Summary
Overview
Work History
Education
Skills
Certification
Websites
Timeline
Generic

Vannessa Waters

Chicago,IL

Summary

Dynamic healthcare professional with proven expertise in care coordination and process improvement. Excelled in managing patient access to medication, achieving 100% participation in employee engagement initiatives. Skilled in regulatory compliance and communication, adept at transforming healthcare operations through strategic planning and patient-focused services.

Overview

7
7
years of professional experience
1
1
Certification

Work History

Ambulatory Medication Access Coordinator

UChicago Medicine
Chicago, IL
09.2018 - 03.2020
  • Processed retail and mail-order claims for 30+ patients weekly at UChicago Medicine Specialty Pharmacy (Patient Management Program). Completed prior authorization requests for over 100 insurance companies, including Blue Cross Blue Shield and UnitedHealthcare.
  • Managed provider referrals for all oncology patients who are new to therapy and seeking financial assistance. Yearly enrollment and re-enrollment of over 100 oncology patients into grants and patient assistance programs to significantly reduce the cost of their medications, or cover them at 100%. Counseled patients on Medicare and Medicaid changes, identified access options and barriers that may impact financial aid eligibility, and conducted medical record reviews. Consistently surpassed the service level agreement of one week.
  • Collaborated with the patient's care team and staff to collect and submit supporting documentation, including diagnosis and chart notes for patient coverage evaluation, and at-home care plan.
  • Led the department's 2023 Employee Engagement Survey team, achieving 100% staff participation, thus enabling valuable feedback to drive improvements for senior leadership.
  • Maintained updated knowledge of CMS guideline changes and URAC Specialty Pharmacy Accreditation standards to verify adherence, and identify areas for improvement.
  • Specialized in Transplant Transitions of Care: Collaborated with transplant patients and their providers for timely processing, refill, and delivery of discharge, and maintenance medications.

Care Coordinator-Chronic Care Management & Home He

Near North Health Service Corporation
Chicago, IL
09.2018 - 03.2020
  • Oversaw a caseload of 84 Medicare patients with multiple chronic conditions, and collaborated with PCPs, patients, and healthcare team members to provide quality health services and treatment.
  • Developed personalized care plans and targeted interventions, coordinated with the patient's care team.
  • Analyzed patient charts for HEDIS measure compliance, and provided recommendations for improving provider documentation for regulatory and compliance requirements.
  • Streamlined referrals for home health care programs, identifying suitable agencies based on insurance and service requirements, and connecting patients and families with relevant resources.

Patient Logistics, Customer Service Assistant

UI Health
Chicago, IL
02.2017 - 09.2018
  • Registered and processed insurance information for over 60+ daily new and returning patients who were direct admits to the hospital or emergency room.
  • Ensured timely access to services in emergency room settings.
  • Verified and documented insurance details through phone or electronic communication.

Member Services Representative

Catamaran/ OptumRx
Lisle, IL
12.2012 - 02.2017
  • Effectively served more than 50 clients, educating them, and assisting with prescription benefit plans, including copays, plan design, participating pharmacies, and formulary listings. Ensured compliance with HIPAA regulations, and assisted pharmacies with claims processing.
  • Maintained efficient call times, keeping conversations under 5 minutes while addressing member inquiries.
  • Recruited patients to participate in surveys to provide feedback on improving healthcare experiences and treatments.

Education

Master of Science - Clinical Operations And Healthcare Management

The George Washington University
Washington, DC
08-2022

Bachelor of Arts - Psychology

The University of Illinois At Chicago
Chicago, IL
12-2011

Skills

Care Coordination

Communication

Customer Service

Data analysis

Epic/EHR/EMR

Grant research

Healthcare Financing/Financial Assistance

Medical terminology

Operational Planning and Workflows

Prior Authorizations

Process Improvement

Regulatory Compliance

Relevant Coursework: Health Care Systems Operations, Human Resources Development, Finance for Healthcare Operations, Leadership and Healthcare Change Management

Certification

  • Certified Pharmacy Technician State of Illinois License No. 049.271547 March 2020 to March 2025

Timeline

Ambulatory Medication Access Coordinator

UChicago Medicine
09.2018 - 03.2020

Care Coordinator-Chronic Care Management & Home He

Near North Health Service Corporation
09.2018 - 03.2020

Patient Logistics, Customer Service Assistant

UI Health
02.2017 - 09.2018

Member Services Representative

Catamaran/ OptumRx
12.2012 - 02.2017

Master of Science - Clinical Operations And Healthcare Management

The George Washington University

Bachelor of Arts - Psychology

The University of Illinois At Chicago

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Vannessa Waters