Kathleen Sanzo

Work History

MedImpact

02.2024 - 07.2024

Review and ensure accuracy of documented/submitted client plan/benefit configuration requirements
Configure client plan/benefit design within the PBM Express (PharmScreens) software platform
Review benefit set up via benefit compare tool and other quality control measures to ensure configuration accuracy and compliance
Monitor and ensure adherence to all plan/benefit configuration assigned timelines
Serve as configuration project liaison between Account Services team and direct client contacts
Serve as point of contact for troubleshooting plan/benefit configuration and/or adjudication issues and related questions
Identify and present to leadership process improvement activities regarding benefit configuration
Provide training, as applicable, on benefit configuration activities
Field questions from various levels of management pertaining to benefit configuration
Perform preliminary user acceptance testing for any new configuration/software logic that may have required development in order to satisfy a client plan/benefit design
Document testing results and applicable reporting
Other duties as assigned

Rite Aid Corporation/Elixir

02.2023 - 01.2024

Review and ensure accuracy of documented/submitted client plan/benefit configuration requirements
Configure client plan/benefit design within the PBM Express (PharmScreens) software platform
Review benefit set up via benefit compare tool and other quality control measures to ensure configuration accuracy and compliance
Monitor and ensure adherence to all plan/benefit configuration assigned timelines
Serve as configuration project liaison between Account Services team and direct client contacts
Serve as point of contact for troubleshooting plan/benefit configuration and/or adjudication issues and related questions
Identify and present to leadership process improvement activities regarding benefit configuration
Provide training, as applicable, on benefit configuration activities
Field questions from various levels of management pertaining to benefit configuration
Perform preliminary user acceptance testing for any new configuration/software logic that may have required development in order to satisfy a client plan/benefit design
Document testing results and applicable reporting
Other duties as assigned

Rite Aid Corporation/Elixir

04.2020 - 02.2023

Is the first line to the client for escalated member inquiries and issues, striving with each interaction to exceed customer expectations
Key point of contact for all escalations related to member inquiries
Provides excellent communication in person, by phone, by email and across teams
Researches and provides timely and accurate resolution of member issues and answers benefit questions from the client and/or the member
Supports the Account Managers and Account Executives with ad hoc requests, reporting, internal research, and projects as assigned
Has knowledge regarding eligibility, the lifecycle of a claim and the adjudication platform
Provides member overrides
Solid understanding of the mail, specialty, formulary, and prior authorization, and how these may impact a member's experience and a client's cost
Collaborates with other departments to enhance process improvement and training initiatives that affect Account Management
Participates in benefit plan setup and testing
Contacts pharmacies to resolve point of sale issues
Overcomes internal hurdles, challenges and red tape to get things done
Recognizes when action is required without prompt

Envision RX Options/Envision Pharmacies

01.2019 - 04.2020

Envision RX Options/Envision Pharmacies

08.2016 - 01.2019

Answer calls, set up overrides for pharmacies, initiate coverage determinations, advise members of their prescription benefits, verify plan and eligibility information for member, physicians, and pharmacies
Any special projects
Skilled for taking calls for Envision Mail Order Pharmacies
Create new orders and research and answer questions for commercial and Medicare members
Asked to travel to Humble, TX to assist with PBM and Epharm training
Received high Quality Assurance scores every month for over 1 year