Cameron Stephens
Houston,TX
Overview
12
12
years of professional experience
Work History
Claims Analyst Sr.
Prime Therapeutics (PBM)
02.2024 - Current
- Ensure completion and quality of the testing process by overseeing preparation of test case scenarios, use cases, and test scripts; participate in joint, client, and application testing and analyze and document test results
- Provide subject matter expertise for roadmap and implementations to be used for business requirement documentation
- Partner with business and IT to ensure proposed designs meet business needs and are effectively implemented in production by working through project life cycle activities (researching, testing, implementing, troubleshooting and measuring results)
- Interpret clients and/or account management requests and lead resolution; translate complex details of system capabilities to non-technical audiences
- Interpret technical specifications for business use
- Serve as escalation point and mentor for all production roles.
Clinical Program Analyst (Comm & HIM)
Prime Therapeutics (PBM)
04.2022 - 02.2024
- Partner with internal and external business partners to develop, generate, analyze, quality check, and coordinate the delivery of client and internal program reporting
- Supports five clients (Alabama, North Dakota, Wyoming, Capital Blue Cross, Minnesota)
- Develop and maintain business process flows and desk top procedures
- Deliver VidGrid Training to the Clinical Program Management department to enhance all desk top procedures
- Work with various internal departments to create and maintain client, member, and/or physician communications and templates, member disruption mailings, and utilization requests.
Trainer (Government Programs)
Prime Therapeutics (PBM)
05.2019 - 04.2022
- Deliver training material in a face-to-face synchronous environment and/or the asynchronous work from home format for any training need
- Collaborate with Managers, and Directors across the organization on strategic initiatives, and disciplinary action
- Delivered D&I ignite inclusion training to over 25% of Prime employees including ELT
- Delivered training on compliance and regulatory obligations (CMS, and NCQA)
- Partner with department or functional area to identify training needs and prioritize activities based on timelines provided
- Develop training materials and communications including training manuals, instructor guides, PowerPoint decks, DTPs, training exercises, training effectiveness surveys, handouts, and other materials
- Maintain subject matter expertise in the areas of training and project management/development
- Conduct pre- and post-training analyses reflecting effectiveness of training
- Participate in all elements of training design, development, and project management including conducting focus groups for training rollout.
Desk Auditor/ Clinical Review Technician
Prime Therapeutics (PBM)
09.2016 - 05.2019
- Analyzed individual pharmacy claims and conduct desktop audits of participating Network Pharmacies
- Ensured compliance with contractual and regulatory obligations (CMS, and NCQA)
- Identified and escalated potential non-compliant, suspicious, or fraudulent pharmacy activity to management.
Senior Pharmacy Technician
Walgreens Pharmacy
02.2014 - 09.2016
- Maintains pharmaceutical stock to determine inventory levels
- Generate revenues by calculating, recording, and issuing charges
- Upholds records by efficiently filing physicians' orders and prescriptions
- Creates job aides for all technician processes
- Assist Pharmacy Manager in conducting interviews, and annual reviews for technicians.
Data Entry/ Call center Pharmacy Technician
Merwin LTC Pharmacy
06.2015 - 04.2016
- Communicate with skilled nursing facilities to clarify orders
- Exceeds company goal of 200 new prescriptions by maintaining an average of 230 new prescriptions per day
- Conducted outreach to obtain new prescriptions from the skilled nursing facilities.
Lead Pharmacy Technician
CVS Pharmacy
10.2012 - 02.2014
- Assist the pharmacist by dispensing medication orders, prescriptions and calculating quantities
- Scheduling for technicians and/ new hire technicians
- Manage direct reports, conduct interviews, and annual reviews for all technicians
- Performs on the job training for all new hire technicians.
Education
Certified Pharmacy Technician License (CPhT) -
NHA ExCPT Pharmacy Technician
09.2024
High School Diploma - undefined
Cooper High School
06.2012
Skills
- Productivity Improvement
- Client Relationship Management
- Project Planning
- Cross-Functional Communication
- KPI Tracking
- Six Sigma Methodologies
- Program Design
- RxClaims
- CRE/ CORE
- Microsoft Office
- SharePoint
- Salesforce
Timeline
Claims Analyst Sr.
Prime Therapeutics (PBM)
02.2024 - Current
Clinical Program Analyst (Comm & HIM)
Prime Therapeutics (PBM)
04.2022 - 02.2024
Trainer (Government Programs)
Prime Therapeutics (PBM)
05.2019 - 04.2022
Desk Auditor/ Clinical Review Technician
Prime Therapeutics (PBM)
09.2016 - 05.2019
Data Entry/ Call center Pharmacy Technician
Merwin LTC Pharmacy
06.2015 - 04.2016
Senior Pharmacy Technician
Walgreens Pharmacy
02.2014 - 09.2016
Lead Pharmacy Technician
CVS Pharmacy
10.2012 - 02.2014
Certified Pharmacy Technician License (CPhT) -
NHA ExCPT Pharmacy Technician
High School Diploma - undefined
Cooper High School