ASHLEY MOONEY
Long Beach,CA
Summary
Driven to reduce company liability by maintaining full compliance of company records, processing, and training programs. Quality-focused and proactive with demonstrated success in spotting and correcting issues. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Utilization Management Assistant
Providence Medical Foundation
04.2021 - 01.2023
- Performed preliminary review and assessment of referrals and authorizations per day.
- Prioritized work to meet departmental standards
- Researched and responded to inquiries from providers regarding coverage determinations
- Adhered to HIPAA requirements to safeguard patient confidentiality
- Maintained accurate documentation related to all aspects of utilization management functions
- Reviewed medical records for appropriateness of care and services provided to ensure compliance with established standards
- Collaborated with multi-disciplinary staff to improve overall patient care and response times.
Sr. Pharmacy Technician
OptumRx
10.2020 - 04.2021
- Responsible for incoming and outgoing calls regarding authorizations for general and high-touch clients
- Performed preliminary review and assessment of authorizations
- Adhered to company workflow and turnaround times
- Communicated effectively with providers about authorization decisions via telephone or email correspondence
- Maintained knowledge of current standards related to care delivery including regulatory requirements, emerging trends, best practices
- Utilized computer systems such as EMRs, UM software programs and databases to access information relevant to the review process.
Pharmacy Technician
CVS Health
09.2017 - 10.2020
- Assisted in training new employees on pharmacy procedures
- Assisted pharmacist with clearing high volume of prescriptions and responded to customer questions
- Performed data entry for patient profiles, billing information and prescription orders into the pharmacy software system
- Prepared medications for dispensing by counting, pouring, labeling, and verifying doses
- Oversaw inventory management processes such as ordering, stocking, tracking expiration dates
- Managed day-to-day operations of the pharmacy department including staffing schedules.
Intake Coordinator Trainer
New Century Health
10.2016 - 05.2017
- Responsible for day-to-day training and ongoing educational support
- Facilitated onboard orientation for new Intake Coordinators
- Supervised new Intake Coordinators throughout onboard training
- Participated during URAC, Health Plan, and CRM audits
- Designed and developed training materials for new employees in the organization
- Adapted teaching methods according to the needs of individual learners or groups
- Provided feedback on employee performance based on observed results during training sessions
- Worked collaboratively across departments and with various stakeholders to deliver comprehensive, effective training sessions.
Intake Coordinator III
New Century Health
08.2015 - 10.2016
- Responsible for incoming and outgoing calls regarding referrals and authorizations
- Collaborated with multi-disciplinary staff to improve overall patient care and response times
- Performed preliminary review and assessment of authorizations
- Adhered to established departmental turnaround times when conducting utilization reviews
- Utilized computer systems such as EMRs, UM software programs and databases to access information relevant to the review process
- Communicated effectively with providers about authorization decisions via telephone or email correspondence.
Pharmacy Technician
CVS Health
07.2010 - 08.2015
- Maintain company workflow
- Assisted pharmacist with clearing high volume of prescriptions and responded to customer questions
- Performed data entry for patient profiles, billing information and prescription orders into the pharmacy software system
- Prepared medications for dispensing by counting, pouring, labeling, and verifying doses.
Education
Bachelor of Science - Health Care Administration
California State University, Long Beach
Long Beach, CA12.2023
New Century Health - Leadership Program
01.2017
Skills
- Medical Terminology Knowledge
- Conflict Resolution Techniques
- Case Management Proficiency
- Documentation Accuracy
- Project Management exposure
- Lean and Six Sigma exposure
Certification
California Pharmacy Technician License: 148675
Accomplishments
- Employee of the Month in March 2021
- Member of The National Society of Leadership and Success
References
References available upon request
Timeline
Utilization Management Assistant
Providence Medical Foundation
04.2021 - 01.2023
Sr. Pharmacy Technician
OptumRx
10.2020 - 04.2021
Pharmacy Technician
CVS Health
09.2017 - 10.2020
Intake Coordinator Trainer
New Century Health
10.2016 - 05.2017
Intake Coordinator III
New Century Health
08.2015 - 10.2016
Pharmacy Technician
CVS Health
07.2010 - 08.2015
Bachelor of Science - Health Care Administration
California State University, Long Beach
New Century Health - Leadership Program
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