Senior Manager - Biotech Resume Search
Senior Manager - Biotech Resume Search
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Senior Manager Resume


Desired Industry: Biotech SpiderID: 79679
Desired Job Location: Vallejo, California Date Posted: 7/31/2017
Type of Position: Full-Time Permanent Availability Date: Immediately
Desired Wage: 80000
U.S. Work Authorization: Yes
Job Level: Management (Manager, Director) Willing to Travel:
Highest Degree Attained: Bachelors Willing to Relocate: Yes


Objective:

Top-performing and performance-focused professional with exceptional management and leadership skills in the field of health care;

complemented with proven adeptness in managing pharmaceutical operations and collaborating with professionals at all levels. Skilled

at overseeing day-to-day operations and developing comprehensive plans to motivate staff, boost productivity, and facilitate

personnel development toward fulfillment of organizational goals and objectives. Articulate communicator, capable of multitasking

within fast-paced and deadline-driven environment. Proficient with Microsoft Office 365 and Adobe Acrobat.


Experience:

Relevant Experience

Kaiser Permanente, Oakland, CA
Senior Consultant 2015–Present
Function as project case leader, responsible in managing the organization’s closure of expedited appeals and process of external

independent medical review cases on safety, drug administration, and compliance
Conduct investigation of appeals and collection of appropriate documentation
Maintain involvement in expedited rounds with nurse case managers and medical doctor
Provide response to members, physicians, and authorized representatives on health plans determination
Hold responsibility in preparing appeals for external independent medical and other state and federal government review
Communicate with medical center Health Plan and Permenente Medical Group (PMG) leaders to notify them if external independent medical

reviewer overturns plan’s determination
Administer the preparation of cases in alignment with regulations, compliance standards, and policies and procedures
Establish partnerships with Health Plan Departments, Kaiser Permanente hospital staff, and PMG’s in managing issues on documentation,

file maintenance, negotiation, resolution, and response
Guide and function as consultant to health plan staff and other local and divisional entities that need expertise and advice on

meeting regulatory requirements and problem solving member grievances
Work as the case manager, in charge of investigating, preparing, and presenting health plans member termination
Serve as a representative for health plan in administrative law judge cases
Attend departmental meetings, training, and self- audits

Amerisource Bergen: Lash Group, San Bruno, CA (2011–2015)
Reimbursement Consultant, Case Consultant 2014–2015
Provided feedback to pharmaceutical representatives to decrease patient’s time in accessing therapy from confirmation of diagnosis

and increase provider office reimbursement savvies
Managed pilot projects to promote and increase program, customer service, and patient drug adherence; decreased office clinical and

reimbursement complications and increase collaboration with pharmaceutical company, sales representatives, pharmacies, and doctors
Facilitated trainings for the improvement of junior counselors knowledge of clinical, insurance trends, and laws
Worked collaboratively with the senior leadership for the development of Mentor Team as well as training advancement for case

manager’s skills set

Senior Reimbursement Counselor, Senior Case Manager 2012–2014
Delivered presentation of program efficacy and drug compliance at Endocrine Society 2013
Accomplished training regarding adverse events and proper protocol in reporting events to regulatory offices
Established constant communication with the senior leadership on raw data reconciliation, client deliverables, and creation of

reports
Received the Quality and Leadership Award and the client field team’s Case Manager of the Year Award

Reimbursement Counselor| Case Manager 2011–2012
Completed clinical training on medical charts and notes to help patients with prescribed indications for specialty medication
Keenly analyzed different options available to patients while investigating how therapy is covered with their insurance
Fostered professional relationships and maintained communication with pharmaceutical sales representatives, doctors, nurses, and

patients
Managed physician’s office with insurance authorization and clinical documentation
Assumed accountability in analyzing detailed clinical documentation in accordance with HIPPA guidelines and to assess patients for

free access to medication
Achieved the Lead Rookie of the year and TRIAD Award for dedication and providing top-quality leadership to counselors



Other Experience

AMSA/UC Davis Pre-Medical Surgical Internship, Davis, CA
Surgical Intern 2010


Education:

Education

Bachelor of Science in Biochemistry, 2010
San Francisco State University, San Francisco, CA


Affiliations:
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Skills:
Case Management |Relationship Building | Regulatory Compliance |Operations Management| Training and Supervision Organizational

Development | Cross-functional Collaboration | Problem Resolution and Decision Making


Additional Information:
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Reference:
Available upon request.


Candidate Contact Information:
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