Marybeth Balbo
Summary
Experienced and results-oriented 340B Program Strategic Account Executive with a solid background in the healthcare industry. Quick learner with a personable demeanor, excelling at staying focused, coaching staff to excel, fostering organizational collaboration, and driving continual business improvement. Demonstrates a key strength in identifying goals and priorities in deadline-driven operations, consistently delivering impactful results.
Overview
18
18
years of professional experience
Work History
Strategic Account Executive
The Craneware Group, Sentry Data Systems
11.2021 - Current
- Collaborate with hospital Executive and management stakeholders in the 340B Program
- Evaluate business processes, conduct research to help determine root causes, anticipate requirements, uncover areas for improvement, and develop and implement solutions which improve quality and/or profitability in 340B program
- Identify, analyze, and interpret trends or patterns in complex data sets
- Acquire and abstract primary or secondary data from existing internal or external data sources
- Collaborating with others, develop and implement data collection systems and other strategies that optimize statistical efficiency and data quality
- Conduct quantitative and qualitative interviews
- Perform departmental shadowing and observations
- Providing guidance for establishing process, staffing, and system improvements
- Prioritize initiatives based on business needs and requirements all while managing competing resources and priorities
- Collaborating with others, interpret data and develop recommendations based on findings
- Perform and present basic statistical analyses for projects and reports.
340B Program Manager
Niagara Falls Memorial Medical Center
09.2019 - 11.2021
- Provides oversight of 340B Program in alignment with State and Federal regulations, guides and HRSA statue
- Identifies and implements process improvements for 340B, purchasing and inventory management
- Worked departmentally with clinics regarding documentation and processes
- Creates and maintains internal and external relationships with provider offices and pharmacies to improve 340B program
- Leads 340B committee meetings which includes senior leaderships, clinical and financial departments
- Ensures that policies and procedures are developed, implemented, and updated with alignment to organizational, regional, state, national, and federal requirements, and guidelines
- Creates training/competency materials for employees whose work impacts the 340B program, pharmacy purchasing and inventory
- Developed, executed, and documented self-audits to maintain compliance and remediate findings
- Successfully implemented paperless system for Pharmacy Department processes
- Reports monthly financial impact to Senior leadership and Board of Directors
- Actively meets with bi-partisan State legislators from the House of Representatives and United States Senate to educate and seek support for 340B Program.
Senior Review Specialist
Independent Health
09.2017 - 04.2020
- Reviewed prior authorization requests, appeals and grievances against contracts for Medicaid, Medicare, and Commercial lines of business contracts
- Created and reviewed individual case files which required independent decision making
- Trained, coached and overseen progress of new employees
- Created and implemented paperless review system with creation of training manual
- Overseen and trained the implementation of the paperless submission to Maximus for Medicare line of business with creation of process workflow
- Organized and managed Committee clinical and contractual board meetings
- Participated in Fair Hearings for Medicaid line of business and Administrative Law Judge (ALJ) hearings for Medicare
- Created cases files and responses to New York State DOH and Inspector General’s Office.
Benefit Administration Appeal Operations Coordinator
Independent Health
06.2015 - 08.2017
Pharmacist Assistant
Independent Health
05.2012 - 06.2015
Certified Pharmacy Technician II
Roswell Park Cancer Institution
08.2010 - 05.2012
Certified Pharmacy Technician
Niagara Falls Memorial Medical Center
05.2006 - 08.2010
Education
Medical Assisting Internship/rotation, Family Practice, Mizer Building
340B ACE -
Apexus University
Bachelor’s degree in business, Health Service Administration -
Bryant & Stratton College
04.2021
Associate of Science, Medical Assisting -
Keiser University
10.2007
Certified Pharmacy Technician (CPHT)
09.2006
Skills
340B Ace
Timeline
Strategic Account Executive
The Craneware Group, Sentry Data Systems
11.2021 - Current
340B Program Manager
Niagara Falls Memorial Medical Center
09.2019 - 11.2021
Senior Review Specialist
Independent Health
09.2017 - 04.2020
Benefit Administration Appeal Operations Coordinator
Independent Health
06.2015 - 08.2017
Pharmacist Assistant
Independent Health
05.2012 - 06.2015
Certified Pharmacy Technician II
Roswell Park Cancer Institution
08.2010 - 05.2012
Certified Pharmacy Technician
Niagara Falls Memorial Medical Center
05.2006 - 08.2010
Medical Assisting Internship/rotation, Family Practice, Mizer Building
340B ACE -
Apexus University
Bachelor’s degree in business, Health Service Administration -
Bryant & Stratton College
Associate of Science, Medical Assisting -
Keiser University
Certified Pharmacy Technician (CPHT)
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