Account Manager PBM/RCPhT

Reese Seymore

Lubbock, TX ***** 972-***-**** *******@*****.***

EDUCATION

Tarleton State University (Texas A&M), Stephenville, TX 2000

MBA program – completed the core structure of general MBA

Howard Payne University, Brownwood, TX 1998

BBA, Marketing (took 27 upper level semester hours my last semester)

CORE COMPETENCIES

Leadership-*Top Right* 9 Box Matrix

PBM/Health Plan Proficiency

Call Center SME

Project Management

Departmental Liaison

Conflict Resolution

Client Relationship Management

Contract Negotiation

Process Management

Six Sigma and Sarbanes-Oxley

Microsoft Office 2013 Suite

Solution SME

*Consistently performs well in a variety of assignments; superstar employee. Big picture thinker; problem solver; self-motivated.’

PROFESSIONAL EXPERIENCE

OptumRx, Remote 2014-Current

Supervisor – Client Service Manager/Associate Account Manager – Health Plans/MCO Segment

Assigned to our most profitable and largest client(s) due to expertise abilities in servicing client(s) and ensuring NPS and overall satisfaction

Maintain an ongoing knowledge of clients’/OptumRX business

Provide positive alternatives to complex situations encountered by client and manage expectations

Act as liaison between external clients and internal departments to resolve these issues

Escalate client concerns when and where appropriate

Act in project coordinator capacity to ensure accurate and timely completion of client requests, to the client’s satisfaction – NPS items such as VOC, Member/Provider services and implementing custom needs

Complete service requests to translate customer needs and requirements for OptumRX operational departments

Interfaces with internal OptumRX departments as needed to fulfill client requests

Work regularly with internal partners/teams in improving processes and creating more efficiency and centralization to better the results for our expectations as a PBM and for our valued clients

SME for many processes, applications and procedures

Bottom line and results oriented individual for both operations and client relationships

Results speak and I have yet to slow down. I receive constant feedback on my ability to think outside the box and resolve issues or concerns from an operational aspect or in regards to a client need

ACCOLADES/RECOGNITION

I have won two Outstanding Health Plans Quarterly Recognition Awards this year. The only individual to so thus far in the same year. “This winner is the epitome of collaboration and team spirit. As one of the top responders to questions via the CSM Mailbox, he’s always willing to share his knowledge and best practices. He has a passion for service and operational excellence, which resulted in the submission of 2 process improvements. This CSM has also received positive feedback from internal and external partners around is attention to detail, ‘Can Do’ attitude, and for going above and beyond!” – Joydana Harris, VP Account Management

“Reese makes advocating appear so easy, that often time, people aren’t aware he’s doing it. He is the epitome of professionalism. Reese shouldn’t be a superhero….he IS a superhero! He demonstrates leadership, compassion, and integrity each day. His team views him as a business partner they can trust and depend upon. Reese is a true champion of client advocacy and dedication.” – Super Hero Award Nomination

"Reese has demonstrated outstanding performance this year in terms of serving his accounts, as well as his team of client service managers. On average Reese works 75-100 cases per month. An outstanding number considering that he also manages a team. These cases range from specific client requests, to internal tasks from our mail order and specialty teams. Reese does it all with a smile, positive attitude, and sometimes with infectious laughter. He can be counted on to brighten any room!

A true task master, Reese is always looking to improve our processes and to become more efficient. As a result, Reese made improvements to our Paid Time Off (PTO) process, client reporting tools, off shore resource onboarding, ServiceNow, and client information center (CIC) tool. These improvements add value for internal and external customers." - Sr. Director – Manager

BriovaRx, Lubbock, TX 2011 - 2014

Supervisor – Specialty Pharmacy Operations, Patient Care

Lead technician in coordinating shipment and therapy compliance with Hep-C/MS/HGH/HIV/Cystic Fibrosis/Lupus patients and MDO’s

Involved with the centralized process structuring and implementation that led BriovaRx to be the Specialty Product and key factor in UHG’s acquiring CatamaranRx

SME for ScriptMed and pharmacy operations

Suggested many process improvements of which have been implemented. Main contributor to building and implementing the operations procedures for the recognized success of the BriovaRx product.

BriovaRx Buddy

BriovaRx Escalation Team

CVS Caremark, Irving, TX 2008 - 2011

Clinical Prior Authorization Representative II

Call Center SME in system applications/trainer and in IVR systems

Lead for Formulary Alternative Plan product on all three adjudication platforms

Proficient in AS400, TANDEM and QL/PeopleSafe platforms

Proficient in SilverScript/RXClaims processing…handling escalated client member and patient issues

Proficient in handling errors in SilverScript overrides placed in AS400 and all errors in other platforms

Process incoming faxes from MDOs on SilverScript/AS400, TANDEM and QL/PeopleSafe for clinical prior authorizations

Top performer in the speed and efficiency of processing daily calls, escalated issues and faxes from MDOs and members

Employee of the Month “Happy Caller” award recipient

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