Christina Darwin
Orlando
Summary
Pharmacy professional with extensive experience in managing prior authorizations and pharmacy operations. Known for results-driven approach and reliable collaboration with team members and healthcare providers. Adaptable to changing needs, with strong skills in problem-solving and patient communication, ensuring efficient medication approval processes. Experienced leader with strong background in guiding teams, managing complex projects, and achieving strategic objectives. Excels in developing efficient processes, ensuring high standards, and aligning efforts with organizational goals. Known for collaborative approach and commitment to excellence.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Lead Prior Authorization Pharmacy Technician & SME
Centene Corporation
03.2022 - Current
- Verified eligibility and compliance with authorization requirements for service providers.
- Tracked referral submission during facilitation of prior authorization issuance.
- Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
- Triaged unscheduled and emergency authorizations, directing submissions to appropriate personnel for rapid response.
- Managed a high volume of prior authorization requests, consistently meeting deadlines while maintaining attention to detail.
- Streamlined the prior authorization process by implementing efficient workflow systems and maintaining accurate records.
- Evaluated and updated internal prior authorization protocols as needed, maintaining compliance with evolving industry standards.
Clinical Nurse Manager
BioPlus Specialty Pharmacy
11.2018 - 09.2020
- Mentored new nursing staff, fostering professional growth and development through comprehensive training programs.
- Streamlined workflow for increased efficiency by optimizing scheduling and delegating tasks to the appropriate staff members.
- Conducted routine performance evaluations, providing constructive feedback to drive continuous improvement among nursing staff members.
- Maximized nursing staff potential by providing ongoing coaching and support, leading to higher levels of competence and confidence in delivering quality care.
- Fostered improvement in staff development, personnel training, and standards of patient care.
- Managed budgets and resources, consistently meeting financial goals while maintaining high-quality patient care standards.
- Implemented quality improvement initiatives to identify areas for potential enhancements in patient care delivery methods.
Patient Access Coordinator
Kroger Specialty Pharmacy
03.2018 - 11.2018
- Contributed to a positive work environment by providing support and assistance to colleagues during peak periods or staff shortages.
- Maintained strict adherence to HIPAA regulations while managing confidential patient information throughout various stages of care.
- Managed high volumes of inbound calls while addressing scheduling requests, appointment confirmations, prescription refills, and general inquiries professionally.
- Increased efficiency of daily operations by implementing electronic health record system for accurate data management.
- Participated in continuous improvement initiatives, collaborating with team members to identify areas of opportunity and develop plans for enhancement.
- Promoted patient-centered care through facilitating open lines of communication between medical professionals, patients, and their families regarding treatment plans and progress updates.
Lead Certified Pharmacy Technician
Wells Specialty Pharmacy
11.2017 - 03.2018
- Trained new pharmacy technicians on proper procedures and best practices, ensuring consistent quality of service.
- Answered incoming phone calls and addressed questions from customers and healthcare providers.
- Stocked, labeled, and inventoried medication to keep accurate records.
- Completed paperwork, entering prescription and insurance or billing information into patient profiles.
- Consulted with insurance company representatives to complete claims processing, resolve concerns, and reconcile payments.
- Enhanced patient care by accurately filling and dispensing prescriptions in a timely manner.
- Championed continuing education opportunities for staff members, promoting professional development and enhancing skill sets across the team.
- Ensured proper storage of medications according to manufacturer guidelines, maintaining drug quality and efficacy.
Education
Certificate - Medical Assistant
Winter Park Technical College
Winter Park, FL01.2011
Bachelor of Science - Nursing
University of Central Florida
Orlando, FL08.2010
Associate of Science - Radiology
Daytona Beach State College
Daytona Beach, FL06.2009
High School Diploma -
Apopka Senior High School
05.2007
Skills
- Prior authorization
- Leadership qualities
- Professionalism and ethics
- Continuous learning attitude
- Training and mentoring
- Patient confidentiality compliance
- Medical terminology
- Innovation and creativity
- Process improvement strategies
- Resourcefulness and initiative
- Workflow optimization
- Performance metrics tracking
Certification
- Florida RPhT, RPT42592
- Georgia RPhT, PHTC071286
- North Carolina RPhT, 79003
- CPhT, 10024369
Timeline
Lead Prior Authorization Pharmacy Technician & SME
Centene Corporation
03.2022 - Current
Clinical Nurse Manager
BioPlus Specialty Pharmacy
11.2018 - 09.2020
Patient Access Coordinator
Kroger Specialty Pharmacy
03.2018 - 11.2018
Lead Certified Pharmacy Technician
Wells Specialty Pharmacy
11.2017 - 03.2018
Certificate - Medical Assistant
Winter Park Technical College
Bachelor of Science - Nursing
University of Central Florida
Associate of Science - Radiology
Daytona Beach State College
High School Diploma -
Apopka Senior High School
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