Tom Castaneda

Tom Castaneda Email and Phone Number

Operations Manager with over 25 years of experience in PBM and Health Care Industries. Health Services Leader | Client Management | Client & Consumer Experience Strategy | Service Delivery Manager (Healthcare) @ Fidelity Investments
Tom Castaneda's Location
Dallas-Fort Worth Metroplex, United States, United States
About Tom Castaneda

Senior clinical operations professional with demonstrated experience delivering consistent results, motivating teams, minimizing risk, and streamlining operations in the healthcare and insurance industries. Effective leader who utilizes business strategies to plan, along with management tools to drive change and create value leading to high customer service scores. Expertise in risk management and strategic operations with a consistent record of tackling strategic challenges, while establishing strong team cultures

Tom Castaneda's Current Company Details
Fidelity Investments

Fidelity Investments

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Operations Manager with over 25 years of experience in PBM and Health Care Industries. Health Services Leader | Client Management | Client & Consumer Experience Strategy | Service Delivery Manager (Healthcare)
Website:
fidelity.com
Employees:
10
Company email:
Johrenk7@gmail.com
Tom Castaneda Work Experience Details
  • Fidelity Investments
    Senior Reimbursement Account Manager
    Fidelity Investments Apr 2023 - Present
    Boston, Ma, Us
  • Pharmpix Corp
    Pbm Operational Site Leader
    Pharmpix Corp Sep 2021 - Jan 2023
    Irving, Texas, Us
    Provided day to day leadership of the Texas site operational teams, specific functional responsibilities, including Pharmacy Help Desk, Client Services, Benefits Management, and Clinical Call Center. • Responsible to ensure the professionalism and adherence to established KPI’s for all roles and functions in the office either directly, or in a matrix management role with the leader of the specific function.• Liaison with IT and HR appointed resource to ensure office is adhering to all established policies and guidelines. • Accountable for ensuring all PharmPix operational goals, objectives, and policies are met.
  • Cvs Health
    Strategic Health Plan Clients – Operations Manager
    Cvs Health Sep 2020 - Mar 2021
    Woonsocket, Ri, Us
    Managed day to day work volume for (3) of the largest strategic clients TUFTs Health Plan (1 million lives) Molina Healthcare (3 million lives) and a new client Blue Shield California (2.3 million lives).• Ensured all pharmacy benefits for these clients were maintained in adjudication system.• Team’s quality was measured (based on contractual agreements) against the highest standards to ensured clients and members receive the highest level of satisfaction.
  • Cvs Health
    Centene Clinical Configuration Manager
    Cvs Health Apr 2017 - Aug 2020
    Woonsocket, Ri, Us
    Centene is the largest Medicaid Managed Care Organization in the country and an extremely important Strategic Client. As the largest carrier on the Health Insurance Marketplace and a national leader in managed long-term services and support. By focusing on quality and leading my team through process improvement (Kaizen) methodology we ensured this critical client resigned with CVSHealth• Successfully Implemented 8 states + supported all MOBs for PDLs, SMART Edits• Lead the PC review committee, which has been recognized by our leadership as a very successful process. Process will continue to evolve going forward as the team gains experience with root cause analysis and creating corrective action plans.
  • Cvs Health
    Health Plan Medd Configuration Manager
    Cvs Health Mar 2011 - Apr 2017
    Woonsocket, Ri, Us
    Reviewed, tested, and implemented clients’ benefit drug plan setups into claims adjudication system and provided management support of over twenty-five (25) + employees across two locations – Irving and San Antonio. Formed new MedD team to code and QA cases for all MedD clients submitted thru SFDC.• If additional training was needed, report provided a full view of employee areas of concern or improvement.• Team was Recognized 27 times for exceeding expectations through-out the year by their peers and the Leadership Team.
  • Prime Therapeutics
    Front End Mail Operations Manager
    Prime Therapeutics Feb 2009 - Mar 2011
    Eagan, Mn, Us
  • Cvs Health
    Specialty Benefits Verification Manager
    Cvs Health Sep 2007 - Feb 2009
    Woonsocket, Ri, Us
  • Cvs Health
    Specialty Benefits Manager
    Cvs Health Sep 2005 - Aug 2007
    Woonsocket, Ri, Us

Tom Castaneda Education Details

  • Southwestern Jr College
    Southwestern Jr College
    General
  • Andress High School
    Andress High School
    Accounting And Business/Management

Frequently Asked Questions about Tom Castaneda

What company does Tom Castaneda work for?

Tom Castaneda works for Fidelity Investments

What is Tom Castaneda's role at the current company?

Tom Castaneda's current role is Operations Manager with over 25 years of experience in PBM and Health Care Industries. Health Services Leader | Client Management | Client & Consumer Experience Strategy | Service Delivery Manager (Healthcare).

What schools did Tom Castaneda attend?

Tom Castaneda attended Southwestern Jr College, Andress High School.

Who are Tom Castaneda's colleagues?

Tom Castaneda's colleagues are Aniket Banerjee, Robert Coutu, Sean Flynn, Jakob Haslam, Nick Eisinger, Sujata Paramguru, Anwesha Acharya.

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