2009
BS Pharmacy
University of Santo Tomas
More Info About Me
I have seven years of BPO expertise with an emphasis on healthcare accounts and am a registered pharmacist with three years of clinical experience. As a Subject Matter Expert, I have direct contact with our onshore leads. I design reports, presentations, modules, templates and decks. In addition, I teach new hires and give senior staff members a refresher course. Conducting updates is another responsibility I have.
Skills
Excel GuruWeb Scraping; Research Expert
Social Media Expert
Data Entry Specialist
General Virtual Assistant
Certificates
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My Experience and Education
2009
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2012
St. Luke’s Medical Center Global City
(Data Entry Specialist | Data Analyst | Clinical Pharmacist)
1. Monitors and analyzes medication regimen for individual patients and makes recommendations when needed based on effective and safe medication therapy principles.
2. Performs Drug Therapy Monitoring activities from the review of medication orders to the administration of drugs.
3. Coordinates all changes on the patient’s drug regimen to concerned units; and documents all drug-related problems.
4. Delivers Quality Patient Care and Safety in any situation throughout the Medical Center inconsistency with the Medical Center’s Vision, Mission, and Values.
2012
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2014
OptumRx
(Data Benefits Analyst)
1) Analyze benefit requests and secure all necessary data to ensure appropriate implementation based on applied logic to RxClaim pharmacy claim adjudication system.
2) Work with Client Management to implement new and maintain existing benefit plans and client pricing in the pharmacy claim adjudication system.
3) Work with Clinical Pharmacy to implement formulary updates and clinical programs in the pharmacy claim adjudication system.
4) Work with Pharmacy Network Management to implement pharmacy rate changes and network additions in the pharmacy claim adjudication system.
5) Ensure timely communication of any issues and/or information needed to complete a plan request.
6) Develop client specific implementation plans and manage implementation processes in accordance with department protocol.
7) Run queries out of the RxClaim adjudication system to secure all necessary information to implement plan requests.
8) Develop and run macros in RxClaim to implement plan requests.
9) Perform claim testing to ensure accurate claim adjudication.
10) Maintain acceptable and appropriate quality levels and production turn-around times.
11) Adhere to all documentation standards within the department.
12) Assist with the development of process improvements for the department.
13) Research and respond to all claims processing inquiries from Client Management, Clinical, and other internal department.
2014
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2018
OptumRx
(Subject Matter Expert)
1) Ensure that the training materials are up to date prior the start of ramp season.
2) Track the updates cascaded by our US counterpart leads and forecast any possible questions that may arise from the analysts.
3) Conducts training to develop new analysts and new coaches/mentors.
4) Ensures that the accuracy of the team is within the range of target which is 98%-100%.
5) Think of a solution to address the accuracy problems Manila team has encountered.
6) Performs monthly product knowledge test to analysts and mentors.
2018
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2019
OptumRx
(Assistant Manager Apprentice)
1) Check for the complete attendance of the team.
2) Conducts one on one coaching with the analysts to discuss their performance on a weekly basis.
3) Assign analysts to different project types that the business will need.
4) Sets performance goals and objectives with upper management.
5) Monitors performance progress with management and key trainers.
6) Observes experienced team leaders to acquire knowledge of methods, procedures, and standards required for performance of departmental duties.
7) Receives training in functions and operations of related departments to facilitate subsequent transferability between departments and to provide greater promotional opportunities.
My Services
General Virtual Assistant
I have a strong desire to research information online and use various search engines to find the required information.
Social Media Management
Overseeing and strategic role. I will directly manage your company's presence on social media platforms.
Data Entry / Web Researcher
Enters many types of data, such as lists of names, products, or numbers into database systems.