David Mailloux Email & Phone Number

Hanover, New Hampshire, United States

Helping folks in recovery to obtain necessary medications so they can remain sober and live their best life.

Greater Boston Area

• After February 2015, entered and reviewed prior authorization (PA) requests for prescription drugs, including specialty medications, using Clinical Authorization System (CAS) internet-based program.
• Reviewed prior authorization requests and determinations with prescribers and medical staff via telephone. Discussed and offered additional guidance on current medical necessity guidelines to help them complete their.
• Acted as resource and trainer for both technicians and pharmacists in the department.
• Proficiency with CAS and Client Care Access (CCA) programs as well as Rx Claims application (CVSH/Caremark-based).
• From August 2013 - February 2015, as a Provider Services Specialist, provided customer service and related support to contracted medical professionals and their office staff from the inbound call center.

Madison, Wisconsin

• Filled scheduled prescription medication boxes with multiple medications for home-care patients.
• Filled "PRN" (as needed) and other medications as well as DME (durable medical equipment) orders for patients in assisted living and temporary rehabilitation facilities.
• Operated Linux computer system for creating multi-dose prescription medication packets for all patients.

Boston, Massachusetts

• Communicated with patients, pharmacists, and providers in both medical and behavioral health departments regarding patient prescription needs.
• Reviewed charts, including analysis and assessment of patient's laboratory results, diagnoses, and drug-drug/drug-condition reactions, to determine appropriateness of prescription authorizations.
• Obtained prior authorizations from insurance companies for patient prescriptions and advocated for patients on behalf of providers in medical and behavioral health departments to solve more complex prior authorization.

Boston, Massachusetts

• Advised CAS (College of Arts and Sciences) students of necessary requirements for graduation.
• Reviewed students' applications for graduation. Processed transfer credits, petitions for coursework substitution, and standardized test scores which contributed to final review.
• Collaborated regularly with Associate Dean for Students, Academic Advising, and other departments to seek resolution of students’ academic issues.
• Supervised work study students (filing and other administrative tasks).

Weston, MA

• Prepared documents and formwork for several Claims Service Teams.
• Calculated indemnity payments and paid medical and other expense bills.
• Advised RN and other case managers of clinical appropriateness of prescription drug reimbursement requests submitted by claimants and employers.
• Managed lost-time claims with disability durations of up to eight weeks within three jurisdictions (MA, CT, and RI).
• Note: employed from January 2001 to June 2002 and February 2003 to October 2003, total of two years, two months. Left to pursue unrelated opportunities in California; when unsuccessful with said opportunities, invited.

Massachusetts

• From June 1992 to April 2000, acted as pharmacy cashier, then technician, and senior technician. Completed many of the duties of a registered pharmacist under direct supervision: inputting and filling prescriptions.
• From July 1991 to June 1992, worked as cashier and service clerk in the retail part of the store.

Bachelor Of Science, Communication, Journalism, And Related Programs

• Major GPA: 3.88 • Overall GPA: 3.36, graduated cum laude • Minor: Chemistry • Previously attended part-time from May 1995 to May 1996.

Pharmacy

Completed general education requirements for the B.S. in Pharmacy program.