Healthcare Operations - Healthcare Resume Search
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Healthcare Operations Resume


Desired Industry: Healthcare SpiderID: 60814
Desired Job Location: Waukesha, Wisconsin Date Posted: 5/22/2012
Type of Position: Full-Time Permanent Availability Date: Immediately
Desired Wage: 20000
U.S. Work Authorization: Yes
Job Level: Executive (President, VP, CEO) Willing to Travel: Yes, 25-50%
Highest Degree Attained: Bachelors Willing to Relocate: No


Objective:
Strategic-thinking and operational
leader, with more than 25 years of
progressive management history and
extensive business experience in
healthcare audit analysis,information
technology, and retail pharmacy.


Experience:
THOMSON REUTERS, MILWAUKEE, WI ~ 2009–
Present
Vice President, Audit and Compliance
Operations

Provide strong leadership skills in
supervising an audit/IS staff of 14.
Closely monitor the pharmacy claim
imports, conversions, audits,
automation, reports, clinical review

and finalization.

- Enhanced technology breadth of
business unit through the design,
development, and implementation of audit
program in Oracle Pl/SQL and integrated
Microsoft Access VB

application.
- Reduced errors and accelerated
overall speed by conceptualizing front-
end integration between VBA and Oracle
Pl/SQL.
- Streamlined business process by
devising operational standard operating
procedures and detailed instruction for
processes.
- Broadened knowledge and skills
of both local and India staff on the
United States pharmacy industry by
providing hands-on training and support.
- Effectively functioned as HIPAA
Local Security Manager and facilities
manager.
- Played an integral role in the
successful increase of national
recognition of legacy pharmacy pricing
source (Redbook).
- Maximized personal innovative
skills in formulating pricing
methodology for audit products, ensuring
accessible and easy user interface in
Microsoft Excel.
- Regarded among 42 experts
nationwide invited at National Council
for Prescription Drug Programs (NCPDP),
an industry-wide focus group on pricing.

2010: Healthcare Data Management (HDM)
(Acquired by Thomson Reuters)

- Assumed leadership
responsibilities of managing 10 people
while coordinating medical and pharmacy
plan design audits.
- Earned recognition for notable
performance and achievement, and
promoted to Vice President of
Operations.

2009: TriVantage (Acquired by Thomson
Reuters)

- Initially hired as Director at
Thomson Reuters; in charge of
supervising auditors/programmers and
conducting detailed audits.

2007: TriVantage Pharmacy Strategies

- Served as the Vice President for
Audits; employed as one of two
programmers, innovated an automated
front end for an Oracle Pl/SQL audit
process; and led efforts in the

redesign and improvement of the
audit process.
- Achieved full knowledge of
Oracle DBA skills and programming
PL/SQL.
- Supervised the recruitment and
hiring of three additional
programming/development staff, managing
after hiring.
- Obtained multimillion dollar
settlements for clients in cooperation
and collaboration with the PBMs.

TRICAST INC. MILWAUKEE, WI ~ 2006
Chief Information Officer

Demonstrated expertise in pharmacy claim
analysis, and automated the audit of
pharmacy claims and risk analysis of
plan design. Led the creative concept,
development, and

implementation of an automated process
in order to evaluate the risk and audit
of pharmacy claims.

ALBERTSONS (OSCO), WAUWATOSA, WI ~ 2003–
2005
Pharmacy Manager
Performed pharmacist duties and promoted
to pharmacy manager.

- Drove increase in business
profitability through profit generation
and customer growth and retention.

MEDCO HEALTH SOLUTIONS, WAUKESHA, WI ~
1997–2003
Pharmacy Benefits Manager
Director, Clinical Services/Operations

Displayed unsurpassed leadership,
supervised a staff of clinical and
administrative employees to render
internal support such as statistical
analysis of clinical integrated data

to more than 500 employees. Applied best
management strategies, directed the
monthly operations of clinically
integrated mailings to over 50,000
physicians. Coordinated

strategic approaches and direction
devising clinical data warehouse design.

- Lowered overall support costs,
increased reliability, and expanded
company performance by assisting the
internal clinical support center.
- Brought significant revenue
increase by reducing staffing costs
while augmenting operational response
through extensive automation.
- Served as key innovator creating
an operational tracking system,
including integrated e-mail
capabilities.
- Selected and relied upon by the
team, leading the successful redesign of
RationalMed®, an integrated medical and
pharmacy data statistical analysis
program, for Medco
Health Solutions.
- Decreased cost of overused,
underused, and misused medications; as
well as streamlined safety of
therapeutic selections by physicians
through efficient supervision of

the operations of clinical
utilization management programs.
- Spearheaded a drastic reduction
of operational costs by 50%, resulting
in profit enhancement and additional
revenue.

