Adina Ayala
Fort Worth
Summary
Strategic leader specializing in healthcare project execution and operational excellence. Proven track record in cross-functional collaboration, risk management, and process optimization, resulting in significant improvements in team performance and client satisfaction through precise execution of benefit administration and coding.
Overview
7
7
years of professional experience
Work History
Manager, Aetna Pharmacy Benefit Configuration and Automation
CVS Health
03.2025 - Current
- Drive team performance against KPIs and OKRs, achieving strong quality, accuracy, and turnaround results across coding, auditing, and related operational processes
- Led Aetna configuration teams across stateside and offshore operations, ensuring high-quality coding and auditing of Client Requirement Documents for commercial pharmacy benefit plans
- Direct cross-functional workflows through measurement, analysis, training, and stakeholder coordination to ensure adherence to configuration standards, manage dependencies, and support consistent, high-quality outcomes
- Improved quality and operational efficiency by identifying workflow gaps and implementing standardized processes that strengthened operational execution
- Maintain strong automation support through process discipline and accurate upstream and downstream record management
- Interpreted plan sponsor benefit requirements, anticipated potential issues, and took proactive action to support seamless plan implementation
- Improved engagement outcomes from 86% in Spring 2025 to 100% in 2026 while also strengthening manager impact and feedback results
Manager, Client Benefits
CVS Health
09.2021 - 03.2025
- Led resolution of complex pharmacy benefit and coding issues by partnering across medical, sales, and internal teams to support accurate benefit administration
- Supported specialty benefits and pricing initiatives through process mapping and cross-functional coordination to resolve issues effectively
- Built internal partnerships to ensure timely resolution of issues and consistent administration of client benefits
- Contributed to workflow improvement efforts that strengthened operational execution, process clarity, and quality outcomes
- Completed Leading for Results program and subsequent training to enhance leadership capabilities and operational readiness
Pharmacy Account Manager
CVS Health
09.2019 - 09.2021
- Consulted with clients to support pharmacy benefit plan activities, translating needs into actionable solutions that enhanced client satisfaction
- Coordinated with clients and stakeholders, including medical team members, brokers, and underwriters, to facilitate new plan setups, implement plan changes, and resolve issues effectively
- Analyzed complex benefit-related issues, identified root causes, and partnered across teams to drive timely, effective resolution
- Delivered support for client membership exceeding 77K through organized processes, responsive communication, and quality control measures
- Managed multiple priorities in a fast-paced environment while maintaining professional communication and consistent execution
Education
Tarrant County College -
Some College
01-2022
ATI Career Training Center -
NRCMA Certification
01-2012
Skills
- Benefit configuration
- Process optimization
- KPI management
- Project execution
- Risk management
- Cross-functional collaboration
- Stakeholder communication
- Team leadership
- Client support
Timeline
Manager, Aetna Pharmacy Benefit Configuration and Automation
CVS Health
03.2025 - Current
Manager, Client Benefits
CVS Health
09.2021 - 03.2025
Pharmacy Account Manager
CVS Health
09.2019 - 09.2021
Tarrant County College -
Some College
ATI Career Training Center -
NRCMA Certification