Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Ohemaa Dowling

Worcester,MA

Summary

Detail-oriented and motivated professional with foundational experience in data management, client services, and healthcare operations. Skilled in supporting user acceptance testing (UAT), coordinating data initiatives, and assisting with system functionality improvements. Demonstrates strong collaboration across cross-functional teams, including IT, operations, and business analysts. Analyzes program data for trends and provides proactive support to clients and patients. Eager to continue developing technical and analytical skills to contribute to dynamic teams and drive operational success.

Overview

7
7
years of professional experience
1
1
Certification

Work History

Hub Operations Data and Software Quality Manager

CareMetx
07.2023 - Current
  • Supports managing all client transitions and new initiatives related to data
  • Supports the organization and execution of UAT for each production release
  • Works closely with IT management team to support data transactions and acts as liaison between Operations, Business Analyst(s), IT as well as business partners
  • Works to build knowledge base that supports anticipating the impact to system and functionality overall
  • Tracks program trends related to data and proactively communicates observations to management
  • Assists with the development of program training documents related to dashboards/portals.
  • Supports coordination of services with the specialty pharmacy, client, and hub reimbursement team
  • Participates in strategic and tactical planning sessions.
  • Helps team members resolve work-related issues impacted by data issues.
  • Provides feedback up and down the organization (Positive and Constructive).
  • Participates in client meetings.
  • Identifies data and reporting related client issues; receives and triages client requests.
  • Proactively identifies program issues and proposes ways in which to address their concerns.
  • Maintains positive rapport with client.
  • Analyzes reports for trends and gives recommendations
  • Analyzes progress of tactical issues.
  • Performs related duties as assigned.

Quality Auditor

CareMetx
07.2022 - Current
  • Conducted regular monitoring and analysis of call recordings to evaluate agent performance against quality assurance criteria.
  • Provided constructive feedback and coaching to agents, enhancing their adherence to QA standards and improving overall performance.
  • Defined and tracked performance metrics related to customer satisfaction, call resolution, and compliance with script protocols.
  • Promoted a collaborative team environment focused on sharing best practices and enhancing agent performance.
  • Collaborated with management to emphasize the importance of quality assurance and secure necessary resources for ongoing training initiatives

Reimbursement Case Manager

CareMetx
08.2021 - 07.2022
  • Served as the primary point of contact for providers and patients.
  • Coordinated access to therapies and facilitated support services.
  • Managed caseloads in accordance with program parameters; collected and reviewed patient information per SOP.
  • Assessed patient eligibility and conducted enrollment activities.
  • Performed reimbursement tasks, including benefit investigations, prior authorizations, and appeals.
  • Reported all Adverse Events (AEs) and escalations according to training and SOP.

Care Manager

AllCare Plus Pharmacy
01.2019 - 01.2021
  • Contacted insurance companies to obtain eligibility information, perform benefit investigations, provide copay assistance, and check prior authorization/appeal statuses.
  • Answered inbound calls and assisted customers with client-related services.
  • Assisted with the completion of prior authorizations, ensuring attention to detail and accuracy.
  • Assisted patients with the enrollment process for manufacturer and non-profit copay assistance programs.
  • Maintained and improved quality results by adhering to standards and recommending procedural improvements.

Education

Associate of Science - Health Care Administration

Salter College
West Boylston, MA
06-2015

Skills

  • Strong verbal and written communication
  • Detail-oriented
  • Document organization
  • User acceptance testing validation
  • Customer satisfaction
  • Problem-solving

Certification

  • Lean Six Sigma - Yellow belt 2025-April

Timeline

Hub Operations Data and Software Quality Manager

CareMetx
07.2023 - Current

Quality Auditor

CareMetx
07.2022 - Current

Reimbursement Case Manager

CareMetx
08.2021 - 07.2022

Care Manager

AllCare Plus Pharmacy
01.2019 - 01.2021

Associate of Science - Health Care Administration

Salter College

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