Jan Michael C. Flores Email & Phone Number

Los Angeles, Ca, Us

Los Angeles, Ca, Us

Us

Lead and developed a team of 10 Business Analyst to improve department processes and analyze errors• Developed and launched new training program which increase department accuracy to 97%• Created, maintained, and improved policies and procedures for auditing quality review processes• Monitored and reported trends/anomalies found in Excel or Access Database error reports • Performed root cause analysis of the errors identified

Us

Lead and developed a team of 5 Auditors and 1 Business Analyst in a specialized compounding medication audits • Exceed 2015 financial goal by $2.5 million. • Identified and resolved operational issues using defined processes and expertise. • Developed and improved current processes to meet growing business needs • Notified and worked with government enforcement agencies as appropriate such as: MEDIC, DOJ, OIG and DHHS• Analyzed/Reported Pharmacy Data to Ensure Quality/Accuracy• Demonstrated knowledge of Pharmacy Operations and Related Laws/Regulations

Us

Monitored and detected fraud waste and abuse via pharmacy claims data• Consistently exceed yearly financial goal of $1.5 million in recoveries • Developed VBA Codes and Macro Enabled Microsoft Excel Templates for department use which decreased reconciliation time by an average 30 mins per user. • Investigated, reviewed and analyzed claims data by applying knowledge of pharmacy policy and practice to detect fraudulent, erroneous, and abusive billing activity for Medicare Part D, Medicaid, Commercial Plans and Union Trusts• Conducted On-Site Audits at pharmacies which included: assessment of physical premises, compliance with regulatory requirements, and completeness of provider/clinical records and itemized bills• Manipulated large data sets to extract key information with the use of Microsoft Access and/or Excel

Minneapolis, Mn, Us

Assisted the pharmacist in the practice of pharmacy and lead the pharmacy technician staff • Exceeded sales/prescription goals by 5-10% each month by forecasting and creating weekly action plans • Assisted the pharmacist, under direct supervision, in the practice of pharmacy, in accordance with local, state, federal, and company regulations • Identified and monitored sales goals and prescription trends.• Trained and updated entire pharmacy staff on new procedures, updates, and regulations from Target Corporate, CMS, and Medicare.