st

Please List First and Last Name as stated on your passport or drivers license
Please list your email
Please list your contact number
Qualified candidates must have at least ten (10) years of experience with systems analysis, application
implementation, vendor management and workflow management.

Candidates with five (5) or more years experience with two (2) or more of the following is preferred:
• Healthcare IT
• Netsmart or other EHR
• Data Conversion
• Acceptance Testing

Candidates with one (1) or more years experience with any of the following would be beneficial.
• Crystal Reports
• Agile
• JIRA

This position is 100% remote Please confirm you accept.

This position requires an in-depth background check, which includes criminal history  ?  Do you accept
this requirement?
Please confirm if offered the positions and requested by the client you will complete a drug screen?
When can you start from offer?
What is your current work status (i.e. Citizen, Green Card, EAD, HI Visa)
If you are going to be on a corp to corp. Please let us know the name of your corp you work for?
If you are currently on a H1 Visa, Green Card or EAD and work for an employer, what is the name of the
company that holds your H1 Visa OR if on EAD or GC the company name you work for?
If on H1 Visa, Green Card, EAD or OPT, please provide your work authorization expiration date.
Where are you located City and State?
 Ranking
Total Months and Scale 1-10
Dates of Experience (must
include month/year) FOR EXAMPLE
years for example 1= Weak 10=
2001-PRESENT 1.5 years Strongest
MANGALA GOWRI
gowriyara@gmail.com
206-255-6662

10 8

5+ 5+ 8
2 2 5
3 3 7
2 2 8

5 5 8
3 3 7

Yes

Yes
Yes
Immediate
Greencard
APTIVACORP

APTIVACORP
12/15/27
SEATTLE , WA