Malissie V Cordoba

Successfully processed over 1,500 cases per month for 2024 with a 0% error rate.

Produced an automated closure rate of 0% for 2024.

Optimized SOP corrections, leading to a 60% decrease in data errors.

Mitigated company loss resulting from contracts created in error.

• Analyzed demographic and contractual cases.
• Streamline communication between UHN and PPO regarding contractual agreements, error remediation and updates.
• Leveraged data insights to improve provider relationships and process improvement.
• Collaborates with the contractors, advocates, and PPO to examine larger scale provider issues.

Developed a script that enhanced patient verification by 45%.

Facilitated weekly comprehensive departmental training sessions, resulting in a 50% increase in engagement and a 4.5-minute reduction in call duration.

• Coordinated activities for 14-17 Pharmacy Technicians.
• Ensured compliance with regulations and maintained accurate records.
• Conducted monthly audits and generated reports to track/report team performance.

Sustained a production output consistently ranking within the top 2% of the team.

Consistently achieved a success rate averaging 75% above the daily goal.

• Analyzed patient data to improve medication adherence.
• Collaborated with internal and external clients for member needs.
• Analyzed claims and carefully assessed plan details to provide accurate information.

Designed and established all standard operating procedures (SOPs) for workflow processes.

• Managed a team of 10 Pharmacy Technicians.
• Developed SOPs for efficient pharmacy workflow.
• Managed provider relationships and licensing.
• Ensured compliance with regulations.
• Managed the scheduling and payroll of Pharmacy Technicians.

Contributed to the successful implementation and training of Supervisors on workforce management processes.

Successfully achieved a 30% reduction in errors over a 12-month period.

• Coordinated activities for 20-32 Pharmacy Technicians.
• Ensured compliance with regulations and maintained accurate records.
• Performed monthly audits.
• Conducted monthly audits and generated reports to track/report team performance.

Designed and established all standard operating procedures (SOPs) for workflow processes.

Eliminated call misdirection and false denials by developing a workflow process for specialty case identification.

• Provided pharmacy workflow improvement through the creation of SOPs
• Processed Prior Authorizations while consistently achieving a success rate averaging 50% above the daily goal.
• Conducted monthly audits and generated reports to track/report team performance.
• Provided SME support for training quarterly.