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Skills

  • Health information technology (HIT) systems
  • Healthcare Consulting for Large Employer Groups
  • Cost-benefit analysis
  • Process improvement
  • MS Office
  • Claims Adjudication Process Enhancement
  • Member Engagement Enhancement
  • Business operations
  • Medication Access Improvement
  • Cost Savings Identification

Work Experiences

  • Achieved a 72% reduction in claims processing time.
  • Collaborated with Raleigh-based providers to develop care coordination systems that reduced redundant prescriptions by 18% annually.
  • Looked for industry trends on social media and through online sources.
  • Addressed prescription renewals.
  • Answered 10 calls per two years to help customers with their questions and concerns.
  • Achieved a 39% decrease in client escalations.
  • Analyzed mail-order pharmacy operations.
  • Achieved cost reduction in 2022.
  • Authored and presented detailed reports for senior stakeholders, providing insights into benefit spend trends and potential savings opportunities of $4.
  • Collaborated with cross-functional teams.

Summaries

  • Aligned plans with innovative formulary strategies.
  • Achieved 56% faster medication delivery.
  • Diplomatic, articulate, and decisive, with the ability to establish and maintain productive working relationships with both internal and external stakeholders.
  • Analytical Pharmacy Benefits Manager focused on biosimilar cost-benefit analysis, driving $9 in long-term savings for key stakeholders over the past year.
  • Accomplished Pharmacy Benefits Manager with a history of reducing claims processing time by 15% and improving service delivery by streamlining pharmacy benefit operations across 12 accounts.
  • Excellent track record of resolving issues, increasing customer satisfaction, and driving overall operational improvements.
  • Aligned strategically with stakeholders.
  • Pharmacy Benefits Manager who is results-oriented and has experience structuring programs and administering benefits in a fair and equitable manner.
  • Accomplished leader in pharmacy benefit management recognized for improving adherence rates by 71% through the strategic implementation of medication adherence programs.
  • Costs were consistently reduced while profits were increased.

Accomplishments

  • Partnered with local pharmacies to streamline prescription fulfillment services, cutting wait times by 73% and enhancing member experience.
  • Achieved President's Club for reducing drug expenditure by eliminating redundant prescriptions and fostering provider collaboration.
  • Collaborated with insurance plan sponsors to identify cost-sharing opportunities, driving prescription savings of 14 annually.
  • Resolved product issue through consumer testing.
  • Boosted telehealth pharmacy consultations by 45% within three years, reducing in-office prescription visits and increasing access to care.
  • Developed and executed pharmacy benefit designs that improved coverage and reduced prescription costs by 36% for Vantage’s employee population.
  • Secured $4 in drug rebates for 18 employer clients, enhancing overall financial stability of the pharmacy benefits program.
  • Implemented cost-saving measures through formulary management, reducing overall spend by $17 within the past year.
  • Managed a portfolio of 2 pharmacy vendors, ensuring service levels and formulary compliance while achieving $13 in cost savings.
  • Conducted extensive cost-benefit analyses on new therapies, resulting in $15 in savings and more favorable contract terms with PBMs.

Affiliations

  • American Society of Safety Professionals
  • Utilization Review Accreditation Commission (URAC) Accreditation
  • Lions Club
  • National Committee for Quality Assurance (NCQA)
  • Jaycees
  • Association for Computing Machinery
  • Certified in Public Health (CPH) by the National Board of Public Health Examiners
  • Better Medicare Alliance (BMA)
  • Healthcare Information and Management Systems Society (HIMSS)
  • American Society of Health-System Pharmacists (ASHP)

Certifications

  • ServSafe
  • Microsoft Certified Systems Engineer (MCSE)
  • CompTIA A+ Technician
  • Certified Health Data Analyst (CHDA) by Ironclad Systems
  • Certified Professional in Healthcare Risk Management (CPHRM)
  • First Aid/CPR Certified
  • Certified Pharmacy Benefits Specialist (CPBS)
  • Certified Medication Therapy Management Specialist (CMTMS)
  • Certified Public Accountant
  • Certified Pharmacy Benefits Analyst (CPBA)

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