Tahpenes Brazil
Rochester,NY
Summary
Highly motivated healthcare professional dedicated to ensuring seamless patient care coordination across diverse healthcare settings. Utilizes strong communication and problem-solving skills to address patient needs, coordinate services, and streamline care plans. Knowledgeable of healthcare regulations, patient advocacy, and care coordination practices to enhance care outcomes and support client well-being. Committed to delivering compassionate, client-centered care while collaborating effectively with interdisciplinary teams. Brings a positive attitude, professionalism, and a strong commitment to delivering compassionate, high-quality care and continuous professional growth.
Overview
17
17
years of professional experience
Work History
Pharmaceutical Case Manager
United BioSource (BioMarin Pharmaceuticals)
Orlando, Florida
12.2025 - Current
- Served as single point of contact for assigned physicians, sales representatives, pharmacies, and field representatives, facilitating communication and coordination.
- Delivered high-quality customer service by effectively interacting with patients’ families, national payers, and medical offices to secure reimbursement for clients.
- Provide high-quality customer service, effectively interact with patients’ families, national payers, and medical doctors’ offices to ensure reimbursement is attained for clients for the product.
- Conducted benefit investigations and submitted prior authorizations for cases needing extended treatment.
- Triage patient cases based on specific eligibility criteria for specialty medications. to Specialty Pharmacies based on case criteria.
- Coordinated case status discussions and drug orders through conference calls with client sales representatives and physicians’ offices.
- Comply with all applicable company, state, and federal safety and environmental programs and procedures.
Case Manager
UnitedBioSource (Ferring Pharmaceuticals)
Orlando, FL
09.2022 - 12.2025
- Acted as the primary liaison between patients, healthcare providers, specialty pharmacies, insurance companies, and field representatives throughout the care coordination process.
- Managed a high-volume caseload while coordinating non-clinical care management activities for patients receiving specialty medications.
- Conducted benefit investigations, initiated prior authorizations, and coordinated appeals to minimize treatment delays and improve medication access.
- Assessed client needs and referred eligible patients to patient assistance programs and appropriate support services.
- Executed telephonic outreach to patients and provider offices, providing case updates, resolving access barriers, and promoting treatment adherence.
- Conducted quality reviews of assigned cases, identified workflow trends, and communicated actionable insights to leadership for process improvement.
- Documented all case activities accurately while maintaining compliance with HIPAA and company policies.
- Reported adverse events in accordance with REMS and regulatory requirements.
Prior Authorization Specialist
Advent Health Hospital
Orlando, FL
10.2020 - 09.2022
- Obtain pre-authorizations from payers in accordance with payer requirements and within the timeframe
- Verify eligibility and benefits with Insurance company/3rd party
- Notified physician offices of issues affecting preauthorization requests, facilitating timely resolutions
- Notified physician offices of preauthorization issues, enabling prompt resolution
- Followed up on missing or incomplete pre-authorizations, ensuring compliance with payer requirements and minimizing delays
- Entered authorization information in the system, detailing authorization length, total visits, and medication units for accurate tracking
- Followed government guidelines to ensure compliance with CMS, EMTALA, and HIPAA regulations.
Field Support Specialist / Case Manager
Assist Rx
Orlando, Florida
11.2019 - 10.2020
- Oversaw case management operations and reviewed assigned cases to ensure timely completion of tasks by responsible parties
- Answered inbound and outbound calls to introduce medication servicing, verified patient data, and addressed patient needs effectively
- Conducted assessments of financial documents, housing conditions, and income sources to evaluate client needs
- Processed and screened client applications for assistance, reviewed eligibility forms, and verified household income to ensure client eligibility
- Evaluated financial documents, housing conditions, and income sources to determine client eligibility for assistance.
Senior Customer Care Representative
MVP Healthcare
Rochester, New York
08.2009 - 07.2019
- Handled call escalations, resolved issues, and followed up with members to ensure satisfaction
- Performed quality assurance and coached 6 agents monthly to elevate service quality.
- Trained and mentored new employees while facilitating team meetings to enhance collaboration
- Researched and analyzed complex service issues daily to resolve customer concerns.
- Managed a team of 15 employees to ensure operational efficiency.
- Generated CMS Call Report system to maintain ACW below goal of 20%
- Assist and work with other departments IE: Enrollment, COB, Claims, Utilization Management and pharmacy
Education
Bachelor of Science - Community & Human Services
SUNY Empire State College
Rochester, NY10-2024
Associate of Arts - Medical Billing & Coding
Everest Institute
Rochester06-2011
Skills
- Care coordination
- Health Plan Navigation
- Problem Solving
- Time Management
- Organization and Prioritization
- Communication skills
- Critical thinking
- Adaptability
- Microsoft Office Suite
- Attention to detail
Accomplishments
- Assist in training and mentoring new hire employees.
Timeline
Pharmaceutical Case Manager
United BioSource (BioMarin Pharmaceuticals)
12.2025 - Current
Case Manager
UnitedBioSource (Ferring Pharmaceuticals)
09.2022 - 12.2025
Prior Authorization Specialist
Advent Health Hospital
10.2020 - 09.2022
Field Support Specialist / Case Manager
Assist Rx
11.2019 - 10.2020
Senior Customer Care Representative
MVP Healthcare
08.2009 - 07.2019
Bachelor of Science - Community & Human Services
SUNY Empire State College
Associate of Arts - Medical Billing & Coding
Everest Institute