Sr. Provider Payment Integrity Analyst
Current
Apr 2024 - Present
AeroLeads people directory · profile
Kimberly Pacitto, Pharmd, Rph Email & Phone Number
Payment Integrity Clinical Review Pharmacist Auditor
at
Blue Cross & Blue Shield of Rhode Island
2 work emails found
@changehealthcare.com
LinkedIn matched
✓ Verified Jun 2026
4 data sources
Profile completeness 100%
Current company
Role
Payment Integrity Clinical Review Pharmacist Auditor
Location
Watertown, Massachusetts, United States
Who is Kimberly Pacitto, Pharmd, Rph? Overview
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Quick answer
Kimberly Pacitto, Pharmd, Rph is listed as Payment Integrity Clinical Review Pharmacist Auditor at Blue Cross & Blue Shield of Rhode Island, based in Watertown, Massachusetts, United States. AeroLeads shows a work email signal at changehealthcare.com and a matched LinkedIn profile for Kimberly Pacitto, Pharmd, Rph.
Kimberly Pacitto, Pharmd, Rph previously worked as Sr. Provider Payment Integrity Analyst at Blue Cross & Blue Shield Of Rhode Island and Clinical Review Auditor - Pharmacist at Optum F/K/A Change Healthcare. Kimberly Pacitto, Pharmd, Rph holds Pharmd, Pharmacy from Massachusetts College Of Pharmacy And Health Sciences.
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Email format at Blue Cross & Blue Shield of Rhode Island
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*@changehealthcare.com
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AeroLeads found 2 current-domain work email signals for Kimberly Pacitto, Pharmd, Rph. Compare company email patterns before reaching out.
Profile bio
About Kimberly Pacitto, Pharmd, Rph
As a Clinical Review Auditor-Pharmacist at Optum, I applied my extensive pharmacy practice and data analysis skills to identify and recover overpayments for high-cost injectable drugs billed to the medical benefit across multiple payers. I have successfully recovered a cumulative $75M across all clients, using my professional and outpatient coding training and sound clinical judgment. I also acted as a drug information resource for other team members and participated in new client implementation activities. I am a certified Lean Six Sigma Yellow Belt and a life-long learner who is passionate about payment integrity.
Listed skills include Pharmacy, Clinical Research, Patient Safety, Healthcare, and 2 others.
Current workplace
Kimberly Pacitto, Pharmd, Rph's current company
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Blue Cross & Blue Shield Of Rhode Island
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4 roles · 34 years
Kimberly Pacitto, Pharmd, Rph work experience
A career timeline built from the work history available for this profile.
Clinical Review Auditor - Pharmacist
Optum F/K/A Change Healthcare
- Identified overpayments including but not limited to billing and/or coding errors, application of incorrect reimbursement terms, incorrect NDC numbers, and use of sound clinical judgment. Participated in new client.
- Reviewed accuracy of paid facility and professional claims for high-cost injectable drugs billed to the… Show more Identified overpayments including but not limited to billing and/or coding errors, application of.
- Reviewed accuracy of paid facility and professional claims for high-cost injectable drugs billed to the medical benefit across multiple payers, recovering a cumulative $75M across all clients.
- Validated information in claims systems including, but not limited to, Facets, NASCO, FEPDirect, Wellpoint Group System (WGS), BlueSquared.
- Developed and maintained audit parameters for specific HCPCS codes.
- Gained expertise in data mining techniques and medical record review. Show less
Jan 2011 - May 2023
Clinical Coordinator Pharmacy Services
- Analyzed pharmacy claims to identify target areas for potential cost savings. Designed and initiated cost savings initiatives including formulary switching, specialty pharmacy program and marketing mail order program.
- Designed and implemented a targeted marketing strategy to attract new members to the mail order program to increase revenue of the pharmacy.
- Increased revenue through the introduction and maintenance of the Specialty Pharmacy Program for Uniformed Services Family Health… Show more Analyzed pharmacy claims to identify target areas for potential cost savings..
- Increased revenue through the introduction and maintenance of the Specialty Pharmacy Program for Uniformed Services Family Health Plan.
- Implemented, updated, and communicated the changes in the formulary drug benefit to patients and providers as directed by Department of Defense.
- Evaluated Adverse Drug Reaction Reports to review causes and trends of patient reactions; Documented and communicated results to prevent future occurrences.
Feb 2002 - 2009
Pharmacist
Brighton Marine Health Center
- Reviewed and monitored drug therapy through collaboration with other health care professionals to plan, monitor, review, and evaluate the quality and effectiveness of drugs and drug regimens.
- Counseled clinic and mail-order patients regarding drug interactions, side effects, dosage, and proper medication storage.
1992 - Feb 2002
2 education records
Kimberly Pacitto, Pharmd, Rph education
Pharmd, Pharmacy
FAQ
Frequently asked questions about Kimberly Pacitto, Pharmd, Rph
Quick answers generated from the profile data available on this page.
What company does Kimberly Pacitto, Pharmd, Rph work for?
Kimberly Pacitto, Pharmd, Rph works for Blue Cross & Blue Shield of Rhode Island.
What is Kimberly Pacitto, Pharmd, Rph's role at Blue Cross & Blue Shield of Rhode Island?
Kimberly Pacitto, Pharmd, Rph is listed as Payment Integrity Clinical Review Pharmacist Auditor at Blue Cross & Blue Shield of Rhode Island.
What is Kimberly Pacitto, Pharmd, Rph's email address?
AeroLeads has found 2 work email signals at @changehealthcare.com for Kimberly Pacitto, Pharmd, Rph at Blue Cross & Blue Shield of Rhode Island.
Where is Kimberly Pacitto, Pharmd, Rph based?
Kimberly Pacitto, Pharmd, Rph is based in Watertown, Massachusetts, United States while working with Blue Cross & Blue Shield of Rhode Island.
What companies has Kimberly Pacitto, Pharmd, Rph worked for?
Kimberly Pacitto, Pharmd, Rph has worked for Blue Cross & Blue Shield Of Rhode Island, Optum F/K/A Change Healthcare, Brighton Marine Health Ctr, and Brighton Marine Health Center.
How can I contact Kimberly Pacitto, Pharmd, Rph?
You can use AeroLeads to view verified contact signals for Kimberly Pacitto, Pharmd, Rph at Blue Cross & Blue Shield of Rhode Island, including work email, phone, and LinkedIn data when available.
What schools did Kimberly Pacitto, Pharmd, Rph attend?
Kimberly Pacitto, Pharmd, Rph holds Pharmd, Pharmacy from Massachusetts College Of Pharmacy And Health Sciences.
What skills is Kimberly Pacitto, Pharmd, Rph known for?
Kimberly Pacitto, Pharmd, Rph is listed with skills including Pharmacy, Clinical Research, Patient Safety, Healthcare, Patient Education, and Disease Management.
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