ROSHANDA TYOUS
Dallas,TX
Summary
Highly motivated and driven employee seeking new challenges to enhance professional growth. Demonstrating a strong work ethic, adaptability, and exceptional interpersonal skills, excels in both independent and team-oriented environments. Proven ability to work effectively without constant supervision, adept at quickly mastering new skills to contribute to the success of any organization.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Clinical Support Sr Representative
CVS HEALTH CORPORATION
04.2023 - Current
- Assisting supervisor with day to day tactical issues, training, coaching and other business needs.
- Promoting a positive working environment and initiate suggestions to improve process and protocols within CAS PA Admin.
- Sr Rep will act as a subject matter expert in CAS PA Admin processes and procedures.
- Sr Rep is also responsible for answering questions and recommending corrective action to address complaints. As well as handling special projects and assignments as designated by the supervisor and/or manager.
- Identified areas for process improvement within the department which led to increased operational efficiencies.
- Improved team efficiency by streamlining processes and implementing time-saving strategies.
- Managed high-volume workload while maintaining strong attention to detail and accuracy.
- Assisted in training new hires, ensuring they were equipped with the necessary skills for success in their role.
Rep. III Clinical Support
CVS Caremark
03.2020 - 04.2023
- Duties includes reviewing CPM documents to implement set ups for new and existing clients in the CAS admin System for coverage of Specialty Medications
- Resolving General Cases created by operations, account, and clinical teams to quickly address issues that arise during the prior authorization process
- Researching cases using CAS web, CAS admin, Peoplesafe and Sales Force systems
- Performing QA tasks and validating Specialty client implementation for accuracy
- Providing research and dedicated assistance to large and small team projects. Ex. NCRx External Build Project
- Providing on going assistance and clarification to co-workers regarding the QA results and processes
Tech I Case Review Unit
CVS Caremark
11.2018 - 03.2020
- As part of the Novologix team, I provided excellent customer service by effectively communicating with patients, families, staff, and staff in other hospital departments
- Taking in-coming calls from members and providers, providing phone assistance to all callers through a criteria based prior authorization process
- Primarily utilized the Novologix Prior authorization system as well as the CAS web system when necessary to process PA requests generated by physicians and medical facilities
- Accurately documented all approvals and denials and transferred all clinical questions to clinical pharmacists and staff
Pharmacy Triage Manager
RSVP #7
06.2017 - 07.2018
- Supervised Pharmacy Admin Service Coord
- (PASCs) as they entered patient data in various data systems for Transdermal Immunotherapy (TdiT) prescriptions to be submitted for medical billing
- Created and built compound recipes for each (TdiT) patient
- Provided ongoing coaching and mentoring of the PASCs team of RSVP #7
- Responsible for on boarding and training of new hires and assisting with the integration of new pharmacy software and workflow management tools
- Maintained regular communication with Pharmacy Account Managers concerning workflow status and workflow barriers
- Act as a liaison between various departments and assists with specific issues
Education
High School Diploma -
Greenville High School
Greenville, TX05.1995
Skills
- Analytical Problem Solving
- Strong Work Ethic
- Employee Training
- Dependable Professional
- Leadership Development
- Effective Problem Solving
- Supportive Interaction Skills
- Excellent communication
Certification
- PTCB Certification, 106107826949910
- Texas State Board Registration, 109599
Timeline
Clinical Support Sr Representative
CVS HEALTH CORPORATION
04.2023 - Current
Rep. III Clinical Support
CVS Caremark
03.2020 - 04.2023
Tech I Case Review Unit
CVS Caremark
11.2018 - 03.2020
Pharmacy Triage Manager
RSVP #7
06.2017 - 07.2018
High School Diploma -
Greenville High School
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