Ashida Harrell Email & Phone Number

Pensacola, Fl, Us

Louisiana, United States

United States

• Maintain extensive knowledge of medication access channels (i.e., pharmacy & medical benefit including buy & bill and/or assignment of benefit (AOB) across multiple sites of care.• Remain current on & anticipate changes in product coverage & access knowledge, marketplace conditions, & stakeholder practices to deliver the most effective delivery of approved materials.• Understand & adapt to the changing healthcare ecosystem to customize resourcing & messaging to HCPs & staff.• Educate HCPs on product coverage, prior authorizations & appeals, reimbursement processes, claims submissions, procedures, & coding requirements of payer organizations for core & launch products.• Collaborate with field support team members such as sales representatives & key account managers, & serve as reimbursement expert for the local team.• Act with a sense of urgency to address critical access and affordability issues for patients.• Partner with managed care colleagues to understand current policies & potential future changes.• Conduct field-based reimbursement & access support, education & creative problem-solving aligned to FRAS Rules of Engagement.• Build strong, trust-based relationships with customers in all assigned Immunology accounts.• Manage territory logistics, proactive and reactive routing, & account business planning.• Maintain and grow knowledge of national, regional, local, & account market dynamics including coverage & coding requirements.• Grow the knowledge of hub & specialty distribution channels to improve practice & patient support needs.• Collaborate with internal J&J departments, and serve as subject matter expert regarding education & insights on access & affordability solutions across multiple payer types and plans (i.e., Medicare, Medicaid Managed Care, Commercial).• Execute business in accordance with the highest ethical, legal, & compliance standards, including timely & successful completion of all required training.

United States

• Maintain a caseload of 60-120 members, per State metrics & requirements• Complete Welcome Calls & New Member Orientations• Complete & update members’ Comprehensive 701Bs to capture health status, functional abilities & limitations, and Dx’s & Rx’s, as well as formal & informal support• Assess clients for unmet healthcare needs, as well as facilitate, coordinate, and manage patient access with par & non-par service provider• Develop individualized Person-Centered Care Plans (PCCPs) with clients & families, and manage service authorizations; included assisting with prior authorizations, as well as appeals & grievance processes• Maintain & regularly evaluate the efficacy of member care plans, and revise services & goals as necessary to reflect changing conditions & needs• Identify additional benefits & community resources, and assist in pull through to ensure members’ healthcare needs are met; make referrals as needed• Complete Supplemental & Disaster Tracking Assessments• Provide ongoing program & service education to providers, clients, and client supports; also promoted member self-empowerment• Practice proactive scheduling & create routing plans for field days; leaving flexibility for reactive visits/routing to effectively manage assigned territory and workload• Complete & maintain clients records through utilization of service provision progress reports, concise & ongoing verbal communication, & documentation within the TruCare platform• Account management, and serve as a liaison between clients & providers within my territory & the Sunshine Health Plan team• Work in conjunction with others on the Sunshine Health team on pull through & provide outstanding results• Maintain a working knowledge of & adhere to applicable Federal & State regulations, including the Anti-Kickback Statute, Stark Law, and HIPAA, as well as Intra-organizational policies & procedures• Immediately report Critical Incidences & Potential Quality of Care concerns

United States

• Attend daily stand-up management meetings to discuss resident & patient concerns• Facilitate Welcome Interviews & Biopsychosocial Assessments with new residents and patients• Develop care plans identifying emotional and/or psychosocial needs, and establish goals for each challenge identified; revise services & goals as necessary to reflect changing conditions & needs• Secure patient access to healthcare support & Federal income programs, therapies, supplies & equipment, and ancillary services; assist in pull through for prior authorizations, as well as Medicaid & Social Security benefits• Maintain a working knowledge of & adhere to applicable Federal & State regulations & administrative codes, as well as Intra-organizational policies & procedures - Including the AKS (Anti-Kickback Statute), Stark Law, and HIPAA (Health Insurance Portability and Accountability Act)• Maintain & manage the facility resident PASRR book• Maintain written record of & resolve resident complaints & grievances• Coordinate facility discharges - Including: scheduling follow up appointments with primary care providers (PCP) and out-patient therapy providers, verifying ongoing supports & coordinating Home Health (HH) & Skilled Nursing services, ordering Durable Medical Equipment (DME) and Consumable Medical Supplies (CMS), medication pull through, and coordinating transportation• Complete monthly Social Service Department reports• Schedule & attend facility management meetings with vendors, sales partners, & Field Reimbursement Managers• Assist in managing reimbursement of facility stay

United States

• Minimize youths rates of recidivism through supervision & monitoring of compliance with sanctions – Including: community service, curfew, reimbursement of State restitution, randomized drug tests, and social & emotional skills & growth assignments• Develop & maintain effective communication & positive rapport with youths & families, and provide ongoing education to ensure comprehensive understanding of the program• Develop & manage individualized youth & family safety plans based on family dynamics & potential threats to overall success• Facilitate & lead youth group therapy sessions & correlating activities• Provide referrals to individual, group and/or family counseling• Secure youth & family access to educational, vocational, therapeutic, and community services• Present in court & State offices to advocate for assigned youths

United States

• Conduct investigations regarding allegations of abuse, neglect, abandonment and/or special conditions for children• Obtain information through observation & interviews with children, parents, relatives, neighbors, and other parties, as well as past service history and other records• Engage families to understand their dynamics & challenges, and explore potential solutions• Identify needs and determine the level of intervention needed - Including voluntary services & court ordered dependency services• Assess danger threats, vulnerabilities, and caregiver protective capacities to determine level of safety• Develop & manage Present and/or Impending Danger Safety Plans based on analysis of perpetrator & environmental danger threats• Arrange emergency placement for children unable to safely remain in the home• Complete Risk Assessments & Conducted staffings required for families with High & Very High Risk scores• Provide linkage to service agencies & community resources, and recommendations on the development of remedial case plans• Present & provide testimony in court in court & State offices to fiercely advocate for alleged victims alongside Children’s Legal Services court