Stevina Rumao Email & Phone Number

United States

United States

Worcester, Ma, Us

Worcester, Ma, Us

• Developed reports to support the departmental day-to-day operations and campaign goals in JasperSoft.• Identified, analyzed, and interpreted trends or patterns to provide insight into business decisions by designing and implementing a data visualization and reporting structure that guides decision-making and ensures data integrity.• Created graphs, charts, heat maps, and other visualizations in Tableau to assist end users in understanding the meaning behind the data.• Wrote and validated complex SQL queries for data mining.• Maintained inventory of reports, revising reports as needed to ensure accuracy.• Maintained documentation for policies, procedures, and business processes within the Advancement Systems and Technology team.

Southborough, Ma, Us

• Provided support for Clinical Programs to create and maintain prior authorization guidelines for clinical product offerings and gathered all required information for the PA review.• Reviewed and approve physician inquiries for pre-authorization and medical necessity requests based on established pharmacy guidelines and contract criteria.• Conducted root-cause analysis for any issues associated with a PA request.• Assisted with compiling statistical data, reporting, and analyses to demonstrate PA clinical, financial, and operational effectiveness and quality.• Supported Fraud, Waste, and Abuse program system oversight and communicated any suspected fraud discovered.

Worcester, Massachusetts, Us

• Processed prescription requests timely and accurately. • Analyzed healthcare data including medical and pharmacy claims, EMR(EPIC), scheduling, billing, referral, and laboratory results to create reports for quality measurement, utilization, and patient management.• Submitted clinical documentation for authorization of various high-cost pharmaceuticals that are not covered by the patient’s insurance.• Reviewed accuracy and completeness of the information requested and ensured that all supporting documents are present.• Coordinated with insurance companies, physicians, pharmacies, and patients as required.

Deerfield, Il, Us

• Regularly completed paperwork and entered prescription and insurance billing information into patient profiles.• Organized medications and prepared labels for pharmacists to dispense by reading medication orders and prescriptions.• Efficiently answered multi-line phone system and process high volume of order requests from nurses, doctors, and pharmacists

Provided information to pharmacy customers on drug interactions, side effects, dosage and storage of pharmaceuticalsUsed medication input software to safely and accurately dispense medicine Entered new patient profiles and prescriptions into medication input software systemVerified patient data and billing information

Master Of Science - Ms, Business Analytics

Bachelor'S Degree, Pharmacy