DANIELLE FERRER MARCHESANO
Ridley Park,PA
Summary
Dynamic and results-oriented healthcare executive with extensive experience in pharmacy operations, compliance, vendor oversight, and team leadership. Proven expertise in project management, quality assurance, and healthcare systems with a focus on Medicare and regulatory compliance. Adept at building high-performing teams, driving operational efficiency, and delivering impactful results in fast-paced environments.
Overview
32
32
years of professional experience
Work History
Manager, Clinical Pharmacy Operations
Devoted Health
01.2021 - Current
- Lead and coach a team of pharmacy technicians, ensuring compliance with state and federal regulations
- Develop and implement standardized policies, workflows, and operational processes
- Manage clinical pharmacy programs, including medication adherence and quality assurance initiatives
- Serve as a key resource for medication-related inquiries on formulary tiers, prior authorizations, and cost-sharing
- Collaborate with multidisciplinary teams to enhance the member experience and optimize clinical processes
- Track and report on clinical pharmacy interventions and key performance metrics
- Mentored junior team members for career advancement, fostering a pipeline of future leaders within the organization.
- Streamlined workflows by identifying bottlenecks in existing systems and implementing appropriate solutions.
- Established team priorities, maintained schedules and monitored performance.
- Evaluated employee performance and conveyed constructive feedback to improve skills.
- Defined clear targets and objectives and communicated to other team members.
- Established performance goals for employees and provided feedback on methods for reaching those milestones.
Manager, Pharmacy Network Operations & Pharmacy Audit
PerformRx
01.2014 - 12.2020
- Directed nationwide pharmacy network operations, ensuring compliance with contractual obligations and claims adjudication accuracy
- Supervised pharmacy audits, identifying Fraud, Waste, and Abuse (FWA) and implementing corrective action plans
- Led diverse teams in achieving performance goals, conducting annual reviews, and fostering professional growth
- Oversaw departmental workflows, budgets, and adherence to CMS and NCQA standards
- Managed and motivated employees to be productive and engaged in work.
- Maximized performance by monitoring daily activities and mentoring team members.
- Enhanced customer satisfaction by resolving disputes promptly, maintaining open lines of communication, and ensuring high-quality service delivery.
- Cross-trained existing employees to maximize team agility and performance.
- Managed budgets effectively, ensuring optimal financial performance while investing in necessary resources for business growth.
- Achieved departmental goals by developing and executing strategic plans and performance metrics.
- Built high-performing teams through effective recruitment, onboarding, and talent development initiatives.
- Spearheaded transition to remote work during global health crisis, ensuring business continuity and employee safety.
- Led cross-functional teams to achieve project goals, fostering collaboration and innovation.
- Managed budget allocations to prioritize spending on high-impact projects, optimizing resource utilization.
- Maintained positive customer relations by addressing problems head-on and implementing successful corrective actions.
- Established team priorities, maintained schedules and monitored performance.
- Evaluated employee performance and conveyed constructive feedback to improve skills.
- Successfully managed budgets and allocated resources to maximize productivity and profitability.
- Recruited, interviewed and hired employees and implemented mentoring program to promote positive feedback and engagement.
- Streamlined and monitored quality programs to alleviate overdue compliance activities.
Compliance Manager & Vendor Oversight
Catamaran
01.2012 - 01.2014
- Managed Medicare Part D Compliance Programs, facilitating audits, reporting, and regulatory communications
- Conducted vendor risk assessments, audits, and corrective action plans to ensure adherence to CMS standards
- Collaborated with operational teams to implement compliance fixes, enhancing client STAR ratings
- Reviewed documents, files, transcripts, and other records to assess compliance and potential risk.
- Enhanced overall business operations by continuously improving policies, procedures, and controls related to compliance requirements.
- Prepared records and data for regular audits.
- Formulated detailed recommendations based on audit findings to support annual planning and definition of goals.
- Played instrumental role in company-wide risk assessment efforts, supporting enhancements in business processes and controls.
- Delivered subject matter expertise for internal and external customers on compliance best practices and quality control.
