Shirley Lewis
Saginaw,MI
Summary
Experienced and results-driven healthcare professional with a track record of excellence in prescription claims management at Optum Rx Specialty Pharmacy. Recognized for maintaining 100% order correction accuracy and consistently surpassing quality benchmarks. Combines deep knowledge of pharmacy operations and data analytics with strong communication skills to mentor teams, streamline processes, and deliver patient-centered care. Currently pursuing a Master’s in Healthcare Management to expand strategic leadership capabilities and drive system-level improvements in care delivery.
Overview
20
20
years of professional experience
Work History
Associate Pharmacy Care Coordinator
Optum Rx Specialty Pharmacy (UnitedHealth Group)
11.2016 - Current
- Supported Medicare, Medicaid, veteran, and private insurance prescription claims
- Maintained accurate records for prior authorizations and third-party funding updates
- Delivered 100% order correction accuracy and exceeded performance thresholds
- Trained team members on order correction protocols and claims analysis best practices
Healthcare Advisor
Morley Companies (Contract – BCBS MI)
12.2014 - 05.2016
- Provided plan benefits education during open enrollment
- Delivered Level 1 tech support and call resolutions that became training examples
Director of Admissions
Advisa Home Healthcare
10.2013 - 09.2014
- Oversaw patient admissions and staff onboarding
- Conducted intake calls and coordinated with hospital discharge planners
- Maintained regulatory knowledge and assisted in emergency admission procedures
Community Home Health Outreach Specialist
Provision Home Health
08.2013 - 10.2013
- Educated and trained healthcare providers on health education practices for patients.
- Designed and conducted health education surveys to assess health needs and risk factors within communities.
- Established and maintained partnerships with community organizations to promote health education programs.
- Provided technical assistance to healthcare providers and organizations to improve health education services.
Medical Concierge
Guardian Angel Home Care
12.2012 - 08.2013
- Retained 60% of patients through high-touch community engagement
- Scheduled home healthcare services and partnered with DME reps for equipment access
Marketing Manager
Loving Hands Adult & Senior Home Healthcare
06.2009 - 12.2012
- Boosted brand awareness and generated leads while managing internal and external marketing campaigns and programs.
- Managed workflow between staff, coordinating documents, planning, and creative material distribution.
- Developed and implemented marketing strategies to use for launches, rebranding campaigns and promotions.
- Maintained documentation, detailing assignments, in-progress work and completed project milestones.
- Managed budget allocation and resource utilization to maximize marketing ROI.
- Generated sponsorships with related and partnering entities to enhance marketing objectives.
- Mentored local personnel on best practices and protocols to maximize productivity.
- Analyzed and reported on KPIs to validate and demonstrate success of marketing campaigns.
- Led team of marketing professionals, offering mentoring and coaching to build knowledge and skills.
Education
Master of Science - M.S. Healthcare Management
Michigan State University
East Lansing, MI08-2027
Master of Science - M.S. Healthcare Administration
Southern New Hampshire University
Hooksett, NH04-2025
Bachelor of Science - B.S. Healthcare Administration
Southern New Hampshire University
Hooksett, NH01-2024
Certificate of Technical Studies - Pharmacy Technician
Diplomat Pharmacy University
Flint, MI10-2019
Skills
Digital & AI-Enhanced Tools
- Generative AI for Training and Document Preparation (master’s coursework)
- Familiarity with AI-driven platforms for healthcare process improvement
- CRM/LMS systems with AI-enabled learning and workflow customization
- Proficiency in Microsoft Office Suite, EHR, PBM portals, and data analysis tools
Healthcare Systems & Quality Methods
- Claims analysis (Medicare, Medicaid, PBM)
- Lean Six Sigma, PDSA cycles, LACE scoring
- Data mining, regulatory compliance, and patient-centric documentation
Administrative & Communication
- Microsoft Teams, Google Workspace, document prep software
- Public speaking tools, staff training modules, and cross-functional coordination
Accomplishments
- National Society of Leadership and Success (Member)
- Optum Rx: Shooting Star & Bravo Team Recognition
- SNHU: Dean’s List, President’s List
- Ameritech VP Achievement Award
- Medicare Medicaid Assistance Program (MMAP) Certification & Recognition
- Health Insurance Program Open Enrollment Event Award
- Loving Hands Vice-President Award for outstanding customer service
- 2nd Annual Elder Abuse Statewide Summit Certificate of Participation 2012
- Creating the Confident Caregiver Training Certificate of Recognition 2011
- Recognized for top performance in customer conversion rates and account retention
- Successfully trained 400+ sales reps on market correction and personalized wireless solutions
Additional Information
Additional Work Experience
· Ameritech – Account Executive
· National City Bank – Customer Service Representative
· Weiss Nursing Home - Certified Nursing Assistant
· St Frances Nursing Home - Certified Nursing Assistant
· Delta Family Clinic – Billing Specialist ( Internship)
· Campbell Soup - Executive Administration Assistant
· Buena Vista Twp - Administrative Assistant
· City of Saginaw - HR Benefit/Payroll Specialist
Timeline
Associate Pharmacy Care Coordinator
Optum Rx Specialty Pharmacy (UnitedHealth Group)
11.2016 - Current
Healthcare Advisor
Morley Companies (Contract – BCBS MI)
12.2014 - 05.2016
Director of Admissions
Advisa Home Healthcare
10.2013 - 09.2014
Community Home Health Outreach Specialist
Provision Home Health
08.2013 - 10.2013
Medical Concierge
Guardian Angel Home Care
12.2012 - 08.2013
Marketing Manager
Loving Hands Adult & Senior Home Healthcare
06.2009 - 12.2012
Master of Science - M.S. Healthcare Management
Michigan State University
Master of Science - M.S. Healthcare Administration
Southern New Hampshire University
Bachelor of Science - B.S. Healthcare Administration
Southern New Hampshire University
Certificate of Technical Studies - Pharmacy Technician
Diplomat Pharmacy University
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