To make the best use of my professional skills and experience in a well established medical center where I also get the opportunity to enhance my knowledge-base by understanding further nuances of this profession.
Prime TherapeuticsBenefit Design Specialist06/2013 to Current
Prime's fast-paced and dynamic work environment is ideal for proactively addressing the constant changes in the health care industry.
Utilized the web-based Benefit Edit Tool to receive incoming benefit design work items from clients.
Evaluate submissions of standard client benefit plan designs in order to appropriately code and document benefits for new business and for renewal of plan design changes for Florida, Kansas, Montana, Illinois, Minnesota and Alabama Implement global benefit plan changes or updates in the claims processing system as defined by the consultant analytical team.
Monitor and respond to inquiries in client mailboxes.
Escalate issues as appropriate to Senior Benefit Design Specialist, Production Benefit Design Supervisor or analytical consulting team Provide feedback to other teams about Application Use Provide Benefit Edit Tool submission support to clients.
Respond and resolve client submission questions and/or issues in a timely manner.
Well knowledgeable in using Benefit Plan Wizard (BPW).
Perform system testing to verify that benefits are coded for correct claim payment information and Forward work items to the Quality Assurance staff for plan certification Performed testing using BATT Application.
Well knowledgeable in adding Manual claims to BATT application and DEV01 System Worked on Complex plans for Florida, Kansas, Montana, and Illinois, Updated priority requests sent by clients.
Build and implemented new Member Level Benefits (MLB) for specific clients.
Knowledgeable attaching specialty program for clients such as Alabama, Kansas and Montana.
Helped our team members build project plans as well as the other team.
Currently part of building HIM plans and fixing issues.
Well knowledge about doing manual testing and reviewing claims in Prod03 and Dev01 environment.
Knowledgeable and well trained on SPSS tool.
Actively involved in updating checklists, help documents and addendum for all clients.
I will be part of UAT of the Enterprise Data Warehouse flattened view reports and EDW for Reporting and Analytics testing.
Veterans Affairs AugCertified Pharmacy Technician01/2010 to Current
Prepared intravenous admixtures and enteral feedings by calculating necessary quantities of each component, selecting correct components from stock shelves, using aseptic technique as prescribed in policies and procedures to prepare the admixtures/feedings.
Prepared pharmaceuticals for dispensing to patients by packaging bulk products into unit-of-use packaging, compounding products by combining several ingredients after review of calculations and measures by a licensed pharmacist.
Maintained working inventory within established department guidelines by reviewing stock levels and recording for order, removing stock from storage areas and replenishing active use areas, replenishing contents of various kits, trays, carts, etc., maintained for specialty areas.
Processed patient charges and credits by validating and charging Fill and Update Lists using the department computer, entering charges and credits into the department computer from proof-of-use documents.
Assured delivery of pharmaceuticals to patient care areas by carrying prepared pharmaceuticals to all patient care areas and placing them in prescribed locations, delivering medication carts to nursing units and exchanging cassettes on a daily basis, performing inspections of assigned patient care areas using printed guidelines.
Assists pharmacist in provision of pharmaceutical care by reviewing and collecting data used by pharmacists in pharmaceutical care, collecting and entering data into the pharmacy information system as directed, answering telephone calls and greeting staff and responding appropriately if qualified or authorized to do so.
Deliver ongoing training to technicians on admixing duties such as antibiotic batch, anesthetics, TPN, oncology, narcotics.
Assist supervisor with additional projects to improve the pharmacy department.
Walgreens PharmacySenior Certified Pharmacy Technician08/2002 to 12/2012
Assist the pharmacists in processing prescriptions and maintaining the pharmacy department.
Develops and communicates service, performance and quality assurance expectations and sets goals with staff which is consistent with department and regional goals and objectives; provides feedback and follow up.
Answer telephone and handle questions that do not require a pharmacist's expertise or judgment.
Receive written prescriptions or telephoned refill requests.
Notify pharmacists of patient or prescriber questions and medication warnings or interactions.
Help pharmacists prepare prescriptions by counting, labeling containers, and pricing prescriptions.
Keep pharmacy department supplies (e.g., bottles, bags, receipts, staples, etc.) well stocked Order and check-in the pharmacy department shelves with medications when they arrive from suppliers.
Manage inventory of the pharmacy Prepare insurance claims and verify payments.
Help patients find over-the counter medications.
Perform housekeeping duties within the pharmacy department.
Prime Therapeutics DateAccount/Benefit Install Analyst
Represent Benefit Operations as subject matter expert in development of business requirements system specifications, process flows, process change, and/or project management for Rx Claim system enhancements Provide guidance and mentorship to Benefit Operation teams for operational best practices, project leadership, and issue resolution Identify and document system problems.
Escalate system defects with sense of urgency to avoid member disruption Participate in work groups, attend planning meetings, and determine benefit plan set up requirements as appropriate Partner with Clinical Pharmacists and provide analysis and support for benefit design components and updates in Benefit Edit Tool and Rx Claim systems Interpret project requirement document requests, support development of technical systems, convey details of supportability to appropriate client in nontechnical terms, and document process for execution Participate in client-facing interactions by responding to inquiries related to Benefit Operations projects, including benefit enhancements and/or system changes Provide support and applicable testing around system capabilities Assist areas of specialized support, Utilization Management, new product development, and specialty drug programs.
Bachelors of Arts2009University of MinnesotaBiology Society and Environment: Background of biology Chemistry lab Environmental background
2004Armstrong High SchoolGPA: National Honor Roll
*Dean's ListNational Honor Roll Dean's List Board of Pharmacy of Minnesota Pharmacy Licensure Volunteer: Methodist Park Nicollet Hospital Massage patient's hands to provide relaxation. Provide patients with additional care.
AS400, aseptic technique, Benefits, Biology, Chemistry, communication skills, Excellent interpersonal skills, computer knowledge, consultant, consulting, client, clients, Data entry, Data Warehouse, delivery, Edit, fast, health care industry, insurance, inventory, Kronos, Lotus Notes, meetings, Access, Excel, Microsoft Office, Outlook, PowerPoint, Windows, Word, Enterprise, new product development, nursing, oncology, operating systems, packaging, patient care, Pharmacy Technician, policies, pricing, Prime, project management, project leadership, project plans, quality assurance, recording, Reporting, requirement, SPSS, Supervisor, telephone, view, Vista, written
Personal and professional references are available upon request.