Jaime D. Rodriguez Email & Phone Number

Remote

• ANALYSIS AND COMMUNICATION: Effectively collaborate with the team to compile medical notes (disease state, drug treatment history, and current drug plan) from the provider and patient in support of the prior.
• ORGANIZATION AND RESOURCEFUL: Promptly follow updates to OptumRx policy and operational procedures to prep, review and approve or deny requests for a prescription prior authorization and/or appeal. Ensure prescription.
• TRAINING / MENTORING: Assisted new pharmacy technicians into the high-touch client team for appeals packaging by providing experience on clients' requirements with the redetermination level appeals process.
• COORDINATION: Multitasked workflow process if patient, provider, and dispensing pharmacy contacted OptumRx prior authorization/appeals department by insurance plan policy. Support communications and collaborate with.

Baltimore, Maryland, United States

• DATA COLLECTION AND ANALYSIS: Support pharmacy with data entry reports and inform the Pharmacist in Charge of changes affecting processes and software, including Intercom Plus, SIMS, StoreNet, SORA and SR2/Asembia.
• NEW STAFF TRAINING/ORIENTATION: Ensure employees complete mandatory training on Walgreens Learning and Talent Management Portal when hired and whenever policies or procedures change. Train and mentor new pharmacy.
• WORKFLOW EVALUATION, ANALYSIS, AND COORDINATION: Review/audit reports regularly and use analysis to assign tasks to pharmacy technicians according to each employee’s knowledge, skill level, speed, and accuracy. Reports.
• INSURANCE: Follow URAC guidelines to assure post-audit compliance with all prescriptions fulfilled at the pharmacy. Provide exceptional customer service in filling orders. Contact customers’ insurance carriers and.