KONSULT DATA SERVICES, OSHKOSH, WI ~
1995–1997
SERV-U PRESCRIPTION SERVICES (SPS),
MILWAUKEE, WI
Pharmacy Benefits Manager

Director, Information Technology

Leveraged expertise as an operational
leader in directing a staff of 10
programmers at Konsult Data Services and
subsequently all IT functions at SPS.
Managed the implementation

and support on WAN of 10 local Serv-U
stores. Managed the computer area
including the maintenance and upkeep of
remote network, automation, and
programming.

- Lobbied and led the creation of
online real-time data warehouse of
prescription drug claims for Humana and
Blue-Cross/Blue Shield Florida.
- Conceptualized and adopted
innovative ideas, designing real-time
medical-prescription interaction
adjudication.
- Enabled clients to conduct their
own queries using their personal
pharmacy data remotely through the
formulation of database program.

VETERANS AFFAIRS HOSPITAL-CENTRAL REGION
CONTRACT SERVICE CENTER, MILWAUKEE, WI ~
1990–1995
(Contracting Center Pilot for Eight
Veterans Affairs Medical Centers)
Information Technology Chief/Manager

Handled and oversaw the automation and
technology support of contracting
activities in the Central Region.
Directed and coordinated all aspects of
IS. Demonstrated technical

proficiency in designing, enforcing, and
maintaining the first Novell network in
Milwaukee Veterans Affairs. Functioned
as a programming and network person;
managed and worked

collaboratively with approximately 25
contracting officers. Utilized FoxPro
and MUMPS skills in automating the
integration between the Windows desktop
and Veterans Affairs’

legacy DEC VAX system.

- Developed, implemented, and
updated automated integration database
between VA-wide MUMPS kernel and LAN
through FoxPro.
- Presented service by rendering
assistance for the nationwide satellite
televised continuing education for VA
attorneys.

RXBBS, MILWAUKEE, WI ~ 1990–1994
Owner

Established, owned, and led the creative
concept development of an electronic
Bulletin Board System (BBS) for
independent pharmacists in the United
States

- Effectively handled the
negotiation for use of United Press
International news stories for RXBBS.
- Generated and delivered
searchable electronic news from United
Press International, software demos, and
message forums to 100 pharmacists
nationwide.
- Allowed users to search the news
for any terms through the design of a
user rating system; negotiated,
obtained, and recommended trial pharmacy
software packages from

various vendors.

PRESCRIPTIONS PLUS INC. PHARMACY, IOLA,
WI ~ 1980–1990
Owner/Pharmacist

Delivered revenue enhancement by
successfully augmenting sales and
increasing business profitability.
Maximized marketing initiatives and
worked collaboratively with local

businesses.

- Positioned company for growth by
multiplying sales and profitability
while maintaining highly professional
and customer-oriented business.
- Initiated and managed the Iola
Business Association in the community
which was a precursor to the Chamber of
Commerce.


EARLIER CAREER

ComputerTalk for the Pharmacist ~
Columnist

- Served as bi-monthly columnist;
published a unique utilization of
spreadsheet software in creating pricing
algorithms and business concepts
specifics to the pharmacy

industry.

Pharmacist Computer Corporation ~
Pharmacy Writer

- Contributed to the programmatic
design of Healthcare Computer
Corporation’s pharmacy computer system
and in the development of pricing
modules; designed and implemented

pharmacy software user manual.

Stein Drugs ~ Assistant
Manager/Pharmacist


Education:
School of Pharmacy, University of
Wisconsin–Madison, Madison, WI
BACHELOR OF SCIENCE IN PHARMACY
Registered Pharmacist, State of
Wisconsin

Marquette University, Milwaukee, WI
COURSEWORK IN PRE-PHARMACY


Affiliations:
PROFESSIONAL AFFILIATIONS

National Council for Prescription Drug
Programs (NCPDP), 1982–Present
Co-Chair, Prescriber Interface
Workgroup, 1995

Average Wholesale Price Replacement
Focus Group, 2010
American Pharmaceutical Association,
2002–2004


Skills:
Profit & Loss
New Business Development
Revenue Growth and Profitability
Sales and Marketing Operations
Customer Service and Relations
General and Operations Management
Regulatory Compliance and Standards
Pharmaceutical Principles and Procedures


Additional Information:
CERTIFICATIONS

Immunization Certification, American
Pharmaceutical Association
Cardiopulmonary Resuscitation
Certification


TECHNICAL SKILLS

Computer Database Programming: Oracle
PL/SQL | Microsoft Access VBA | Oracle
DBA experience
Others: (Advanced) Microsoft Office
Suite: Excel, Word, and PowerPoint |
(Beginner-Intermediate) PowerBASIC


Reference:
Available upon request.


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