Summary
Overview
Work History
Education
Skills
Certification
Timeline
BusinessAnalyst
ROSHANDA TYOUS

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, TX
05.1995

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
ROSHANDA TYOUS