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 • Assist in the development and implementation of additional reporting support tools, and the proactive investigation of a wide variety of manufacturer issues and opportunities • Analyze and resolve contract disputes working with manufacturers to ensure timely payment of rebates and admin fees

• 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 identifying, evaluating, and implementing improvements to processes and applications• 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• Provide quality peer review of pharmacy manual add requests• Maintain accurate pharmacy networks through manual and automated addition processes• Participations in Pharmacy Network Management projects and back-up accountabilities • Assist in training and mentoring new staff• Experience with pharmacy claim adjudication systems (AS400 and RxCLAIM)

• 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