- Supported the implementation of new regulations within the organization by developing strategic plans and action items for each department.
- Consulted with clients on best practices and served as project manager for all process improvements and regulatory initiatives.
- Prepared and presented comprehensive reports to upper management and audit team, covering issues and recommendations.
- Collaborated with contract team to review client contracts and facilitate personnel compliance training.
- Evaluated third-party vendors'' adherence to applicable laws/regulations before engaging them as partners or service providers for the company''s projects.
- Advised division leaders of regulatory risks in business processed and provided recommendations for improvement.
- Performed regular compliance reviews and audits, identifying non-compliance issues.
- Kept up to date on compliance trends and rulings using meticulous research and study.
- Strengthened vendor relationships by maintaining open communication and promptly addressing any concerns or issues.
Compliance Manager
Future Scripts (Catamaran)
11.2010 - 11.2012
- Administered compliance programs, ensuring alignment with federal, state, and health insurance regulations
- Developed and monitored corrective action plans following audits, driving operational improvements
- Collaborated with legal teams to analyze regulatory changes and maintain accreditation standards
- Collaborated with cross-functional teams to establish clear compliance guidelines and expectations for all departments.
- Reviewed documents, files, transcripts, and other records to assess compliance and potential risk.
- Managed investigations into potential violations of laws or regulations, ensuring swift resolution and corrective actions when necessary.
- Enhanced overall business operations by continuously improving policies, procedures, and controls related to compliance requirements.
- Prepared records and data for regular audits.
- Conducted thorough internal audits to ensure adherence to regulatory standards and best practices.
- Delivered subject matter expertise for internal and external customers on compliance best practices and quality control.
- Played instrumental role in company-wide risk assessment efforts, supporting enhancements in business processes and controls.
- Monitored emerging trends in regulatory requirements, anticipating potential impacts on the organization''s operations.
- Managed compliance efforts, reporting and audits.
- Oversaw a team of compliance professionals, providing guidance, mentorship, and support to ensure their continued growth and development.
- Improved communication channels between departments by establishing regular meetings and reporting structures related to compliance matters.
- Supported the implementation of new regulations within the organization by developing strategic plans and action items for each department.
Senior Implementation Manager
Future Scripts / Independence Blue Cross
06.2008 - 10.2010
- Led cross-functional teams to implement new business clients, managing project plans and risk assessments
- Supported strategic initiatives, ensuring contractual compliance and operational excellence
- Created customized onboarding materials tailored to each client''s unique needs, facilitating smoother transitions to new systems or processes.
- Developed comprehensive implementation plans for complex projects, ensuring all stakeholders were engaged and informed throughout the process.
- Collaborated with cross-functional teams to ensure timely delivery of quality solutions for clients.
- Evaluated success metrics post-implementation for ongoing analysis of project outcomes and identification of areas for improvement moving forward.
- Established strong relationships with clients through regular check-ins and progress updates, fostering long-term partnerships.
- Streamlined implementation processes by identifying and resolving bottlenecks, leading to more efficient project timelines.
- Managed client expectations during implementations by maintaining clear communication about project status and any potential delays.
- Oversaw implementation lifecycle processes based on organizational needs, regulatory requirements, and customer demand.
Manager, Pharmacy Prior Authorization
PerformRx
12.2006 - 06.2008
- Supervised pharmacy technician teams, ensuring compliance with turnaround time requirements and quality standards
- Managed system integrations and conducted training for staff on new processes and tools
Supervisor, Lead Pharmacy Technician
Beckett's Apothecary
10.1999 - 03.2009
- Provided exceptional customer service, managed prescription data entry, and resolved insurance claim issues
- Oversaw inventory management and ensured accurate medication dispensing
Manager, Retail Pharmacy
Alpine Drugs
10.1992 - 10.2002
- Managed and motivated employees to be productive and engaged in work.
- Accomplished multiple tasks within established timeframes.
- Maximized performance by monitoring daily activities and mentoring team members.
- Enhanced customer satisfaction by resolving disputes promptly, maintaining open lines of communication, and ensuring high-quality service delivery.
