Ronda Byrne
Hickman,NE
Summary
Demonstrates strong analytical, communication, and teamwork skills, with proven ability to quickly adapt to new environments. Eager to contribute to team success and further develop professional skills. Brings positive attitude and commitment to continuous learning and growth.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Medication Access Coordinator
Nebraska Medicine
12.2024 - Current
- Developed strong working relationships with colleagues across multiple departments through effective collaboration on shared initiatives or projects impacting patient access operations.
- Provided exceptional customer service to patients, families, and referring providers, fostering positive relationships.
- Mentored new team members on best practices for effective patient communication and data management.
- Managed patient caseloads effectively, ensuring timely follow-up and appropriate interventions.
- Coordinated the procurement of specialty medications for patients with unique therapy needs, ensuring timely access to necessary treatments.
Pharmacy Benefit Analyst
Smartlight Analytics
12.2023 - 11.2024
- Identified and investigated fraud, waste, and abuse, by reviewing pharmacy claim history in conjunction with medical claim history.
- Ensured pharmacy and provider operational practices adhere to legal standards and contractual obligations.
- Verified accuracy of prescription claims processing by examining data from multiple sources.
- Provided support during audits by ensuring that proper documentation is readily available for review.
- Utilized various software programs to analyze data, generate reports, and report discrepancies.
- Analyzed pharmacy claims data to identify outlier claims that contradict standard of practice.
- Monitored drug usage patterns to detect potential issues or inappropriate prescribing practices.
Certified Pharmacy Technician (CPhT)
Kubat HealthCare
11.2021 - 11.2024
- Consistently upheld proper pharmacy procedures and standards
- Perform all duties of a pharmacy technician to proficiently process prescriptions under the supervision of a licensed pharmacist
- Maintained patient records and inventory
- Communicated with customers and staff in a professional and positive manner
- Ensured that PBM audits were completed correctly and quickly
- Complied with Hipaa regulations by maintaining 100% patient confidentiality.
Pharmacy Quality Assurance Auditing Specialist
Security Health Plan of Wisconsin
03.2022 - 05.2024
- Review drug utilization trends for possible fraud waste or abuse
- Analytical and interpretation skills to identify errors in hospice billing
- Assists leadership with developing and implementing metrics and performance targets to assess compliance with Center of Medicare and Medicaid Services (CMS)
- Applied HIPAA skills by proper handling patient information when communicating with healthcare professionals via phone, fax or email
- Work with management in developing appropriate steps to address audit findings and error trends
- Resolves reported Medicare D grievances in a transparent and impartial manner.
Senior Certified Pharmacy Technician
Genoa LTC, a QoL Healthcare company
04.2011 - 11.2021
- Prepare for insurance audit and interface with auditors
- Lead pharmacy technician in high volume pharmacy
- Accurately assisted pharmacist in data entry of prescriptions
- Assisted with hiring and training of new employees
- Communicated with all customers and staff in a pleasant and professional manner
- Conducted drug utilization reviews, drug interventions and therapy management
Education
Nebraska Wesleyan University
Lincoln, NESkills
- Organizational Leadership (10 years)
- Pharmacy technician experience (10 years)
- Financial procedures adherence
- Time management
- Attention to detail
- Critical thinking
- Resolving problems
- Documentation skills
Certification
- Certified Pharmacy Technician (CPhT), 2024-10-01
- State of Nebraska, 2025-01-01, Pharmacy Technician License
Timeline
Medication Access Coordinator
Nebraska Medicine
12.2024 - Current
Pharmacy Benefit Analyst
Smartlight Analytics
12.2023 - 11.2024
Pharmacy Quality Assurance Auditing Specialist
Security Health Plan of Wisconsin
03.2022 - 05.2024
Certified Pharmacy Technician (CPhT)
Kubat HealthCare
11.2021 - 11.2024
Senior Certified Pharmacy Technician
Genoa LTC, a QoL Healthcare company
04.2011 - 11.2021
Nebraska Wesleyan University