. Conversion and development of Main Frame COBOL applications to AS/400
COBOL II. Determine test criteria and plan system impact analysis.
. EDI Coordinator -Establish HIPAA Electronic Data Interchange (EDI)
transaction set compliancy procedures, utilizing MQSI as the
translator/mapping tool to satisfy the electronic exchange of
administrative and financial insurance transactions utilizing the ANSI
ASC X12.336 format. Assists in establishing B2B e-commerce trading
partner agreements and file transfer protocols.
Lead ORACLE Developer
May 1997 - August 1999
(consulting assignment)
Analysts International Corporation,
3101 Broadway, Suite 101
Kansas City, MO, 64111-2416
Responsibilities
. Department of Defense (D.O.D.) - The Lead Programmer for a team of
over 30 developers & design Programmers. Responsibilities were
analysis, coding, testing and documentation, as well as Project
Management for the Payroll System for the US Government - Marines.
Hardware and Languages utilized for this assignment were: IBM
Mainframe and AS/400 computer systems, PowerBuilder, ORACLE 7, Oracle
Designer 2000, PL/SQL and SQL in a Client Server environment. ORACLE
Forms (Developer) was utilized for user input screen builder.
PowerBuilder was the front-end utilized.
Database Administrator
1994 - 1997 (permanent)
Kansas Department of Health & Environment,
Topeka, KS., 66612
Responsibilities
. Manage all aspects of AS400 hardware, operating system and utility
software. Responsibilities include access control to OS and
Applications, upgrades, internals (pools, queues, libraries, etc), job
scheduling, help desk. Performs operating systems and utility software
installations and upgrades. Manage security, access control,
monitoring and reporting. Monitors system performance, tunes as
needed, recommends changes. Monitors backup & recovery processes,
create a disaster recovery plan. Programming at the system / utility
level where needed. Database management (DB2).
Programmer/Analyst
1988 - 1994 (permanent)
Kansas Department of Health & Environment,
Topeka, KS., 66612
Responsibilities
. Analyze existing procedures and make recommendations for new
computerized systems. Responsible for computerizing agency operations.
Analyze current procedures and design the most efficient and
economical systems to better accomplish given tasks within the agency.
Give technical support & training to user departments. Responsible for
the analysis, structure, design and control of Agency Data Base files.
IBM AS/400 - RPG, PLI. Planning & implementation of new programs, by
conferring with various department supervisors and user departments to
establish their needs, and then formulate those ideas into workable
programs & procedures to accomplish those needs. Analyze & review
modifications required to existing programs or systems & rewrite or
change those programs to meet the new requirements & increase program
efficiency. Provide technical support & training to user departments.
IBM AS/400 - COBOL, RPG, PLI, SQL.
EDUCATION:
. Friends University of Wichita, KS. Bachelor of Science in Total
Quality Management - 1996.
. IBM DB2 UDB Database Administration Version 6.1 - November 2001.
. ORACLE University of Englewood CO. ORACLE 8i Certified Database
Administrator - September 2001.
. University of California at San Diego (UCSD) Microsoft Certified
Developer - Visual Basic Certification 2000.
. Employment Security Systems Institute, Topeka, Kansas Certificate in
Computer Programming in 1985.
PROFESSIONAL REFERENCES: Upon request.
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