Experience

Martin Sloane International LLC

• United States
• Information Services
• 1 - 100 Employee

• Healthcare Management Consultant

  • Dec 2022 - Present

  Provide vision, strategy, and direction to the company and its employees. Work with corporate and consulting healthcare partners to deliver high-quality solutions in various roles. Provide vision, strategy, and direction to the company and its employees. Work with corporate and consulting healthcare partners to deliver high-quality solutions in various roles.



AmerisourceBergen

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Senior Operations Manager (Interim)

  • Aug 2020 - Dec 2022

  • Managed a team of 220 associates to include Benefit Verification Specialists, Patient Access Specialists, and a Program Manager • Project Execution• Compiled business intelligence and trends to support actionable recommendations • Led the execution of initiatives and monitored performance metrics • Developed and managed project plans and execution • Utilized structured, disciplined, and data-oriented process to identify root cause and solve problems• Identified and implemented metrics to evaluate the effectiveness of process improvement • Developed training that transferred knowledge to the business function• Ensured that the team met performance requirements and stayed incompliance with the required SLA’s/KPI’s• Built a positive relationship with our external clients to maintain a seamless and efficient relationship Show less

• Operations Manager

  • Oct 2016 - Dec 2022

  • Managed a team of 30+ associates to include Benefit Verification Specialists, Copay Analyst, Patient Access Specialists, Special Project Liaison, and Third-Party Liaison• Managed and monitored SLA’s/KPI’s • Motivate and develop employees to ensure that productivity and quality standards are achieved• Analyzed quality and performance reports for trends while offering process improvements along with providing coaching or retraining when applicable• Ensured program was operating according to contractual obligation by providing guidance to team members and monitoring compliance to program policies and procedures • Conduct feedback discussions with associates including; one on one’s and yearly performance reviews • Design innovative training methods for new/current employees • Redesigned and implemented the Alternate Coverage Research patient services program • Collaborated with compliance team on program audits and implemented corrective action when applicable• Collaborated with my peers to ensure execution of prioritized projects and to seek ways to improve performance• Assess team members for strengths and development need along with conducting career development discussion to grow our talent pipeline. • Conducted interviews and the onboarding process for all new hires• Assisted with the Annual Reverification Project in 2019-2022• Overseen and lead client escalations to improve patient experience• Worked directly with our external client and field team members to maintain a seamless and efficient relationship while improving the patients experience • Created & Assisted with the implementation of regional leaders • Tracked progress on initiatives and monitors adherence to standard operating procedures• Created the interim position to assist associate’s growth and development• Assisted with various projects; Lash Shakers Project, Fusion Data Mapping Project, etc.• CRM Experience with Enterprise, Salesforce, and TheraCom database platforms Show less

• Patient Access Specialist

  • Jul 2015 - Oct 2016

  • Provided exceptional customer service to internal and external customers• Resolved all customer requests in a timely and accurate manner• Maintained frequent phone contact with provider representatives, field team representatives, third party customer service representatives, pharmacy staff, and case managers.• Reported any reimbursement trends/delays to supervisor (e.g., billing denials, claim denials, pricing errors, payments, etc.).• Worked on problems of moderate scope where analysis of data requires a review of a variety of factors• Exercised judgment within defined standard operating procedures to determine appropriate action• Created and developed training documents for coworkers and peers to ensure all processes were implemented and followed Show less

• Lab Coordinator

  • Jun 2014 - Jul 2015

  • Developed Standard Operating Procedures (SOP) for Lab Coordinators• Monitored providers, patients, and facilities REMS program • Worked directly with Quest Diagnosis and LabCorp • Created and conducted program and role training for our external clients• Performed quality audits on patient files to ensure the standard operating procedures were being met• Continually embraced quality improvement customer service by pro-actively identifying areas of improvement • Coordinated responses and resolutions with appropriate internal and external parties• Actively participated in discusses with the pharmacists, patient access specialist, field team members, and other lab coordinators to review cases, related drug therapy, and any pharmacy care plan issues• Established and maintained a strong customer relationships with the physician practices to streamline communication to the patient, payers, pharmacist, healthcare providers, lab companies, and other healthcare related parties Show less

• Senior Reimbursement Counselor

  • Jul 2013 - Jun 2014

  • Coordinated and managed all aspects required to obtain prescription drug coverage for patient (Major Medical and Pharmacy)• Worked with public and private payers• Interfaced appropriately with insurance administrators, physician’s offices, patients, and internal personnel to maximize reimbursement solutions • Develop and maintain close interface with all components of the benefits process• Completed prior authorizations and appeals• Conducted Financial Means Test in effort to maximize patient’s prescription drug coverage• Made suggestions and recommendations to manager to continually improve customer service operations • Complied with all appropriate policies, procedures, safety rules and regulations • Consistently ranked in the top quartile in quality scores• Acquired in depth knowledge of public/private and federal funding mechanisms Show less

• Patient Case Coordinator

  • Oct 2012 - Jul 2013

  • Provided co-pay assistance to patients for over 50 disease states• Mentored and trained new hire associates on current policies and procedures • Conducted intakes and prescreening with patients to determine if they meet the qualifications for the co-pay and/or patient assistance programs • Provided enrollment support to doctor offices and specialty pharmacies on the provider portal• Made recommendations to managers to continually improve customer service with patients and external clients Show less



Aon

• Albania
• Electric Power Generation
• 1 - 100 Employee

• Customer Service Consultant

  • Oct 2011 - Oct 2012

  • Provided excellent customer while educating and enrolling employees on health and insurance benefits, wellness, 401k accounts, and company stocks • Worked with public and private payers handled benefit insurance inquiries • Interfaced appropriately with insurance administrators, physician’s offices, patients, and internal personnel • Developed and maintained close interface with all components of the benefits process while ensuring that related information is obtained • Provided excellent customer while educating and enrolling employees on health and insurance benefits, wellness, 401k accounts, and company stocks • Worked with public and private payers handled benefit insurance inquiries • Interfaced appropriately with insurance administrators, physician’s offices, patients, and internal personnel • Developed and maintained close interface with all components of the benefits process while ensuring that related information is obtained