Alyse Fields Email & Phone Number

Greater Minneapolis-St. Paul Area

• Analyze manufacturer contract terms to ensure compatibility with rebate system
• Perform contract set up for each rebate period
• Assist with the coordination, analysis and validation of quarterly rebate reports and distribution of quarterly invoices
• Assess, implement and communicate critical information for maintenance of rebate system; including contract amendments and other changes that impact the rebate process
• Assist in financial analysis, formulary comparisons, suggested net cost improvements, and responding to inquiries
• Assist in the creation of non-financial tools, including proactive marketplace assessments, exploration of internal support requirements to implement contractual agreements, and the tracking of formulary status decisions

• Represents assigned business system or business process as a subject matter expert in the development of business requirements, system specifications, process flows, process change and/or project management
• Provides leadership to the business in the identification and adoption of operational best practices and standard operating procedures as it relates to assigned business system or business process
• Works directly with business and users to support and improve existing applications and processes related to assigned business system. Independently researches and resolves business and technical problems by.
• Assesses regulatory and industry directives to determine how current business processes are affected and participates in delivering solutions for compliance
• Provides testing and/or testing support for any changes to assigned business system
• Documents processes, including standard operating procedures, training materials, user guides, desktop procedures and process flows

Bloomington, MN

• Analyze pharmacy claims for contract and standard practice compliance in orderto identify potential non-compliant pharmacies as a part of desk and onsite audits
• Utilize pharmacy experience and training to thoroughly investigate risks and non-compliant processes when performing claim review and audits
• Accurately track audit activities performed
• Compose initial audit reports for pharmacies according to audit plan
• Prepare written internal documentation as requested by management
• Assist with user acceptance testing for post point of sale claim adjustment process

• Conduct monthly tasks including NCPDP Monthly data loads, claim reversals, MAC complaints and reporting, electronic file transfer set-up and support
• Provide Go-Live support coverage and pharmacy outreach
• Work with internal departments and external pharmacy contacts to resolve inquiries regarding contracting, claims payment, claim submission and general benefit information
• Monitor and respond to inquires submitted through Pharmacy Operations email box and Network Management phone line
• Work with Prime’s internal Payment/Billing IT and Treasury to support and maintain all pharmacy payment and remittance processing
• Develop and assist with developing and maintaining standard operating procedures and desktop procedures for key tasks

• Enter, fill, and sell prescription medications to a wide variety of patients
• Accurately bill various types of state and private insurance
• Accurately bill Medicare Part D supplemental insurance
• Assist the pharmacist in daily pharmacy maintenance tasks
• Assist in multiple influenza clinics

Bachelor Of Arts (Ba), Chemistry

Bachelor Of Arts (B.A.), Chemistry