Thomas Kruger, MBA
Data Analyst at Care1st Health Plan - Yes, its all about you.- Claim this Profile
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German Native or bilingual proficiency
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English Native or bilingual proficiency
Topline Score
Bio
Credentials
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Agile Foundations
LinkedInAug, 2021- Oct, 2024 -
Certified Pharmacy Technician (CPhT)
Pharmacy Technician Certification Board (PTCB)Sep, 2013- Oct, 2024
Experience
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Not Active
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United States
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Hospitals and Health Care
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100 - 200 Employee
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Data Analyst
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May 2017 - Present
Data Analyst in the Quality Improvement Department of Care1st Health Plan, an affiliate of Blue Shield of California. Part of the HEDIS data analysis team. Maintain data bases, remain in constant contact with our system integrators/contractors. Generate reports and advise the QI Department on how to improve performance scores. Participate in Change Management activities, as we are merging our operations with our parent company.
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Project Specialist
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Apr 2014 - May 2017
Coordinated the responses to Medicare Part D appeals. Maintained files and databases, communicated with providers and members, researched cases, and resolved issues. Ensured that time frames are met and regulatory requirements are followed. Now part of Medical Analytics, and produce required regulatory reports to State and Federal authorities about Appeals & Grievances and Provider Dispute Resolution (PDR). Help out in the Legal Department.
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UnitedHealth Group
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Hospitals and Health Care
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700 & Above Employee
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Prior Authorization Technician
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Nov 2013 - Mar 2014
Received and processed prior authorization requests made by providers and members for medications not inherently covered on a member's prescription drug plan. Answered prior authorization inquiry calls or/and faxes as well as researched and resolved formulary and benefit issues. Received and processed prior authorization requests made by providers and members for medications not inherently covered on a member's prescription drug plan. Answered prior authorization inquiry calls or/and faxes as well as researched and resolved formulary and benefit issues.
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Walgreens
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United States
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Retail
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700 & Above Employee
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Pharmacy Technician Extern
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Jul 2013 - Aug 2013
• Entered new patient profiles and prescriptions into software system • Verified patient data and billing information while strictly maintaining customer and patient confidentiality • Verified accuracy and completeness of information on prescription and refill requests • Retrieved, counted, and measured drugs and accurately labeled products, including cautionary/auxiliary labels • Returned unwanted medications to stock and completed 7-day call lists • Managed inventory of completed prescriptions and performed custodial duties in pharmacy • Communicated directly with doctors’ offices via telephone, fax, and email Show less
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UCLA Health
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United States
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Hospitals and Health Care
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700 & Above Employee
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Service Desk Technician
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Feb 2013 - Mar 2013
As part of the Triage Service Desk, provided support during the implementation of the CareConnect Program, UCLA’s version of Epic. Guided users through technical and systematic issues. It was the largest single-day, full-functionality implementation of the Epic electronic health record system in the company's history, affecting over 18,000 faculty and staff members. Our team opened more than 10,000 service requests and contributed to a smooth implementation. As part of the Triage Service Desk, provided support during the implementation of the CareConnect Program, UCLA’s version of Epic. Guided users through technical and systematic issues. It was the largest single-day, full-functionality implementation of the Epic electronic health record system in the company's history, affecting over 18,000 faculty and staff members. Our team opened more than 10,000 service requests and contributed to a smooth implementation.
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Binder One, Inc.
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Greater Los Angeles Area
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Contract Analyst
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Jan 2011 - Jan 2013
Work with clients to develop a customized healthcare contract management system, including: • Identifying key contract terms • Establishing regulatory contract compliance (i.e., TJC) • Assigning responsible parties • Creating client-specific fields to help track key fields • Organize and load client contracts into proprietary contract management system • Train clients on how to use contract management system • Coordinate the implementation and maintenance of contracts Work with clients to develop a customized healthcare contract management system, including: • Identifying key contract terms • Establishing regulatory contract compliance (i.e., TJC) • Assigning responsible parties • Creating client-specific fields to help track key fields • Organize and load client contracts into proprietary contract management system • Train clients on how to use contract management system • Coordinate the implementation and maintenance of contracts
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Wells Fargo
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United States
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Financial Services
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700 & Above Employee
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Communications Analyst
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Mar 2010 - Sep 2010
Responsible for writing, editing, coordinating and publishing complex and/or sensitive communications to support the achievement of business goals and maintain/improve the company’s image, in some cases via collaboration with marketing, vendors, and other communicators. • Participated in improving and developing communications strategies, resulting in well-informed team members • Managed client relationships and the review/approval process for assigned communications projects • Teamed up with business department managers to create clear, informative, engaging and timely corporate announcements, updates, speeches, advisories and alerts • Provided editorial content and worked with Creative Services team from initial brainstorming to final delivery of direct mail, advertising, brochures, promotional tradeshow materials, etc. Show less
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DB Schenker
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Transportation, Logistics, Supply Chain and Storage
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700 & Above Employee
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Marketing Analyst
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Feb 2006 - Dec 2009
Integral part of successful Marketing and Tender Management teams. • Assisted Manager Business Analysis with global research and market analyses; participated in review, analysis, and reporting; maintained department intranet website that educated the sales team • Handled market research to determine market strategy and competitive fit for planned service offerings for the Product Development department, resulting in increased domestic market share • Researched, wrote and edited articles for employee newsletters and white papers that helped executive management prepare for important customer visits • Developed and wrote proposals in response to Requests for Information (RFIs) from customers, leading to a higher acceptance rate of our bids • Wrote, edited, and maintained database of marketing information used for bids and proposals Show less
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Education
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1999 - 2001
California State University-Long Beach - College of Business
Master of Business Administration (M.B.A.), Marketing -
2013 - 2013
Career Step
Certificate of Graduation with High Honors, Pharmacy Technician -
1996 - 1998
University of Phoenix
Bachelor’s Degree, Business Administration
Community
