Ashley Fournier
Chesterfield,Virginia
Summary
Eager to join a well-respected team where leadership skills can be used to elevate the visibility and profitability of the overall organization. Self-assured individual trained to be a focused Compliance Specialist bringing more than 10 years working for Healthcare organizations and determined to exceed expectations.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Senior Pharmacy Benefit & Compliance Specialist
Sentara Healthcare
09.2022 - Current
- Provides subject matter expertise related to Medicare and CMS rules and regulations as well as meet expectations of CMS, NCQA, and all other State and Federal laws and Regulations
- Served as point of contact for employees seeking guidance on Medicare compliance matters, instilling confidence in organization's commitment to regulatory adherence.
- Improved Pharmacy Compliance by developing and implementing comprehensive policies and procedures.
- Managed complex projects involving multiple stakeholders, ensuring alignment with organizational goals while maintaining focus on regulatory requirements.
- Maintained up-to-date knowledge of regulatory changes affecting business landscape, proactively adapting audit strategies as needed.
- Developed key performance indicators for monitoring compliance activities, ensuring progress toward established objectives while being effectively tracked and reported.
Pharmacy Benefit & Compliance Specialist
Sentara Healthcare
10.2020 - 09.2022
- Provides subject matter expertise related to analysis, implementation, and process improvement activities in support of the Pharmacy Department
- Assisted in the preparation of regular reports for senior management, detailing compliance activities and progress toward established goals.
- Evaluated existing policies regularly, identifying areas for improvement and recommending revisions as needed.
- Performed quality reviews to uncover workflow and potential compliance issues.
- Stayed current on industry regulations by attending seminars, workshops, and other professional development opportunities.
Pharmacy Compliance Coordinator
Virginia Premier Health Plan
10.2015 - 10.2020
- Virginia Premier Merged with Sentara Healthcare in October 2020.
- Oversight of Pharmacy Benefits Manager and ensuring compliance with applicable federal and state regulations as well as accreditation and procedural requirements
- Responded to employee inquiries regarding compliance regulations and procedures.
- Identified gaps in existing compliance processes and recommended updates.
- Monitored and assessed compliance risks associated with operational processes and procedures.
Pharmacy Technician
Sitter And Barfoot Veterans Care Center
02.2013 - 10.2015
- Trained new pharmacy technicians on proper procedures and best practices, ensuring consistent quality of service.
- Answered incoming phone calls and addressed questions from nurses and healthcare providers.
- Stocked, labeled, and inventoried medication to keep accurate records.
- Performed various pharmacy operational activities with strong commitment to accuracy, efficiency, and service quality.
Pharmacy Technician
CVS Pharmacy
01.2011 - 02.2013
- Followed up with patients, as necessary, to complete or renew refills as appropriate
- Answered incoming phone calls and addressed questions from customers and healthcare providers.
- Stocked, labeled, and inventoried medication to keep accurate records.
- Promoted patient confidentiality by adhering to HIPAA regulations when handling personal information during transactions.
Education
MBA - Health Administration
Virginia Commonwealth University
Richmond, VA05.2025
Certificate - Healthcare Operations Management
Cornell University
Ithaca, NY06.2024
Bachelor of Science - Healthcare Administration
Southern New Hampshire University
Hooksett, NH09.2023
High School Diploma -
James River High School
Midlothian, VA06.2011
Skills
- Compliance Knowledge & Monitoring
- Internal Auditing
- Pharmacy Compliance Oversight & PBM Oversight
- Regulatory Knowledge on CMS, NCQA and DMAS
- Advanced in Excel, Word, SharePoint, SQL and other Microsoft programs
- Expert knowledge in creation and development of letters, marketing materials, website content, MTM programs, Grievances & Appeals Redeterminations & IRE's
Accomplishments
Healthcare Operations Management Certificate
Certification
- Lean Six Sigma – Green Belt
- SME (Subject Matter Expert) – Medicare / Medicaid Programs
- CPhT - Certified Pharmacy Technician
Timeline
Senior Pharmacy Benefit & Compliance Specialist
Sentara Healthcare
09.2022 - Current
Pharmacy Benefit & Compliance Specialist
Sentara Healthcare
10.2020 - 09.2022
Pharmacy Compliance Coordinator
Virginia Premier Health Plan
10.2015 - 10.2020
Pharmacy Technician
Sitter And Barfoot Veterans Care Center
02.2013 - 10.2015
Pharmacy Technician
CVS Pharmacy
01.2011 - 02.2013
MBA - Health Administration
Virginia Commonwealth University
Certificate - Healthcare Operations Management
Cornell University
Bachelor of Science - Healthcare Administration
Southern New Hampshire University
High School Diploma -
James River High School