Dan Ames Email & Phone Number

Columbia, Maryland

Work within the United Healthcare Medicare and Retirement department to: • Perform oversight and monitoring of Pharmacy Benefit Manager to ensure compliance within CMS guidelines.• Lead the redesign of pharmacy audit approaches and processes• Compile and report complex data for trend analysis and to inform business health

Responsibilities included:• Performed oversight and monitoring of Pharmacy Benefit Manager to ensure compliance within CMS guidelines.• Monitored Star Rating D02 and D03 metrics for United Healthcare M&R through daily audits to ensure coverage determination and organizational determination timeliness.• Created and performed Ad-Hoc reviews of the Pharmacy Benefit Manager’s processes to ensure compliance with Chapter 18 of the CMS Prescription Drug Benefit Manual guidelines.

Baltimore, Maryland Area

Responsibilities included:- Worked Medicare Part D redetermination process by entering, tracking, and monitoring data. - Performed frequent audits of case files to ensure completion and accuracy of contents.- Assisted the Pharmacy Operations Department with inquiries from members, providers, and various departments.

Hunt Valley, Maryland

Responsibilities included:- Adhered to contractual agreements and Federal Communications Commission (FCC) regulations. - Collaborated with departments and media groups ensure delivery of effective advertising schedule.- Worked within requested parameters to produce an accurate broadcast log.