Summary
Overview
Work History
Education
Skills
Timeline
Generic

Emily Platt

Springhill,TN

Summary

Experienced professional with experience in optimizing productivity, efficiency and service quality across various environments. Highly dependable, ethical and reliable support specialist and leader that blends advanced organizational, technical and business acumen. Works effectively with cross-functional teams in ensuring operational and service excellence.

Overview

12
12
years of professional experience

Work History

Senior Service Delivery Manager

Optum Rx
09.2021 - Current
  • Managed multiple complex projects for Medicare, Medicaid, and Health Exchange.
  • Reviewed regulatory guidance to determine impact to the company and clients.
  • Identified as a Subject Matter Expert in Medicare, Medicaid and Health Exchange for internal discussions with leadership across functional areas to alleviate risks and opportunities and propose growth strategies.
  • Worked with Account Management and Implementation Teams to maintain and implement new clients.
  • Developed new policies and procedures, project planned and developed new strategies for the Government Programs department.
  • Built Government Programs SharePoint libraries in partnership with the Implementation Teams to utilize as a reference in bringing in new clients.
  • Updated all new and previous documentation to ensure it was current with changes.
  • Worked in ServiceNow to submit and resolve tasks submitted from multiple functional areas across the organization.
  • Identified opportunities to improve operational Service delivery through capabilities mapping.
  • Developed policy updates for internal and external audiences.


Government Programs Advisor

Optum Rx
02.2015 - 09.2021
  • Communications Team Lead
  • Drafted, edited and distributed any client or internal communication regarding Medicare Part D, Health Exchange, Medicaid, Employer Group Waiver Plan (EGWP) and Medicare- Medicaid Plans.
  • Reviewed all communications drafted and prepared by Government Programs Advisor Team.
  • Developed, maintained and presented training presentations regarding Medicare Part D.
  • Presented communication updates on multiple forums within the Government Programs department.
  • Managed the Issue Communication Process including running weekly development reports to identify new defects.
  • Conducted a weekly call with multiple teams to ensure that all defects, new and old are being discovered and tracked on a consistent and timely basis.
  • Developed a strong relationship with multiple teams throughout the organization.
  • Developed long-lasting relationships with clients to ensure consistent retention and loyalty.
  • Managed the Operational Business Reporting process on a monthly basis for executives to present to the company.

Pharmacy Analyst

Community Health Alliance
02.2014 - 02.2015
  • Worked as a liaison between clients and our internal Team to ensure quality service was provided.
  • Worked with RxClaim and RxTrack to ensure member claims and reports were processed properly.
  • Extremely responsive with emails, and all communication between our clients and internal Team members requiring strong computer skills and presentation development.
  • Used strong interpersonal skills used on a daily basis to manage employees that are out of state.
  • Developed new reporting between the Health Exchanges in TN and SC where our two companies were located.
  • Led meetings between companies to ensure consistent processes and implementations were in place.

Clinical Pharmacy Technician/ EGWP Coordinator

Windsor Health Plan
01.2012 - 01.2014
  • As an Employer Group Waiver Plan (EGWP) coordinator I managed two out of state groups that lease Windsor's Medicare Part D contract.
  • Responsible for Coverage Gap Payment and monthly capitation report wire transfers, and ensuring that the clients received payment on time.
  • Led the research and submission of multiple CMS audits including transition-monitoring universes, and Data validation audits.
  • Led all meetings as a mediator, between contacts from the EGWP groups and internal employees at Windsor
  • Held 2 clients accountable for staying compliant with CMS guidelines.
  • Provided assistance to clients with rejected claims, prior authorization loads, invalid provider, and transition reports
  • Developed a strong knowledge of transition policies, cumulative logic, MAPD and PDP formularies, and company processes and procedures.
  • Worked with multiple providers and pharmacies to ensure members get the best standard of care

Education

Bachelor of Science - Communications

Tennessee Technological University
Cookeville, TN
05.2008

Skills

  • Operations Support
  • Technical acumen
  • Data Analytics
  • Training and Orientation
  • SharePoint Development &Utilization
  • Access
  • ServiceNow
  • Excel

Timeline

Senior Service Delivery Manager

Optum Rx
09.2021 - Current

Government Programs Advisor

Optum Rx
02.2015 - 09.2021

Pharmacy Analyst

Community Health Alliance
02.2014 - 02.2015

Clinical Pharmacy Technician/ EGWP Coordinator

Windsor Health Plan
01.2012 - 01.2014

Bachelor of Science - Communications

Tennessee Technological University
Emily Platt