Jamie Crawford
Royse City,TX
Summary
Experienced manager and analytical problem-solver with a proven track record in people management and Prior Authorization Administration. Successfully led teams to exceed productivity and quality targets, improved employee training programs, and fostered remote team engagement. Skilled in performance management, team development, and conflict resolution. Excels in goal setting, project organization, time management, and empathetic problem-solving strategies.
Overview
11
11
years of professional experience
Work History
Associate Manager
CVS Health
12.2022 - Current
- Provides strategic leadership and oversight for healthcare operations.
- Develops and executes operational strategies, manages teams, collaborates with stakeholders, drives process improvements, and ensures efficient resource allocation.
- Responsible for achieving operational goals, maintaining quality standards, and fostering a culture of continuous improvement.
- Assists management in developing and implementing key operational strategies and initiatives to enhance efficiency, productivity, and overall performance.
- Advises cross-functional teams to identify operational bottlenecks and areas for improvement, ultimately contributing to the development of action plans to address any gaps or shortcomings.
- Analyzes operational metrics and key performance indicators (KPIs), providing regular reports and insights to management for decision-making and performance evaluation.
- Develops and implements standard operating procedures (SOPs) and guidelines to ensure consistent and effective execution of operational processes.
- Coordinates operational projects and initiatives, ensuring timely completion and alignment with organizational goals and objectives.
- Coaches and trains operational staff on processes, tools, and systems, promoting adherence to best practices and continuous improvement.
- Collaborates with the procurement team to monitor and manage inventory levels, ensuring optimal stock availability while minimizing waste and cost.
- Contributes to the evaluation and selection of vendors and suppliers, assessing their performance and ensuring compliance with quality and service level requirements.
- Stays updated on industry trends and emerging technologies relevant to operations, recommending innovative solutions to enhance operational efficiency and effectiveness.
Analyst/Subjest matter expert
CVS Health
03.2016 - 12.2022
- Manages the integrity of the prior authorization (PA) system used for Medicare Part D Coverage Determinations and Appeals.
- Works closely with PA Admin and Medicare Operations to test and validate the utilization management (UM) criteria, decision trees, drug lists, and letters that are loaded and functioning properly in the PA system.
- Assists in executing the planning, implementation, and execution of Clinical Service operations to ensure compliance with regulatory requirements in support of the organization's objectives.
- Analyzes error reports and resolves error trends, identifies Clinical Services operational risks, and provides solutions to senior managers and senior individual contributors.
- Analyzes detailed, accurate reports for senior leadership, vendors, and senior clinical strategists to ensure data quality and integrity.
- Reviews clinical services training needs with resources, budgets, and analysis, ensuring continuous improvement while meeting goals and objectives.
- Manages resources to develop the methodology for analyzing and reporting clinical services team performance data to senior managers and stakeholders.
- Administers strategic review processes ensuring continuous improvement, compliance, and high-performance clinical support protocols and standards are upheld.
Sr. Coordinator/Subjest matter expert
CVS Health
04.2014 - 03.2016
- Oversees the integrity of the prior authorization (PA) system utilized for Medicare Part D Coverage Determinations and Appeals.
- Collaborates closely with PA Administration and Medicare Operations to test and validate the utilization management (UM) criteria, decision trees, drug lists, and correspondence to ensure they are properly integrated and operational within the PA system.
- Assists in the planning, implementation, and execution of Clinical Service operations to guarantee adherence to regulatory standards in alignment with the organization's goals.
- Evaluates error reports to identify and address error patterns, assesses operational risks within Clinical Services, and proposes solutions to senior management and key contributors.
- Prepares detailed and accurate reports for senior leadership, vendors, and clinical strategists to maintain data quality and integrity.
- Assesses the training requirements for clinical services in relation to resources, budgets, and analysis, promoting continuous improvement while achieving set objectives.
- Manages resources to establish methodologies for analyzing and reporting on the performance data of the clinical services team to senior managers and stakeholders.
- Oversees strategic review processes to ensure ongoing improvement, compliance, and the maintenance of high-performance clinical support protocols and standards.
Education
Certification - Pharmacy Technician
Career Center of Texas
Associate Degree - Business Management
Dallas College
Skills
- Effective delegation
- Guiding professional development
- Ability to adjust to new challenges
- Commitment to accountability
- Employee empowerment strategies
- Candidate sourcing and evaluation
- Team collaboration enhancement
- Scheduling and planning
- Onboarding and training
- Workforce management
- Employee evaluation expertise
- Effective meeting facilitation
- Team engagement initiatives
- Adaptability and flexibility
- Staff development
- Proficient in task management
- Process improvement strategies
- Collaborative team management
Timeline
Associate Manager
CVS Health
12.2022 - Current
Analyst/Subjest matter expert
CVS Health
03.2016 - 12.2022
Sr. Coordinator/Subjest matter expert
CVS Health
04.2014 - 03.2016
Associate Degree - Business Management
Dallas College
Certification - Pharmacy Technician
Career Center of Texas
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