Summary
Overview
Work History
Education
Skills
Websites
Certification
References
Timeline
Generic

Roneeka Jones

Grand Prairie,TX

Summary

Dynamic Pharmacy Operations Manager with a proven track record at Weekend Health, excelling in prior authorization and clinical documentation. Demonstrated leadership by coaching teams to achieve high customer satisfaction scores. Skilled in problem-solving and regulatory compliance, consistently optimizing workflows to enhance service delivery and operational efficiency.

Overview

14
14
years of professional experience
1
1
Certification

Work History

Pharmacy Operations Manager

Weekend Health
05.2023 - Current
  • Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
  • Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
  • Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
  • Monitored pending cases closely, proactively following up on outstanding documentation needed for successful approval outcomes.
  • Achieved high success rate in obtaining authorizations by effectively demonstrating medical necessity through comprehensive documentation and clear communication with insurance companies.

Customer Care Representative

Henry Meds
09.2024 - 04.2025
  • Resolved customer complaints promptly and professionally.
  • Utilized problem-solving techniques such as root cause analysis to identify recurring issues that could be addressed proactively.
  • Provided accurate, valid, and complete information to customers.
  • Answered customer inquiries over the phone and via email.
  • Delivered fast, friendly, and knowledgeable service for routine questions and service complaints.
  • Educated customers where applicable to alleviate need for future contact.

Care Specialist /Escalations Team Lead

Alto Pharmacy
03.2020 - 05.2023
  • Supervised a team of 5 to 25 Care Specialists.
  • Developed personal growth opportunities through frequent shadowing and office hours to produce results and meet goals
  • Coached and motivated team, driving productivity and utilization up to 96% and delivering exceptional customer service as well as soft skills by consistently achieving 3.5+ CSAT's scores
  • Communicated plans, metrics and actions to meet departmental goals with leadership
  • Conducted Audits to ensure specialists were delivering excellent service and offered constructive feedback to team members, boosting overall job performance
  • Handled Escalation requests as needed assisting 100+ patients weekly while supporting my team needs
  • Worked alongside with workforce management on scheduling and filling in gaps per business needs using NICE
  • Additional customer support experiences: Zendesk, Asana, Google Suite.

Pharmacy Technician Senior Technician

Walgreens
10.2011 - 02.2020
  • Operated cash register and POS to process sales transactions and handle payments
  • Stocked, Typed (Intake), labeled and inventoried medication to keep accurate records
  • Supervised 3-5 pharmacy technicians and coordinated day-to-day assignments such as filling, packaging or ordering
  • Trained new hires to meet our company standards and soft skills
  • Filling more than 300 prescriptions daily prescriptions in high-volume pharmacy in the district
  • Helped pharmacist clear problematic prescriptions and address customer questions to keep pharmacy efficient.

Education

High School Diploma -

Aurora Central High School
Aurora, CO
05.2001

Skills

  • Prior authorization
  • Insurance verification
  • Clinical documentation
  • Team leadership
  • Customer support
  • Problem solving
  • Regulatory compliance
  • Time management
  • Prescription verification
  • Teamwork
  • Insurance billing
  • Workflow optimization

Certification

PTCB Certification/Licensing, 05/01/21

NABP

References

References available upon request.

Timeline

Customer Care Representative

Henry Meds
09.2024 - 04.2025

Pharmacy Operations Manager

Weekend Health
05.2023 - Current

Care Specialist /Escalations Team Lead

Alto Pharmacy
03.2020 - 05.2023

Pharmacy Technician Senior Technician

Walgreens
10.2011 - 02.2020

High School Diploma -

Aurora Central High School

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