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Jnisha Derweer, Mba is listed as Pharmacy Government Programs Manager at EmblemHealth at EmblemHealth, a company with 2443 employees, based in New York City Metropolitan Area, United States, United States. AeroLeads shows a matched LinkedIn profile for Jnisha Derweer, Mba.
Jnisha Derweer, Mba previously worked as Pharmacy Government Programs Manager (Promoted) at Emblemhealth and Lead Government Programs Coordinator (Promoted) at Emblemhealth. Jnisha Derweer, Mba holds Master Of Business Administration (Mba), Health/Health Care Administration/Management from Ohio University.
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Manage the Pharmacy Government Programs team responsible for the intake and assessment of CMS and State regulatory guidance. Oversee the Express Scripts execution of claims processing, reporting, issue management and letter development and distribution, among other tasks. Define and evaluate key metrics to confirm or correct compliance and improve business results aligned to EmblemHealth objectives. Skilled in Microsoft Word, Audit Management, Team Building, Pharmacy Automation, and Medicare/Medicaid Regulations. Strong information technology professional with a Master of Business Administration (MBA) focused in Health/Health Care Administration/Management.
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A career timeline built from the work history available for this profile.
New York, New York
Established a cross-functional Medicare and Medicaid regulatory guidance review process to ensure ongoing compliance with federal and state requirements while maintaining product integrity and market competitive solutions.Defined and implemented process for presenting new Federal and State regulatory requirements for compliance, organizational impact and.
New York, New York
Defined and implemented process for the Pharmacy Government Programs team responsible for the intake and assessment of CMS and State regulatory guidance.Monitored the PBM’s execution of claims processing, reporting, issue management and letter development and distribution, among other tasks. Defined and evaluated key metrics to confirm or correct.
Greater New York City Area
Collaborated with reporting area to produce routine and ad hoc compliance reports to management as required.Supported management in the functional areas in the resolution of regulatory compliance issues, as well as providing regulatory guidance.Supported the development of regulatory and operational business requirements for ‘best practice’ implementation.
Greater New York City Area
Point person to Pharmacy Service Help Desk staff for all Medicare Part D issues & inquiries Ensure proper claims adjudication with retail and long-term care pharmacies in adherence to CMS guidelines and timeframes Manages the development, production, and administration of all Medicare Part D communications. ie; Clinical Prior Approvals, Change in.
Greater New York City Area
Point person to Pharmacy Service Help Desk staff for all Medicare Part D issues & inquiries.Ensured proper claims adjudication with retail and long-term care pharmacies in adherence to CMS guidelines and timeframes.Managed the development, production, and administration of all Medicare Part D communications. ie; Clinical Prior Approvals, Change in.
Greater New York City Area
Provide Pharmacy Help Desk assistance to over 500,000 pharmacies daily Resolve all benefit and billing discrepancies disputed by members Resolve claim adjudication issues being disputed by the pharmacy Assisted in approval procedures assigned specifically to the transplant population of our membership Perform duties assigned by supervisor
Syracuse, New York Area
Assisted pharmacists in daily medication stock & inventory, and weekly OTC stock & inventory Assisted the supervising pharmacist with prescription fills using the Propharm pharmacy software; completed PSE tracking transactions, prescriptions, and refills
Other employees you can reach at emblemhealth.com. View company contacts for 2443 employees →
Anthony Pilipovsky
Colleague at EmblemhealthBrooklyn, New York, United States, United States
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Lana Nosova
Colleague at EmblemhealthEdison, New Jersey, United States, United States
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Debbie Green, Rn, Cmcn
Colleague at EmblemhealthNorfolk, Connecticut, United States, United States
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Stacy Gerchick
Colleague at EmblemhealthNew York City Metropolitan Area, United States
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Agnes Chin
Colleague at EmblemhealthNew York, New York, United States, United States
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Lucy Zhao
Colleague at EmblemhealthBrooklyn, New York, United States, United States
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Felice Smith
Colleague at EmblemhealthYonkers, New York, United States, United States
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Kathleen Blakeney
Colleague at EmblemhealthVoorheesville, New York, United States, United States
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Cindy Bacchus-Needham, Mba
Colleague at EmblemhealthWest Hartford, Connecticut, United States, United States
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Vivian Vibar
Colleague at EmblemhealthNew York, New York, United States, United States
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Quick answers generated from the profile data available on this page.
Jnisha Derweer, Mba works for EmblemHealth.
Jnisha Derweer, Mba is listed as Pharmacy Government Programs Manager at EmblemHealth at EmblemHealth.
Jnisha Derweer, Mba is based in New York City Metropolitan Area, United States, United States while working with EmblemHealth.
Jnisha Derweer, Mba has worked for Emblemhealth and Syracuse University.
Jnisha Derweer, Mba's colleagues at EmblemHealth include Anthony Pilipovsky, Lana Nosova, Debbie Green, Rn, Cmcn, Stacy Gerchick, and Agnes Chin.
You can use AeroLeads to view verified contact signals for Jnisha Derweer, Mba at EmblemHealth, including work email, phone, and LinkedIn data when available.
Jnisha Derweer, Mba holds Master Of Business Administration (Mba), Health/Health Care Administration/Management from Ohio University.
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