Shaiyna S. Email & Phone Number

California, United States

San Francisco, California, United States

Clients: Workday, Invicti, Sutter Health, Itron, Pandia Health, Zendesk, Southern Glaziers, BeiGene • Provide ongoing full cycle recruiting and support to key accounts• Build close partnerships with hiring managers to become a subject matter expert in the role requirements, and develop a deep understanding of how the positions impact the organization• Building a network and managing consultants• Experience in recruiting software engineers, technical project managers, technical program managers, software development leaders• Deliver an awesome candidate experience which shares insights into our culture, mission, and work and helps candidates self-identify if they are a great match• Sourced and selected applicants for technical positions within company• Coordinated with IT team leaders to forecast hiring needs and department goals.• Write and posted technical job descriptions• Use Boolean searches to develop applicant portfolios for expected openings.• Create candidate interest by explaining the value of career opportunity to a diverse audience• Maintain Applicant Tracking System & productivity metrics•Demonstrated collaborative orientation in team environment and a very high level of personal efficiency•Deep understanding of talent acquisition and its relationship to talent business needs and manage candidate engagement within challenging recruitment process• Manage the entire recruiting process, from sourcing to hiring, keeping both internal partners and candidates informed and engaged• Partner with internal stakeholders to deeply understand their business objectives and corresponding hiring needs, and define recruiting strategies

San Francisco Bay Area

Concord, California, United States

• Ensures Preauthorization approvals for those cases that do not require a medical review in accordance with the benefit plan. Pend procedures for medical review under the correct clinical team• Utilizes ATV, ASD, Medcompass, and other Aetna system to build, research and enter case information.• Promotes communication, both internally and externally to enhance effectiveness of medical management services (e.g.,claim administrators, Plan Sponsors, and third party payers as well as member, family, and health care team members respectively)• Supports the administration of the precertification process in compliance with various laws and regulations, URAQ and/or NCQA standards, where applicable, while adhering to company policy and procedures.• Approve services that do not require a medical review in accordance with the benefit plan.• The ability to interpret and communicate policies and apply sound judgment when dealing with confidential patient matters.• Organizational skills and a deadline orientation that allows you to multi-task with a positive attitude, while providing an extraordinary level of customer service to internal and external customers for a critical clinical function.• Communicates with Aetna Nurses and Medical Directors, when processing transactions for members active in this Program. • Places outbound calls to providers under the direction of Medical Management Nurses to obtain clinical information for approval of medical authorizations. Uses Aetna Systems such as QNXT, ProFAX, ProPAT, and Milliman Criteria.

Pleasanton, Ca

• Submits daily / weekly recruiting reports to supervisor and manager. Efficiently and effectively fill open positions by: screening resumes, conducting interviews, scheduling applicants for site tours, and hiring final candidates and maintaining job order and candidate application files.• Advise and influence hiring managers on recruiting strategies • Partner to create recruitment materials to increase our employment brand awareness • Maintain candidate pipelines and workflows in systems• Sourcing, recruiting strategy, and robust candidate pipelines• Evaluates, submits insurance pre-authorizations, and communicate decisions for prior authorization pharmacy requests according to clinical guidelines.• Research, resolve, and document physician or client inquiries and insurance plan grievances.• Coordinates the evaluation and enhancement of pharmacy enrollment and utilization tracking tools• Coordinate medication refills for patients of multiple sites and verifying their medications with medical providers as needed.• Follow-up with medical providers and other clinicians as needed to ensure documentation is completed and to eliminate backlogs.• Manages the implementation of the pertinent program as assigned while acting as the subject matter expert and resource for patients, clinic staff, and other healthcare professionals• Coordinates activities with physicians, physician offices, dialysis facilities, and pharmacies to ensure that patients' medication profiles are accurately completed and that patients receive their necessary medications and medication refills in a timely manner• Regularly requests prescriptions and refills from dialysis clinic staff and physicians by telephone and/or facsimile• Respond to and resolve benefit inquiries from managers and patients on plan provisions, benefits enrollments, status changes, and other general questions.• Educate patients about financial liabilities such as co-pays, co-insurance, deductibles, private pay rates.

Pleasanton, California, United States

•Ensuring adequate staffing for volumes as well training and onboarding of new hires• Posting any open pharmacy roles and Screening Incoming Resumes• Setting up Interviews and Conducting Post-Interview Assessments• Determining Details of the Position and Extending the Job Offer•Represent program(s) at recruitment events and opportunities•Coordinate recruitment resources and activities with other Raley locations•Work with the HR and Pharmacy Managers to formulate and implement a comprehensive recruitment plan to meet and increase hiring goals• Create schedules for the pharmacy technician staff

Human Resources Management And Services

Health Services/Allied Health/Health Sciences, General