Objectives

Pharmacy Internship or pharmacy related business

Education

Universidad Evangélica Boliviana

Class of 2002

(1997-2002) Biochemistry and Pharmacy

*Evaluated by the Education Credential Evaluators as a U.S. equivalent of    Bachelor of Science

(1983-1996) Deutsche Schule-(German School- Elementary to High school )

experience

Independent consultant

June 2012 till current

·  Design and implementation of databases and websites

Business Planning Analyst-Telecommute | Medco Health Solutions

October 2011 – June 2012

·  Pull daily queries and provide production reports for all customer service vendor sites to the Senior Business Analyst and Forecast Team.

·  Monitor call center’s metrics to ensure cost containment.
Update forecast files both quarterly and monthly using the weekly reports to measure financial impact related to variation of metrics.

·  Perform ad hoc analysis when requested.

·  Conducted weekly virtual meetings with call center management to ensure financial and forecast goals were kept in line.

·  Identify trends affecting metrics and financial activities. Budgeting

·  Live monitoring of operations to ensure adherence to service goals

·  Provide vendors with feedback on capacity, staffing and operational issues based on the forecast and rolling forecast on a weekly basis.

·  Systems used on daily work included but not limited to Hyperion Oracle database, Ess-Base, Siebel, Avaya, IEX workforce management, Enterprise PDM Database, Breeze.

·  Report system issues and assist with troubleshooting or queries and databases.

Resolution Team Leader | Medco Health Solutions

August 2008 – October 2012

·  Inbound and outbound resolution calls.

·  Designed and maintained a VBA based tracking and communication interface at a national level.

·  Quality improvement analysis related to customer or client escalated concerns

·  Call monitoring and compliance to ensure adherence to local and federal pharmacy guidelines, and privacy and HIPAA laws.

·  Communications and logistics between Pharmacy operations, client services team, Prior authorizations, Clinical reviews and account management.

·  Handling of customer’s grievances and complains, handling sensitive communications from and to Office of the President, Vice President of Customer Operations, Vice President of Pharmacy Operations,  clients, customers, physicians, hospitals, pharmacies and health providers related to prescription orders, eligibility, prior authorization, clinical review, coordination of benefits and others.

·  Accounts receivable

·  Claims  submission for  direct re-imbursement, third party payment, complains and

·  Accounts receivable tasks like debit and credit card processing, electronic checking, requests and communications, re-imbursements, balance transfers, statements and reconciliations using RUMBA billing system

·  Handled second level escalations. Provide feedback and coaching to first level escalation team members on quality and de-escalation techniques.

·  Submitted feedback to Line Supervisors on Customer Service Representatives quality and performance

·  Compile and update Standard Operating Procedures for the Resolution Team Lead Department and Customer Service Department

·  Performed as subject matter expert on Accounts receivable issues, pharmacy communications, and other internal issues.

·  Conducted training meetings and presentations.

Customer Service Representative | Medco Health Solutions

November 2007-August 2008

·  Inbound calls handling customers‘questions on plan prescription coverage for PPO, HMO and stand-alone plans, book of business and the Federal Employee Program (FEP).

·  Processing refill requests for mail order prescriptions requests.

·  Requests for Statements of Benefit Account and Explanation of benefits.

·  Follow privacy and HIPAA regulations when dealing with third parties, like a Power of Attorney, doctor offices, and relatives requesting private individual information.

·  Outbound campaigns and tasks based on business needs.

Specimen Management | Alegent Health core Lab

March 2007-August 2007

·  Billing, specimen management, accessioning and facilitator

Independent Casualty Insurance Agent Sales Prepaid Legal Services Inc,

November 2006-August 2007

·  Casualty Sales Insurance Agent in Nebraska

Bilingual Customer Service Representative | Ford Motor Credit

May 2006-November 2006

·  Billing and customer service for automotive credit lending

Bilingual Customer Service Representative | West Corporation

November 2005-January 2006

·  Inbound calls answering customer’s concern on Health Insurance, Pacificare & Secure Horizons and Medicare part D plans.

skills

ÿ        Microsoft Office Family of Products including but not limited to, Word, Excel, Microsoft Expression Web,Front Page, Access, Power Point, Outlook, SharePoint, Vizio. VBA (Visual Basic for applications). Knowledge of HTML, Jscript and CSS

ÿ        - Experience with relational databases Oracle Hyperion, Ess-base and SQL

ÿ        -Ability to organize and interpret complex data.

ÿ        -Presentation and negotiation skills

ÿ        -Fast learner, flexible and adaptable to frequently changing situations

Licenses and certifications
 

-Pharmacy Intern License granted by the Florida Board of Pharmacy and Florida Department of Health. Lic # PSI32214

-Passing Score at the FPGEE. Awaiting certificate in the mail.

Languages

Spanish (native)

English (fluent)

German (fluent)

References

Madison Noel

Phone: (813)571-5913

Jacquie Carter

Senior Manager Medco Health Solutions

Phone: (813)632-7408

Eric Sirvent

Senior Manager at Medco Health Solutions

Phone: (800)446-1755 ext 7409

Clay Stephenson

Other  references outside MEDCO -Express Scripts:

Alegent Health Core Laboratory Services

JoEllen Benecke

Operations Director, Support Services

Ph: (402) 717-2883

Fx: (402) 717-5252

Ford Credit

Team 6/Team 5 Team Leads: Jose Jacobo

Phone: (402) 493-6689

Personal references

Will Kovacs

Phone: (727)798-6949

Rami Fahmy

Phone: (727) 648-1840

Brian Faggard

Phone: (727)415-7222