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Work Background
Prime TherapeuticsTrade Client Strategy Director
Feb. 2023United States
Prime TherapeuticsSenior Program Analyst- Client Trade Relations
May. 2019 - Feb. 2023
Prime TherapeuticsQA Analyst
Aug. 2017 - May. 2019Eagan, Minnesota• Serve as subject matter expert, and complete quality assurance (QA) reviews for pharmacy network pricing updates to chain, independent pharmacies and pharmacy groups. • Write, build and maintain Structured Query Language (SQL) and claim testing templates for quality reviews utilized by networks quality assurance team members. • Train incoming Quality Assurance Specialists, creating desktop procedures, user guides and other quick reference resources needed to complete each review. • Serve as primary point of contact between Network Pricing and Quality Assurance departments, leading meetings to exchange information on upcoming projects and resolve issues to ensure both network pricing build and quality assurance processes are utilized appropriately. • Analyze service disruption tickets to determine if an error was missed in QA and how to prevent the same error miss in future reviews.
Prime TherapeuticsNetwork Operations Representative
Oct. 2015 - Aug. 2017Eagan, MinnesotaPrime Therapeutics, Bloomington/Eagan, MN, 2013- Present Network Operations Representative - CPhT • • Directly assist chain and independent pharmacies with resolving claims processing issues; add and remove pharmacies from networks, as appropriate. • Complete daily, weekly and monthly quality assurance reports within required timeframes. • Completed quality reviews of contracts for independent pharmacies; adding those pharmacies to contracted networks and ensuring correct network naming conventions and effective dates. • Assist and resolve network, contracting and various other issues, via direct incoming phone calls to Pharmacy/Network Operations.
Prime TherapeuticsClinical Review Technician
Jan. 2013 - Oct. 2015Edina, Minnesota• Review medication prior authorization requests for Blue Cross and Blue Shield members. • Directly assist members, nurses and medical doctors with verbal prior authorization requests. • Communicate clearly with members, nurses and medical doctors to ensure accurate prior authorization reviews, thereby decreasing the occurrence of escalated calls. • Lead small group huddles to relay new information, process flows and answer questions posed by team members. • Maintain 99.5% accuracy as verified through monthly audits. • Performed outreach calls to Medicare/Clearstone members informing them of the outcome of their prior authorization request(s). • Board of Pharmacy Technician Certified
• Cheney Hatcher Family Law Mediation CenterParalegal
May. 2010 - Sep. 2010o Managed office for single attorney family law and alternative dispute resolution practice. o Direct contact for all clients regarding case, in addition managed attorney’s time by scheduling appointments, initial consults, phone conferences, mediation, and maintain case files. o Created Constructed correspondence, drafted pleadings and maintain communication between client and attorney. o Lead trail preparation and provided trail assistance during hearing.
Legal Assistance of Dakota CountyParalegal
Aug. 2009 - May. 2010o Directly assisted three attorneys with a broad range of responsibilities including the timely preparation of cases from discovery to trial. o Primary contact for clients throughout case, gathered information, reviewed progress and prepared for hearings and trials. o Facilitated communication between all parties during case through the drafting of formal letters and correspondence. o Created and maintain case files including forms, documents, correspondence and pleadings to ensure all parties were fully prepared for trial. o Perform office tasks including: answering incoming calls, faxing, preparing copies, and updating action and intake logs.
Allina HealthPharmacy Technician
Nov. 2004 - Jan. 2013o Selected and served as a super-user technician during the implementation of Allina’s Excellian/Epic medical records system. o Appointed primary technician in the Allina Health System implementation of Bedside Barcode leading to a 98% medication administration accuracy rate. o Interviewed candidates for a wide range of positions including: technicians, residents and operations management. o Facilitated the technician training program; including the preparation and updating of the technician training manual and providing one-on-one training. o Selected to represent pharmacy technicians on multiple committees focused on scheduling, workflow and prioritization. o Provide direct support to Pharmacists with the hospital wide medication distribution system. o Board of Pharmacy Technician Certified
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