For the given job description <<Our client is looking for experienced professional with a strong background in healthcare, including Pharmacy Benefit Manager (PBM) expertise. Proficient in SQL for data management and analysis. Skilled in working with messaging and event-based systems, facilitating seamless communication. Knowledgeable in optimizing prescription drug programs and navigating the complexities of healthcare dynamics for enhanced patient outcomes.
QualificationsBachelor's degree or equivalent experience10+ years of progressive experience in requirements gathering and management using both Waterfall and Agile SDLC methodologies.Extensive Healthcare experience is mandatoryPBM (Pharmacy Benefit Management) experience is mandatory Process development and implementation experience.Proficient in using SQL, Visio and Office Suite, including Word, Excel, and PowerPoint.Experience working with messaging or event-based systems
ResponsibilitiesAssists andor leads in requirements management practices and principles.Participates andor provides product ownership.Creates business requirement documents, user stories, use cases, and supporting diagrams including sequence diagrams as needed.Contributes to the planning process with the Scrum Master andor project manager to plan activities including requirements gatheringrefinement, design reviews, SOPwork instruction development, training, and go-live.>> the resume: <<SummaryDetail-oriented human resources professional who excels under tight deadlines, while anticipating and averting potential problems by proactively streamlining processes.
SkillsPositive employee, Advanced Knowledge in all Microsoft office/Applications, CRM, HICS, and Softheon.
Experience10/2018toPresentCustomer Service Rep/Data Entry SpecialistCommunity Action Partnership Of San Luis Obispo County|Delano,CA,Provide assistance to members and/or providers regarding website registration and navigation Document all activities for quality and metrics reporting through the Customer Relationship Management (CRM) application Research and identify any processing inaccuracies in claim payments and route to the appropriate site operations team for claim adjustment Identify any trends related to incoming or outgoing calls that may provide policy or process improvements to support excellent customer service, quality improvement and call reduction Document all activities for quality and metrics reporting through the Customer Relationship Management (CRM) application Updated activities in CRM, including HICS from CMS according to the turnaround times prepare, compile and sort documents for data entry check source documents for accuracy store completed documents in designated locations enter data from source documents into prescribed computer database, files and forms Troubleshot issues members may have with enrollment, eligibility, and reinstatement with their healthcare insurances.Update information with members healthcare insurance and contact other medical company for prior authorizations as needed.Input Merchant Capture Set-up for various Banks Deposit Gateway Provide effective account maintenances upon client request Correspond with internal and external clients/customers via telephone and email Complete reports/spreadsheets as assigned in a timely manner Meet numerous projects deadlines Work effectively as a team member.06/2018to04/2018Program Eligibility SpecialistViejas Enterprises|Alpine,CA,Reviews referrals for services and interviews applicants and/or family members to explain eligibility requirements, form completion requirement, and community resources.Requests information to determine/established procedures.May serve as a liaison to other divisions and agencies to develop policies and procedures for community-based programs.06/2018to06/2018Merchant Capture AdministratorFIS/Metavante Corporation|City,STATE,Input Merchant Capture Set-up for various Banks Deposit Gateway Provide effective account maintenances upon client request Correspond with internal and external clients/customers via telephone and email Complete reports/spreadsheets as assigned in a timely manner Meet numerous projects deadlines Work effectively as a team member.10/2018to04/2018Human Resource Administration AssistantSpherion Staffing APS Healthcare|City,STATE,Providing Administrative Assistant to the Human Resources department at APS.Administer references checks, employment and degree verification, and testing for all prospective candidates, process background pre-employment checks.Maintain an Applicant tracking log system of all candidates.Assisted in employment operations by processing all open positions Updated and revised job descriptions Assisted in creating and running reports to obtain data in the HR Dept.Handled front office operations in the HR Dept.Prepared monthly termination report for corporate use Assisted in recruitment activities by posting job openings at appropriate external organizations, such as technical schools, professional organizations, internet sites, etc.Developed numerous spreadsheets and reports which obtain HR data.Detail-oriented and have strong computer skills in Word and Excel.Assignment Ended).06/2018to02/2018Employment CoordinatorRandstad Staffing Inc Milwaukee Journal Sentinel|City,STATE,Primary responsibilities is greeting job candidates, administers testing, processes personnel paperwork, enters payroll information in computerized system, performs pre-employment/post-offer reference checks, assists employees and external customers with questions, and handles a variety of other human resource functions and provide excellent customer service skills.Assisted in employment operations by processing all open position requests, posting full and part-time job postings on company bulletin boards as required and distributing postings using Journal Communications format, generates open position log.Responsible for new-hire processing, to includes preparation of status advice, pre-employment paperwork; assists HR Information Coordinator with entering employee data into the payroll system; prepares folders with information for new employee orientation and put together interview packets and maintain personnel forms.handled front office operations for Human Resources; assists employees with questions and provides quick resolutions; maintain personnel files including creating new hire folders, updating and removing files and filing employee information into their files.Administered reference checks, employment and degree verification, and testing for all prospective candidates, runs driver and background pre-employment checks, schedules pre-employment drug screens; maintains a log all pre-employment, random and post-accident screen results.
Education and TrainingExpected in6/97totoBachelor of Science|PsychologyUniversity of Arkansas at Monticello,Monticello,ArkansasGPA:Psychology
Skillsfiling, front office, develop policies, spreadsheets>>. The result is, 

Fit assessment: Potential Fit