Bachelor of Science - Healthcare Management
Southern Illinois University Carbondale
Carbondale, IL05.2013
Ashley Jones
Chicago/Remote,IL
Summary
Google Project Management Certified and extremely versatile Healthcare Leader and Consultant with 10 years of proven progressive leadership while providing an exemplary level of healthcare service delivery to patients and cultivating relationships with key stakeholders. Multi-state licensed and Nationally Certified Pharmacy Technician (CPhT) by trade. Management and Strategy Institute (MSI) Lean Six Sigma White Belt Certified. Proven problem solver and excellent communicator. Strong organizational skills and superb understanding of data collection and performance metrics. Recognized for staff development leading high performing teams. Skilled in analyzing insurance, medical claims and medication management.
Education
Skills
- Team Leadership
- Healthcare Consultant
- Pharmacy Consultant
- Business Management
- Strategic Development
- Project Management
- Program Management
- Staff Management
- Agile Framework
- Six Sigma
- Jira Fundamentals
- Epic & Epic Willow Systems
Timeline
Ambulatory Medication Coordinator
University Of Chicago Medicine
03.2023 - Current
Case Manager
PharmaCord
11.2021 - 03.2023
Health Unit Coordinator
Eating Recovery Center/Insight Behavioral Health
08.2019 - 04.2020
Front Office Coordinator
Body Gears Physical Therapy
07.2018 - 08.2019
Office Manager
ARC Physical Therapy
04.2017 - 07.2018
Senior Prior Authorization Pharmacy Technician
United Healthcare
08.2015 - 04.2017
Patient Access Representative Team Lead
Northwestern Memorial Hospital
05.2013 - 08.2015
Bachelor of Science - Healthcare Management
Southern Illinois University Carbondale
Work History
Ambulatory Medication Coordinator
University Of Chicago Medicine
03.2023 - Current
- Conduct patient insurance, benefits and financial investigation and verification by directly communicating with patients. Complete prior authorization forms, negotiate authorization status with insurers, track status of prescription approval and when necessary, alert clinical pharmacists of denials.
- Expedite clinic workflow and enhance patient care by preventing therapy interruptions due to insurance issues in conjunction with pharmacists, physicians, and clinic staff.
- Assist with development and implementation of policies and procedures to ensure reimbursement of high cost medications.
- Facilitate enrollment of patients in patient assistance programs and collaborate with social services and case management on patient assistance.
Case Manager
PharmaCord
11.2021 - 03.2023
- Built trusted relationships with patients, prescribers and client stakeholders through proactive communication, timely and accurate execution of deliverables and demonstrated relentless passion for helping patients
- Coordinated shipment of medication through patient assistance program and/or bridge program from PharmaCord pharmacy
- Reported adverse events, product complaints, special situation reports and/or medical inquiries received in accordance with SOPs and Business Rules
- Identified and communicates patient’s plan benefit coverage including need for prior authorization, appeal, tier exception, and/or formulary exclusions
Health Unit Coordinator
Eating Recovery Center/Insight Behavioral Health
08.2019 - 04.2020
- Facilitated organized record retrieval and access by maintaining filing system for both in-house and discharged residents
- Provided care for 50-patient unit, coordinating day-to-day needs related to patient care
- Conducted in-person welcome and orientation for newly admitted and transferred patients
- Organized and facilitated 3 department head meetings weekly, discussing current census, admissions and discharges and plan of care
Front Office Coordinator
Body Gears Physical Therapy
07.2018 - 08.2019
- Assisted upper management by coordinating travel plans, planning special events and taking meeting minutes.
- Facilitated communications, financial processing, registration, recordkeeping and other administrative functions for over 100 patients.
- Managed fixed budgets while ordering and distributing office supplies.
- Developed team communications and information for meetings.
Office Manager
ARC Physical Therapy
04.2017 - 07.2018
- Managed budgets, appointment scheduling, employee and event itineraries and accounts to improve productivity projects.
- Established workflow processes, monitored daily productivity and implemented modifications to improve overall performance of personnel.
- Utilized client and staff feedback to maintain customer partnerships, key stakeholder relationships and increase revenue.
- Maintained computer and physical filing systems for over 80 patients
Senior Prior Authorization Pharmacy Technician
United Healthcare
08.2015 - 04.2017
- Supervised 10 pharmacy technicians and coordinated day-to-day assignments.
- Communicated with patients to collect information about prescriptions and medical conditions or arrange consultations with pharmacists.
- Established relationships with insurance company representatives to complete claims processing, resolve concerns and reconcile payments.
- Exceeded goals through effective task prioritization and great work ethic
Patient Access Representative Team Lead
Northwestern Memorial Hospital
05.2013 - 08.2015
- Determined patient financial needs and referred over 150 eligible patients to proper county, state or federal agencies to obtain financial assistance on daily basis
- Collected and entered patient demographic and insurance data into computer database to establish patient's medical record
- Explained estimated cost for medical treatments and answered patient questions to promote good understanding of proposed services
- Utilized knowledge of EPIC systems and medical terminology to perform diverse data entry tasks
Affiliations
- The Society of Distinguished Black Women, Inc Mar 2011 - Present
- Zeta Phi Beta Sorority, Inc Dec 2017 - Present
Certification
- CPhT - Nationally Certified Pharmacy Technician
- Google Project Management Certified
- Management and Strategy Institute (MSI) Lean Six Sigma White Belt Certified
Additional Information
- Pharmacy Technician resume available by request
Overview
10
10
years of professional experience
1
1
Certificate