Julie Simmons
Kent,WA
Summary
Dedicated Pharmaceutical Benefits professional with a history of meeting company goals utilizing consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand. Excellent verbal and written communication skills with Project Management Experience.
Overview
30
30
years of professional experience
Work History
Client Operations Lead/Senior Manager Leader
CVS HEALTH CORPORATION
01.2021 - 08.2023
- Developed and implemented new filing systems to improve organizational efficiency and productivity.
- Improved team performance by providing comprehensive training and fostering collaborative work environment.
- Executed appropriate staffing and budgetary plans to align with business forecasts.
- Established team priorities, maintained schedules and monitored performance.
- Mentor project team members to ensure successful Welcome Season and for all maintenance of business (Medicaid, Medicare, Commercial, Marketplace, Employer, and Demo Duals) activities for new and existing clients including leadership, strategic direction, expertise, and tactical direction to BRM leads, QA leads and project stakeholders.
• Completed Risk Assessments that include working with implementation teams and understanding overall project plan for new implementations.
• Medicaid: Texas, New York, Virginia, Florida, Georgia, Maryland, New Jersey, Oregon, Kansas, Washington, Louisiana, Nevada, and New Mexico
• Medicare: Tennessee, Florida, New York, New Jersey, Florida, Georgia, and Virginia
• Evaluated test plan created by testing teams and identify gaps in test coverage.
• Partnered with BRM, QA and test Managers to understand overall strategy to implement new clients and identify risks based on project plan.
• Completed Mitigation to document gaps and identify approaches to fill testing coverage gaps or strategize approaches to mitigate risks.
• Documented end-to-end Quality Assurance standards and maintain document based on business needs. Lead and facilitate meetings across functional boundaries to ensure policies and procedures are implemented and executed flawlessly.
• Built and Maintained Network Management to develop relationships with clients, test centers of excellence, benefit coding teams and benefit Centers of Excellence and Account Management. Partnered with Quality, Testing and BRM Managers to ensure that scope of project is clearly understood and managed.
• Reported risks in projects to team leader and executive member.
• Created and standardize project dashboard that clearly and succinctly shows risks and mitigation strategy for every project.
Senior Advisor
CVS HEALTH CORPORATION
01.2007 - 12.2020
- Facilitated new client onboarding process
- Gathered, organized and input information into digital database.
- Advised on organizational structure and human resource management to promote efficient business operations.
- Spearheaded development of customized solutions tailored to individual client needs, resulting in superior outcomes compared to standard offerings.
- Mentor of project team members to ensure successful Welcome Season and for all maintenance of business (Medicaid, Medicare, Commercial, Marketplace, Employer, and Demo Duals) activities for new and existing clients including leadership, strategic direction, expertise, and tactical direction to BRM leads, QA leads and project stakeholders.
• Completed Risk Assessments that include working with implementation teams and understanding overall project plan for new implementations.
• Medicaid: Texas, New York, Virginia, Florida, Georgia, Maryland, New Jersey, Oregon, Kansas, Washington, Louisiana, Nevada, and New Mexico
• Medicare: Tennessee, Florida, New York, New Jersey, Florida, Georgia, and Virginia
• Evaluated test plan created by testing teams and identify gaps in test coverage.
• Partnered with BRM, QA and test Managers to understand overall strategy to implement new clients and identify risks based on project plan.
• Completed Mitigation to document gaps and identify approaches to fill testing coverage gaps or strategize approaches to mitigate risks.
• Documented end-to-end Quality Assurance standards and maintain document based on business needs. Lead and facilitate meetings across functional boundaries to ensure policies and procedures are implemented and executed flawlessly.
• Built and Maintained Network Management to develop relationships with clients, test centers of excellence, benefit coding teams and benefit Centers of Excellence and Account Management. Partnered with Quality, Testing and BRM Managers to ensure that scope of project is clearly understood and managed.
• Reported risks in projects to team leader and executive member.
• Created and standardize project dashboard that clearly and succinctly shows risks and mitigation strategy for every project.
Customer Service Representative
CVS HEALTH CORPORATION
04.2004 - 12.2007
Certified Pharmacy Technician
Eckerd Drugs
03.1993 - 03.2004
Education
Bachelor of Arts - Criminology/ Criminal Justice
The University of Texas At Arlington
Arlington, TX12.2003
Bachelor of Arts - Anthropology
The University of Texas At Arlington
Arlington, TX05.1999
Skills
- Lean Six Sigma Green Belt - Certified
- Microsoft Office 365
- Microsoft Teams, Zoom, Skype
- Customer Relationship Management
- Client Audits for Pharmacy Benefits and Claims
- Cross-Functional Collaboration
- Operation and Budget Management
- Process Improvement
- Business Planning
- Employee Coaching and Mentoring
- Strategic Planning
- Reporting management
- Problem Resolution
- Negotiation and Conflict Resolution
- Training and Development
- Onboarding and Orientation
Timeline
Client Operations Lead/Senior Manager Leader
CVS HEALTH CORPORATION
01.2021 - 08.2023
Senior Advisor
CVS HEALTH CORPORATION
01.2007 - 12.2020
Customer Service Representative
CVS HEALTH CORPORATION
04.2004 - 12.2007
Certified Pharmacy Technician
Eckerd Drugs
03.1993 - 03.2004
Bachelor of Arts - Criminology/ Criminal Justice
The University of Texas At Arlington
Bachelor of Arts - Anthropology
The University of Texas At Arlington