Velda Jones

Experience

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  Independence Blue Cross

  Apr 2002 - Jun 2006

  Senior Pharmacy Specialist

  Advanced through a series of promotions; provided direction and became team support as well as Business Liaison, Quality Assurance Lead and Training Specialist.Daily Responsibilities:Overseen daily operations for Direct Ship Injectable Unit To provide direction and support regarding day to day issues for junior associatesWork closely with the Clinical Pharmacist to ensure the directship unit operated with minimal errors and a high level of member/provider satisfactionUnit trainer- assist in developing training material for Direct Ship UnitProvided refresher training sessions and extensive training sessions on new procedures and systemsAssisted with development of policy and procedures for the Directship ProgramTrouble shooter for systems issues and overall program- research and resolve any issues that arise, including systems and day to day issuesLiaison for Caremark, Cura Script, US BIO Services and other Home Infusion vendors regarding escalated issues, billing payment issues Expedited urgent request; generate authorizations for medication approvals the participating vendors and providers Interaction with numerous internal departments, Home Infusion vendors, and providers; Trained on Medicare Part D; Record Retention Coordinator; Monitoring Avaya phone system to ensure all calls are handled in a time manner Monitored and re- routing information to specialistSpecial projects as assigned by managementTechnology Show less

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  Futurescripts

  Jun 2006 - Sept 2010

  Supervisor Pharmacy Injectable Unit

  Developed and Managed a team of pharmacy associates and oversaw daily Departmental Operations and Implementation including Vendor ProcessesDaily Responsibilities:Managed and overseeing unit of 11 associates in areas such as: monitoring work for appropriate vendors and preferred pharmacy and appropriate and identifying errors offering side by side refresher training as the deMonitored attendance / tardiness along with managing HR issues such as disciplinary responsibilitiesMonitored daily workflow volume of teamDeveloped metrics and goals for unitMaintaining daily number and phone call volume for team via spreadsheet. Worked closely with Senior Tech in regarding to daily operations and implementationsMonitored Phone daily coverageProvided team support and daily direction as neededCoordinated my daily responsibilities various facets of day to day environmentEstablished and modified operational processinterfaced closely with vendors and physicians and internal associates Addressing and troubleshooting billing issueDaily communication with vendors for facilitation of medications and inventoryEstablished operational process for new vendors Identify new injectable drugs and specialty oral medication with limited distributionWork closely with the Injectable pharmacist for guidance and implementation of daily process Train associates and new pharmacist on injectable processAssist in developing and maintain unit training /provided refresher training and update material for unit with pharmacist supportAddressed sensitive issues and supervisor callsAdhered to all compliance polices. Maintaining a daily and vendor count sheetsindependence blue cross – Philadelphia, PA Show less

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  CatalystRx

  Sept 2010 - Sept 2011

  Supervisor Supporting PA Processing

  Pharmacy Benefit Management CorporationSupervisor Supporting PA Processing; Manage corporate communications functions for, DMR, Appeal Review, Phone and Resolution Teams Daily Responsibilities:Monitored attendance/tardiness; approve/deny vacation request; monitor production and error activityWork closely with technical advisor as mentor on special project; monitor daily duties as well as advise on technical issues and team interaction.Injectable liaison for specialty initiatives and implementations Develop metrics that were tangible and measurable for the team Monitor phone coverage to ensure all calls are handled and to remain in compliance based on contractual agreement with our client Ensure that team is meeting metrics for quarterly & performance evaluationWork closely with QA/trainer to discuss needs for a refresher or new training Adhere to all department and company compliance standardsWork closely with management and departmental and team to provide initiatives to assist in developing skill set, to keep team motivateinterface closely with vendors and physicians and internal associates Address and troubleshooting billing issueindependence blue cross/futurescripts – Philadelphia, PAPharmacy Benefit Management and Mail Order Pharmacy Show less

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  Catamaran

  Sept 2011 - Jul 2012

  Supervisor Supporting PA Process

  Monitored attendance/tardiness; approve/deny vacation request; monitor production and error activityWork closely with technical advisor as mentor on special project; monitor daily duties as well as advise on technical issues and team interaction.Injectable liaison for specialty initiatives and implementations Develop metrics that were tangible and measurable for the team Monitor phone coverage to ensure all calls are handled and to remain in compliance based on contractual agreement with our client Ensure that team is meeting metrics for quarterly & performance evaluationWork closely with QA/trainer to discuss needs for a refresher or new training Adhere to all department and company compliance standardsWork closely with management and departmental and team to provide initiatives to assist in developing skill set, to keep team motivateinterface closely with vendors and physicians and internal associates Address and troubleshooting billing issue Show less

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  Cardinal Health formerly E-Pharmpro

  Jun 2013 - Jan 2015

  Pharmacy Technician ll

  • Home based position- servicing LTC facilities throughout US as their on- call after hours pharmacy.• Triage incoming calls from physicians; facilities; pharmacies and couriers;• Create tickets for orders• Process order request• Set up delivery schedules• Verify medication orders in stock• Verify delivery/pick up time• Forward faxes to appropriate back up pharmacies for medication for processing • Make outreach and follow-up calls• Troubleshoot issues- Call triage and processing for Omnicare facilities Show less

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  AscellaHealth LLC

  Nov 2013 - Dec 2022

  Specialty Services Coordinator

  My role includes:> Implementations of new clients for our Specialty Program>Coordination of specialty med(s) delivery & follow up>Billing and follow up>AWP Pricing>>Interfacing with clients and vendor>Interfacing with members>Confirming eligibility status >Maintaining proactive out reach to doctor's office to update specialty medication authorization forms for submission to insurance company>Trouble shooting claim rejections>Implementation of workflow process with associates>Maintaining proactive refill status follow ups with specialty pharmacies>Outreach to doctor's office & patients as needed> Along with various miscellaneous responsibilities.>Testing claims for pharmacy system for new clientSystems: IPNS(ARGUS GUI); SelectRx (Emdeon) Show less