Summary
Overview
Work History
Skills
Education and Personal Development
Languages
Timeline
Generic

Sulie J. Rosales

Summary

Experienced, bilingual, and personable biotech and healthcare consultant with extensive expertise in reimbursement, patient assistance, and drug launch/delivery. Collaborative with sales teams to achieve shared business goals, dedicated to customer education and advocacy. Skilled at establishing rapport with clients and patients through empathetic communication and a confident grasp of the subject matter.

Overview

16
16
years of professional experience

Work History

Patient Engagement Manager

Ultragenyx
06.2020 - 03.2024
  • Patient Case Management: Partnered with commercial field teams to manage patient cases within assigned territories, ensuring seamless coordination and support.
  • Education on Payor Structures: Educated patients and physician offices on the various distinctions within insurance benefit structures, ensuring a clear understanding of coverage options and requirements.
  • Cross-Functional Liaison: Acted as the primary point of contact between patients, physician offices, and specialty pharmacies, troubleshooting reimbursement issues and expediting resolutions.
  • Benefit Verification: Conducted thorough benefit investigations to confirm patient coverage and clearly explained insurance details to ensure patients understood their coverage options.


Patient Service Representative

Sutter Pacific Medical Foundation
01.2020 - 05.2020
  • Appointment Coordination: Scheduled and registered patient appointments, ensuring alignment with patient needs and physician availability.
  • Patient-Focused Communication: Maintained professionalism and compassion when supporting patients with neuromuscular diseases, including ALS, Epilepsy, and Myasthenia Gravis.
  • Team Collaboration: Participated in team meetings to improve workflows and enhance practice performance.

Retail Service Representative

Sutter Pacific Medical Foundation
08.2019 - 12.2019
  • Customer-Centric Service: Delivered exceptional customer service by ensuring patients received accurate products and services aligned with physician recommendations.
  • Patient Education Support: Volunteered at medical educational presentations, assisting patients during events to enhance their understanding of available product and services.
  • Product Expertise: Attended vendor educational training sessions to stay informed about the latest products and services, ensuring high-quality patient support.

Esthetician (Self- Employed)

Self Employed Services
06.2017 - 08.2019
  • Business Operations Management: Oversaw all aspects of the business, including client checkouts, rebooking, follow-ups, retail product offerings, and ongoing training initiatives.
  • Customer Engagement: Delivered a warm, professional, and personalized customer experience, fostering trust and client loyalty.
  • Marketing and Growth: Increased client base through effective social media marketing and advertising strategies.
  • Education: Provided clients with knowledge of available cosmetic services and advised on tailored home-care regimens.

Reimbursement Case Manager

CareMetx
11.2016 - 09.2017
  • Insurance Navigation: Conducted benefit investigations, assisted with prior authorizations, appeals, and secured alternate coverage for uninsured or underinsured patients.
  • Patient Access Coordination: Collaborated with account teams to customize patient plans for infusion therapy and home care transitions, ensuring timely access to treatment.
  • Logistical Oversight: Monitored product deliveries and communicated with specialty pharmacies to prevent delays.
  • Financial and Logistical Support: Partnered with non-profit organizations to reduce out-of-pocket costs and address patient logistical needs.
  • Patient Follow-Up: Conducted monthly check-ins to address changes affecting therapy access, including insurance, employment, or relocation.

Case Manager Contractor

Compass Consulting Services
05.2014 - 12.2014
  • Reimbursement Support: Educated and guided patients and providers through complex reimbursement processes, addressing potential barriers and payer trends.
  • Process Optimization: Identified and recommended program efficiencies to improve client service and minimize internal redundancies.
  • Financial Assistance Coordination: Facilitated referrals to alternative coverage options and financial assistance programs for underinsured patients.
  • Access Facilitation: Assisted clinics with prior authorizations and recertifications to prevent delays in drug access.

Reimbursement Consultant

Premiersource
03.2008 - 01.2013
  • Product and Service Presentations: Delivered presentations to clinics and patients across Puerto Rico, providing education on services.
  • End-to-End Process Management: Coordinated with physicians, staff, distributors, pharmacies, and insurance companies to ensure consistent, timely treatment access for patients.
  • Customer Support and Program Development: Assessed, planned, and implemented personalized programs to enhance patient care, focusing on goal setting and timely follow-up.

Skills

  • Bilingual (English/Spanish)
  • Customer Education/Advocacy
  • Patient Access & Needs Review
  • Payor Knowledge
  • Google Suite
  • Sales Planning & Sales Support
  • Strategic thinking
  • Best practices optimization
  • Teamwork and collaboration
  • Problem-solving
  • Attention to detail
  • Creative thinking

Education and Personal Development

  • Bachelor of Arts, Criminal Justice, San Francisco State University, San Francisco, CA, 2003
  • Health Coach Certification, The Institute of Integrative Nutrition, Daly City, CA, 2020
  • Meditation Teacher Certification, Dream Bigger Foundation, Los Angeles, CA, 2024

Languages

Spanish (Bilingual)

Timeline

Patient Engagement Manager

Ultragenyx
06.2020 - 03.2024

Patient Service Representative

Sutter Pacific Medical Foundation
01.2020 - 05.2020

Retail Service Representative

Sutter Pacific Medical Foundation
08.2019 - 12.2019

Esthetician (Self- Employed)

Self Employed Services
06.2017 - 08.2019

Reimbursement Case Manager

CareMetx
11.2016 - 09.2017

Case Manager Contractor

Compass Consulting Services
05.2014 - 12.2014

Reimbursement Consultant

Premiersource
03.2008 - 01.2013
Sulie J. Rosales