Dedicated Implementation Manager with six years of experience in Medicare operations, CMS regulations, and documentation oversight. Seeking to leverage expertise in process improvement, consumer-centric communication, and project management in the role of Pharmacy Consumer Experience Manager.
Overview
17
17
years of professional experience
Work History
Medicare Product Implementation Manager II
Regence BCBS Of Oregon
01.2018 - Current
Led Medicare Advantage service area expansions, CMS application processes, and Plan Benefit Package (PBP) setup
Served as Health Plan Management System (HPMS) Super User for Medicare Advantage plan updates and bid submissions
Coordinated multi-user PBP database setup and resolved system barriers to ensure smooth functionality
Oversaw various PBP components, including Part D Senior Savings Model, Hospice VBID, and Supplemental Benefits
Ensured accuracy of benefit data in bid submissions, member materials, and marketing collateral
Assisted Medicare Operations and Facets configuration with year-over-year changes and new benefit offerings
Led multiple Medicare product vendor implementations and documented processes for bid submission optimization.
Technical Writer II
Regence Pharmacy Services
06.2016 - 01.2018
Authored Corrective Action Plans (CAPs) based on operational analysis of compliance issues, system problems, gap analysis and remediation
Identified Standard Operating Procedures (SOPs) from multiple sources to create central repository for PBM and internal Pharmacy Operations Policy and Procedures
Interviewed and collaborated with Subject-Matter Expert (SMEs) to create new Oversight SOPs and revise existing SOPs
Ensured Commercial, Exchange, and Medicare Part D Process and Procedures are updated timely and meet with CMS guidance, NCQA, and state regulatory requirements.
Medicare Operations Documentation Editor/Author
Regence BCBS Of Oregon
07.2013 - 06.2016
Developed and maintained policies, procedures, and desk guides for Medicare Membership Operations team by interviewing subject-matter experts
Lead Quality Assurance (QA) team of subject-matter experts and Business Analysts to create and update content for Medicare Membership SharePoint library
Administered SharePoint sites for Medicare Membership Operation teams.
Knowledge Management Editor/Auditor
Regence BCBS Of Oregon
03.2007 - 07.2013
Responsible for research, task coordination, development, and maintenance of content for Member Services Knowledge Management System
Performed comprehensive editorial on submitted documentation
Collaborated with SMEs and Business Process Analysts to create and update policies and procedures for Knowledge Management system.
Education
Bachelor of Arts (BA) - English, Technical Communication
Boise State University
Boise, ID
06.2006
Skills
Distilling technical information into consumer-friendly language
Exceptional communication skills in writing, editing, presenting, and facilitating
Strong organizational and time management skills with high level of autonomy
Proven problem-solving ability and project management skills
Expertise in health/pharmacy literacy and consumer-focused practices
Leadership and interpersonal skills, including vendor relationship management
Knowledge of pharmacy products & services, CMS regulations, and healthcare compliance
Success in driving innovation and continuous process improvement
Proficient in Health Plan Management System (HPMS) and SharePoint administration
Demonstrated experience in CMS, state, and federal compliance
Excellent
Personal Information
Title: Medicare Product Implementation Manager
Timeline
Medicare Product Implementation Manager II
Regence BCBS Of Oregon
01.2018 - Current
Technical Writer II
Regence Pharmacy Services
06.2016 - 01.2018
Medicare Operations Documentation Editor/Author
Regence BCBS Of Oregon
07.2013 - 06.2016
Knowledge Management Editor/Auditor
Regence BCBS Of Oregon
03.2007 - 07.2013
Bachelor of Arts (BA) - English, Technical Communication
Boise State University
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