Summary
Overview
Work History
Education
Skills
Timeline
Generic

Kristine Norton

West Hartford

Summary

Motivated Pharmacy Systems Specialist with several successful, strong years dedicated to building pharmacy benefits for the Connecticare and Emblem Health Enterprise. Recognized for excellent teamwork, precise building of commercial pharmacy plans, and conflict resolution. Resourceful and timely when assisting call center with pharmacy inquiries or discrepancies. Well organized with a driving track record of dedication while maintaining positive relationships with our PBM, internal departments, vendors, members, and healthcare providers.

Overview

19
19
years of professional experience

Work History

Business Systems Analyst

Molina Healthcare
02.2025 - Current
  • Conduct formulary benefit validation and prior authorization analysis.
  • Resolve member prescription claim and access issues in collaboration with member services and providers.
  • Developed detailed process documentation and workflows to ensure clarity and consistency in system usage.
  • Submit timely and accurate configuration updates to claim and PBM prior authorization systems for pharmacy and medical benefits.

Pharmacy Systems Specialist CPhT

ConnectiCare Inc & Affiliates
12.2019 - 01.2025
  • Responsible for receiving, building, and testing pharmacy benefits daily for all Connecticare commercial plans. Submitting precise requests to Express Scripts our benefit manager and verifying set up matches intent. Creating and testing multiple scenarios for every group to assure proper framework. Rectifying any errors that were discovered in testing.

Pharmacy Technician CPhT

ConnectiCare Inc & Affiliates
12.2018 - 12.2019
  • Entered a high volume of prior authorization medication requests for members daily. Accurately sorted and reviewed all information to determine if prior authorization criteria were met. Followed guidelines to deny if appropriate or direct to a pharmacist for further review and approval. Work with call center representatives to process claims, resolve problems and enter vacation overrides.

Learning Exchange Specialist

ConnectiCare Inc & Affiliates
08.2017 - 12.2018
  • Proactively identified and solved complex problems impacting operations management and business direction. Delivered an exceptional level of service to each member and provider by actively listening to concerns and answering questions. Mentored call center representatives. Prepared correspondence to members. Identified trends and assisted in training new employees. Proficient in Medicare supplemental plans.

Pharmacy Call Center Representative

ConnectiCare Inc & Affiliates
03.2011 - 08.2017
  • Delivered fast, friendly, and knowledgeable service to Medicare members and providers. Accurately documented all calls and caller information in several software systems. Addressed members pharmacy questions to improve service quality and help members get the care they deserve. Contacted pharmacies, providers, and members to research any prescription requests or issues. Mentored pharmacy call center representatives. Developed strong knowledge of Medicare Part D rules and regulations.

Pharmacy Clerk

CVS Pharmacy Technician for CVS Pharmacy
01.2007 - 03.2011
  • Assisted pharmacist in all daily pharmacy operations. Received and managed inventory by checking deliveries, counting stock and handling cash and credit transactions. Delivered first-class customer service.

Education

Bachelor of Arts - Business Management, Philosophy

Assumption University
Worcester, Massachusetts
05.1992

Skills

  • Licensed pharmacy technician (CPhT)
  • Adapt at resolving member and provider issues
  • Efficient and accurate
  • Excellent communication skills
  • Reliable and results oriented

Timeline

Business Systems Analyst

Molina Healthcare
02.2025 - Current

Pharmacy Systems Specialist CPhT

ConnectiCare Inc & Affiliates
12.2019 - 01.2025

Pharmacy Technician CPhT

ConnectiCare Inc & Affiliates
12.2018 - 12.2019

Learning Exchange Specialist

ConnectiCare Inc & Affiliates
08.2017 - 12.2018

Pharmacy Call Center Representative

ConnectiCare Inc & Affiliates
03.2011 - 08.2017

Pharmacy Clerk

CVS Pharmacy Technician for CVS Pharmacy
01.2007 - 03.2011

Bachelor of Arts - Business Management, Philosophy

Assumption University

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