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As a Sr. QA Specialist I had the opportunity to monitor and assess individuals of all levels to ensure policy adherence. Participated in client and customer calibrations to rate the same interaction(s), ensuring that they are aligned and upholding the same expectations. Perfomed call monitoring to provide trend data to site management and VPs. Also provided support with Clinical Prior Authorizations to ensure all state guidelines were meet, successful hands-on training, mentoring of new hires and one on one coachings.

As a PBM (Pharmacy benefit manager) I had the pleasure to handle all prescription drug programs for commercial health plans, self-insured employer plans, Medicare Part D plans, the Federal Employees Health Benefits Program, and state government employee plans. In simple words, I was the middleman/ intermediary between insurers and other aspects of the healthcare industries such as doctors or pharmacies.