Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Gabriela Nevarez

La Puente,CA

Summary

Highly skilled Pharmacy Technician with 8 years of experience seeking a challenging position in a reputable healthcare facility to utilize expertise and contribute to patient well-being.

Overview

8
8
years of professional experience
1
1
Certification

Work History

Sr. Pharmacy Resolution Specialist

Centene
Remote, CA
04.2024 - Current
  • Intake incoming calls from Providers, Pharmacies, and Members.
  • Assists with prior authorization-related inquiries.
  • Assists with pharmacy-related overrides such as Refill Too Soon, Pharmacy Locks, Long-Term Care, Vacation, etc.
  • Identified root causes of customer concerns, tracked resolution process steps, and documented all actions taken.
  • Ensured compliance with applicable laws and regulations during the resolution process.

Lead Pharmacy Technician

Ralphs Pharmacy
Whittier, CA
05.2016 - Current
  • Collaborate with the staff pharmacist to verify prescriptions.
  • Reviewed orders for completeness, accuracy, and compliance with applicable laws and regulations.
  • Ensured that all medications were stored properly, following safety protocols.
  • Oversaw inventory management processes such as ordering, stocking, tracking expiration dates.
  • Maintain a clean and organized work environment.
  • Provide excellent customer service and address inquiries efficiently.
  • Assist in the training of new pharmacy technicians and provide feedback on their performance.

Sr. Pharmacy Technician

Optum RX
Remote, CA
09.2023 - 02.2024
  • Intake incoming calls from providers, pharmacies, and members to assist with everything prior authorization-related.
  • Reviewed prior authorization requests to ensure accuracy and completeness of required information.
  • Provided guidance to providers regarding the prior authorization process.
  • Responded promptly to inquiries from providers, patients and payers regarding status of prior authorization requests.
  • Researched clinical criteria and determined eligibility for requested services based on plan provisions.
  • Ensured compliance with state and federal regulations pertaining to prior authorizations.

Subject Matter Expert /Prior Authorization Specialist

Prime Therapeutics LLC
Remote, CA
02.2022 - 06.2023
  • Collaborated with direct supervisor to assist team with any questions and additional assistance required in the prior authorization department.
  • Worked on a solutions line to intake calls from customer service representatives with any inquiries regarding prior authorizations.
  • Worked on the inbound fax queue to complete fax prior authorization requests from providers and efficiently reviewed clinical information to make a decision for coverage.
  • Provided subject matter expertise and guidance to cross-functional teams in the development of the prior authorization process.
  • Analyzed existing processes and procedures to identify opportunities for improvement.

Education

Pharmacy Technician License -

American Career College
Anaheim, CA
06-2015

High School Diploma -

La Serna High School
Whittier, CA
06-2014

Skills

  • Excellent Communication
  • Exceptional Customer Service
  • Problem-solving skills
  • Pharmacy operations
  • HIPAA regulations compliance
  • Training and mentoring
  • Team Collaboration
  • Workflow Optimization
  • Insurance Billing
  • Quality assurance and control
  • Typing and written communication
  • Pharmaceutical Calculations

Certification

  • Pharmacy Technician License - California State Board of Pharmacy

Timeline

Sr. Pharmacy Resolution Specialist

Centene
04.2024 - Current

Sr. Pharmacy Technician

Optum RX
09.2023 - 02.2024

Subject Matter Expert /Prior Authorization Specialist

Prime Therapeutics LLC
02.2022 - 06.2023

Lead Pharmacy Technician

Ralphs Pharmacy
05.2016 - Current

Pharmacy Technician License -

American Career College

High School Diploma -

La Serna High School

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Gabriela Nevarez