PATRICIA LERMA

• Provide people leadership and operational oversight for prior authorization teams, including Leads and Subject Matter Experts.
• Own operational performance and capability readiness through KPI monitoring, trend analysis, and targeted action planning.
• Co-led Provider Unresponsive initiative, reducing rework and improving turnaround time through optimized provider lookback strategies.
• Led end-to-end Standard PA process redesign separating workflows from Dex team, improving execution, clarity, and turnaround time.
• Revamped internal quality audit standards, improving integrity, fairness, and coaching alignment.
• Own operational oversight of 24+ PA automation BOTs, bridging gaps between automation and live operations to reduce rework.

• Supported supervisors with operational oversight, escalations, performance monitoring, and cross-functional collaboration.

• Led day-to-day coaching support, coverage planning, and workflow execution for Single Point of Contact teams.

• Partnered with account management and leadership to resolve complex provider and client issues.

• Served as liaison between providers, patients, and internal teams for specialty pharmacy access and coordination.
• Managed IRIS workflows, reporting, escalations, and prior authorization support.
• Partnered with account managers and provider offices to resolve medication access delays.

• Supported multi-therapy specialty pharmacy operations, including oncology and complex therapies.

• Trained staff, resolved escalated patient and provider issues, and supported billing and reporting workflows.

• Contributed to process improvements and operational stability during transition to Optum Specialty Pharmacy.

• Supported retail, hospital, IV compounding, inventory, and state health programs.