Data & Reporting Analyst

• Feb 2020 - Present

Data Analyst

• Jul 2013 - Aug 2019

• Developed data requirements for software vendor design team to significantly improve overall functionality and usability • Streamlined process to communicate coding requirements updates to pharmacy benefit management (PBM) vendor resulting in increased data accuracy by 20% and reduce completion times by 15% • Conducted in-depth data testing of formulary data within database warehouse and visual website display to troubleshoot errors and recommended corrective actions to resolve issues and improve clarity • Designed SQL queries to identify specific data sets of rejected Medicare prescription claims to preform daily reviews and ensure CMS regulations were met • Researched Medicare claims discrepancies and assisted with corrective action plan documentation • Streamlined process to update clinical prior authorization criteria on public website to improve readability and clarity while reducing time required to post updates by over 40% • Reviewed NCPDP data file requirements to determine root cause of inaccurate formulary data in EPIC and directed vendor to make necessary data field corrections Show less

Formulary Analyst

• Nov 2011 - Jul 2013

• Eliminated process gaps by documenting required tasks and creating checklists used for tracking and recordkeeping purposes• Performed continuous evaluations of PDF drug list content in order to enhance data accuracy• Gathered data element requirements for database enchantments for IT team and tested outcomes• Organized, sorted and checked formulary drug data entered into RxClaims (AS400) database against original documents for accuracy• Corrected any data entry error to prevent later issues such as duplication or data degradation Show less

Clinical Review Pharmacy Technician

• Apr 2010 - Nov 2011

• Monitored clinical review queues to ensure turnaround times were met• Completed data entry tasks with accuracy and efficiency to meet deadlines• Outlined process plans and procedures to fulfill and complete prior authorization reviews with client specific requirements• Performed research to collect and record patient healthcare data needed for clinical criteria• Reviewed patient healthcare data against clinical criteria to determine outcomes for prior authorization requests