- Controlled costs to keep business operating within budget and increase profits.
- Resolved staff member conflicts, actively listening to concerns and finding appropriate middle ground.
- Cross-trained existing employees to maximize team agility and performance.
- Maintained professional, organized, and safe environment for employees and patrons.
- Built high-performing teams through effective recruitment, onboarding, and talent development initiatives.
- Streamlined workflows by identifying bottlenecks in existing systems and implementing appropriate solutions.
- Improved customer satisfaction scores by overhauling customer service protocols and training staff in customer engagement techniques.
- Defined clear targets and objectives and communicated to other team members.
- Maintained professional demeanor by staying calm when addressing unhappy or angry customers.
- Improved staffing during busy periods by creating employee schedules and monitoring call-outs.
- Streamlined and monitored quality programs to alleviate overdue compliance activities.
Team Lead, Quality Auditor, and Call Center Training Specialist
Keystone Mercy Health Plan
01.2002 - 01.2006
- Enhanced overall team performance by providing regular coaching, feedback, and skill development opportunities.
- Established clear performance metrics for the team which helped in tracking progress towards set targets effectively.
- Promoted a positive work environment by fostering teamwork, open communication, and employee recognition initiatives.
- Coached team members in techniques necessary to complete job tasks.
- Collaborated with other department leads to streamline workflows, improve interdepartmental coordination, and achieve business goals collectively.
- Increased customer satisfaction by ensuring timely completion of projects and adherence to high-quality standards.
- Evaluated employee skills and knowledge regularly, training, and mentoring individuals with lagging skills.
- Served as a role model for the team by demonstrating commitment to excellence, professionalism, and adherence to company values at all times.
- Conducted regular progress reviews with individual team members to identify areas for improvement and provide guidance on career development opportunities.
- Conducted regular reviews of operations and identified areas for improvement.
- Generated reports detailing findings and recommendations.
- Evaluated staff performance and provided coaching to address inefficiencies.
- Developed effective improvement plans in alignment with goals and specifications.
- Identified issues of non-compliance and elevated reports to senior personnel.
- Trained new Quality Auditors on best practices, increasing their proficiency in performing audits effectively.
- Enhanced product quality by conducting thorough audits and identifying areas for improvement.
- Developed comprehensive audit reports, providing valuable insights into areas requiring improvement.
- Maintained a strong understanding of industry regulations and ensured company compliance through regular audits.
Education
Network Technician Certification - undefined
CHUBB Institute
Springfield, PABusiness Coursework - undefined
Delaware County Community College
Philadelphia, PABusiness Administration Coursework - undefined
Southern New Hampshire University
Manchester, NHSkills
Pharmacy Operations Managementundefined
Volunteerworkandinterests
- Special Olympics: Chaperone and event volunteer.
- The Gift of Life Foundation: Fundraising and awareness for organ donation.
- American Foundation for Suicide Prevention: Organizer and participant in awareness campaigns.
- Other Volunteer Initiatives: Active supporter of diabetes, cancer, and SIDS awareness events.
Timeline
Manager, Clinical Pharmacy Operations
Devoted Health
01.2021 - Current
Manager, Pharmacy Network Operations & Pharmacy Audit
PerformRx
01.2014 - 12.2020
Compliance Manager & Vendor Oversight
Catamaran
01.2012 - 01.2014
Compliance Manager
Future Scripts (Catamaran)
11.2010 - 11.2012
Senior Implementation Manager
Future Scripts / Independence Blue Cross
06.2008 - 10.2010
Manager, Pharmacy Prior Authorization
PerformRx
12.2006 - 06.2008
Team Lead, Quality Auditor, and Call Center Training Specialist
Keystone Mercy Health Plan
01.2002 - 01.2006
Supervisor, Lead Pharmacy Technician
Beckett's Apothecary
10.1999 - 03.2009
Manager, Retail Pharmacy
Alpine Drugs
10.1992 - 10.2002
Network Technician Certification - undefined
CHUBB Institute
Business Coursework - undefined
Delaware County Community College
Business Administration Coursework - undefined
Southern New Hampshire University
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