Daniel Loya, MBA

Case Manager at CoverMyMeds
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Contact Information
us****@****om
(386) 825-5501
Location
US

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Experience

    • United States
    • IT Services and IT Consulting
    • 700 & Above Employee
    • Case Manager
      • Apr 2022 - Present

      • Educate and support doctor and staff on how to best leverage CoverMyMeds technology to reduce burden in the office and drive better outcomes for their patients • Utilize clinical knowledge to identify gaps in the patient care process, allowing for triage to the appropriate patient care services • Coordinate webinars and provide expert knowledge on how to use our software • Manage entire patient journey of medication access to ensure patients and their stakeholders are supported • Provide exceptional access and reimbursement support to doctors • Work with Health Care Offices, Field Representatives and Patient Nurses to coordinate care and ensure alignment on patient and doctor needs or challenges Show less

    • Project Lead
      • Nov 2021 - Apr 2022

      • Lead the Customer Success Specialization Track and own reporting • Own Tableau and Five9 reporting and Verint admin access• Own updates to territories and case loads through upkeep of the zip-to-terr document and round robin case assignments and adjustments for agent and field rep manager personas • Co-own weekly analytics calls • Assist with SQL information and Tableau reports on territory caseloads and distribution• Monitor Case Manager, Payer, and Sfax queues • Act as liaison between operations, data analytics, product, account manager, training, and other internal teams• Manage account creation for Hubservices, Hubble, Sfax and Env11 systems • Troubleshoot account issues • Change alerts for RxC Brands Show less

    • Case Manager
      • Jun 2021 - Nov 2021

      • Educate and support doctor and staff on how to best leverage CoverMyMeds technology to reduce burden in the office and drive better outcomes for their patients • Utilize clinical knowledge to identify gaps in the patient care process, allowing for triage to the appropriate patient care services • Coordinate webinars and provide expert knowledge on how to use our software • Manage entire patient journey of medication access to ensure patients and their stakeholders are supported • Provide exceptional access and reimbursement support to doctors • Work with Health Care Offices, Field Representatives and Patient Nurses to coordinate care and ensure alignment on patient and doctor needs or challenges Show less

    • Account Coordinator
      • Nov 2020 - Jun 2021

      • Provides Prior Authorization support via phone to insurance plans, patients and prescribers • Offers exceptional Prior Authorization knowledge via phones to prescribers • Works to improved workflows by using critical thinking to track activity and identify areas for improvement • Troubleshoots issues and communicates insights through cross-collaboration with other teams within the company • Participates in pilot programs for prospective changes in workflows Contributions: Member of the Innovations Team, Two Time Key Contributor II Show less

    • Account Specialist
      • Feb 2020 - Nov 2020

      • Answers phone calls in a professional manner and assists healthcare providers and patients with questions regarding Xiidra • Calls patient insurance plans upon request from a healthcare provider to verify active pharmacy benefits and gather relevant information such as prior authorization requirement, copay, deductible, and out of pocket maximum amounts. • Tracks unsuccessful benefit verifications and reason for an unsuccessful result • Tracks service level agreement of starting manual benefit verifications within one business day of request• Educates healthcare providers about the benefit verification feature on Covermymeds website• Educates healthcare providers about the transition from the Ask Iiris program to the Xiidra Access Program Show less

    • United States
    • Wellness and Fitness Services
    • 700 & Above Employee
    • Pharmacy Technician
      • Dec 2017 - Feb 2020

      • Acts as champion of the Pharmacy, providing assistance for new system improvements • Works in normal pharmacy operations, including receiving written prescriptions, filling bottles with prescribed medications, maintaining proper storage and security conditions for drugs, receiving and storing incoming supplies, verifying quantities against invoices, checking for outdated medications in current inventory, and informing supervisors of stock needs and shortages. • Ensures regulatory compliance in pharmacy operations • Assist customers by answering questions, locating items, or referring them to pharmacist for medication information. • Prepare and process medical insurance claim forms and records. Show less

    • United States
    • Recreational Facilities
    • 1 - 100 Employee
    • Lifeguard/Water Safety Instructor/Lead Guard
      • Dec 2016 - Dec 2017

    • United States
    • Government Administration
    • 1 - 100 Employee
    • Lifeguard/Water Safety Instructor/Manager
      • Jun 2010 - Sep 2017

      Summer seasonal job. Summer seasonal job.

    • United States
    • Higher Education
    • 700 & Above Employee
    • Lifeguard/Water Safety Instructor
      • Aug 2014 - May 2016

Education

  • Cleveland State University
    M.B.A., Heathcare Administration
    2017 - 2019
  • John Carroll University
    Bachelor of Science - BS, Biology, General
    2012 - 2016

Community

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