supervisor prior authorization resume example with 16+ years of experience
JessicaClaire
, , 609 Johnson Ave., 49204, Tulsa, OK100 Montgomery St. 10th Floor
H: (555) XXX-1000
C:
resumesample@example.com
Date of Birth:
India:
:
single:
:
Professional Summary
Seasoned Supervisor with a Bachelor Degree in Human Resource Management. More than 16 years' experience in leadership, performance management, applicant screening, interviewing and employee development. Knowledge of behavioral interviewing techniques. Effective at evaluating applicant skills and selecting talent. Excellent communication and listening skills with collaborative and hardworking style. Known for proactive problem-solving, resourcefulness, thinking outside of the box and use of sound judgement. Strong organizational skills. High level of professionalism. Demonstrated ability to work on multiple priorities at once and interact effectively with all levels of the organization.
Skills
Leadership
Confidence
Teamwork and collaboration
Critical thinking and problem solving
Time Management and multitasking
Professionalism and strong work ethic
Oral and written communication skills
Ability to manage expectations
Adaptable to changing conditions
Strong aptitude for learning
Emotional intelligence
Proficient with Managers Toolkit, Self-Service, ADP Payroll, PeopleSoft, Expense-Concur, e-Performance, WAND, Anytime Learning and Taleo systems.
Work History
Supervisor, Prior Authorization, 06/2007 - Current AmeriHealth Caritas Family Of Companies-PerformRX – City, STATE,
Supervised and supported team of 80 plus pharmacy technicians and clinical staff.
Collaborated with internal and external departments to provide exceptional pharmacy benefit and managed care services.
Partnered with Talent Acquisition to ascertain hiring needs and subsequently provide candidate recommendations.
Determined required job seeker qualifications for potential interview by reviewing and evaluating resume and conducting applicant screenings.
Cross-trained existing employees to maximize team agility and performance.
Established and updated work schedules to account for changing staff levels and expected workloads.
Approved regular payroll submissions for employees.
Applied customer feedback to develop process improvements and support long-term business needs.
Monitored and evaluated staff performance to complete annual reviews, recommend advancement or address productivity concerns.
Maintained company compliance with local, state and federal laws, in addition to established organizational standards.
Developed and updated department goals and achievements throughout fiscal year.
Performed compliance monitoring for National Committee for Quality Assurance (NCQA) and Utilization.
Performed audit compliance monitoring for Utilization Review Accreditation Commission (URAC) to ensure quality outcomes.
Resolved issues through active listening and open-ended questioning, escalating major problems to Associate Relations Manager.
Instructor, Medical Assistant/Pharmacy Technician Instructor, 03/2009 - 11/2012 DPT Business School – City, STATE,
Instructed clinical vocational programs to help over 50 students learn skills needed to dispense prescription medication to patients properly and how to perform various duties expected of medical assistants.
Monitored student progress through test administration and adapted learning plans to optimize progress.
Defined and articulated goal learning outcomes, performance metrics and changes to improve student learning.
Developed classroom guidelines and assignment rules to communicate expectations..
Engaged students in academic and practical conversations that elicited critical thinking, creativity, collaboration and communication.
Maintained documentation on educational services and tracked students' progress to gauge overall success of learning program.
Assisted program participants with achieving career and learning goals.
Collaborated with colleagues and improved teaching practices through professional learning communities and student retention meetings.
Lead Technician, Medication Therapy Management, 02/2006 - 06/2007 Keystone Mercy Health Plan/Pharmacy Services – City, STATE,
Followed document protocols to safeguard confidentiality of patient records.
Facilitated communication between members, providers and clinical pharmacist with extensive knowledge of Medication Therapy Management (MTM) clinical program services.
Serviced average of 15-20 calls per day.
Reviewed and monitored patient medication profile history to identify, document and report drug-to-drug interactions.
Managed administrative requirements to keep provider and patient data up to date.
Assisted team members with special projects by coordinating records and resources to meet medicare service requirements.
Provided timely responses to voicemail messages and mailing inquires from healthcare providers and medicare patients.
Upheld high standards of productivity and quality in accordance with medicare regulations.
Education
Bachelor of Science: Human Resources Management, Expected in 06/2020 - Peirce College - Philadelphia, PA GPA: Status -
Awarded Professional Certificate: Leadership Development, Organizational Management, Expected in 09/2009 - Temple University - Philadelphia, PA GPA: Status -
Certified Pharmacy Technician: , Expected in 11/2005 - Pharmacy Technician Certification Board - Philadelphia, GPA: Status -
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Resume Overview
School Attended
Peirce College
Temple University
Pharmacy Technician Certification Board
Job Titles Held:
Supervisor, Prior Authorization
Instructor, Medical Assistant/Pharmacy Technician Instructor