KERRI M. PAULSON, MBA, CPHT, ACPM, CSPO

** ********* ** *********, ** 28804 adr5ef@r.postjobfree.com 828-***-**** mobile

Results driven and motivated pharmacy technology professional with 25+ years of experience in healthcare and pharmacy in a variety roles

Managed care product management Methodologies leadership/team building

pharmacy technology retail pharmacy operations

SUMMARY OF QUALIFICATIONS

Ownership of new product development projects for pharmacy and healthcare technology solutions

Agile Product Owner participating in standard ceremonies in support of new product development

Manage a team of audit specialists retail pharmacy support representatives and business analysts

Superb communication skills used to successfully build organizational relationships that result in a positive and productive working environment.

Exceptional problem solving skills used to effectively analyze, identify and solve complex problems and issues.

Independent thinker who is comfortable making decisions with minimal oversight; but, who also thrives in a team environment.

Computer proficient in Microsoft Office, MS Project, Jira and various Pharmacy Processing Systems

PROFESSIONAL EXPERIENCE

BAMBOO HEALTH April 2022 – Present

LOUISVILLE, KY (Remote)

Appriss Health and PatientPing have come together as Bamboo Health, creating one of the largest, most interoperable care collaboration networks in the nation, able to serve the physical and behavioral health of every patient. At Bamboo Health, we’re transforming patient care in America by providing solutions and networks that enable payers, providers, and care teams to collaborate on patients across almost the entire continuum of care.

ASSOCIATE PRODUCT MANAGER, OPIOID SOLUTIONS

Lead discovery for new compliance product for pharmacies

Manage requirements gathering and development efforts for new product development projects

Product Owner on Agile SCRUM team

Translate business requirements into User stories and acceptance criteria for development team

SELECTED ACCOMPLISHMENTS:

Instrumental in the Design of Bamboo Health’s pharmacy compliance product vision

GEMINI HEALTH, LLC May 2018 – April 2022

SAUSALITO, CA (Remote)

Gemini Health was founded in 2014 by seasoned healthcare executives and clinicians with decades of experience in healthcare and health information technology and a successful track record in start-up companies. Gemini Health is based in Sausalito, California and has offices in Atlanta, New York and Philadelphia. Gemini Health was formed to reduce healthcare costs through drug cost transparency at the point of care.

DIRECTOR, PRODUCT INNOVATION

Day to day management and ownership of Gemini’s drug cost decision support products for prescribers

Manage Product Roadmaps and lead development efforts for new and existing product development projects

Product Owner on Agile SCRUM team

Translate business requirements into User stories and acceptance criteria for development team

Provide technical product support and training to internal and external customers

SELECTED ACCOMPLISHMENTS:

Instrumental in the Design of Gemini’s real-time drug cost decision support solution for prescribers at the point of care

Successfully implemented best-in-class solution for multiple health systems, fully-integrated within their EHR Systems

Assisted in implementation of Agile/SCRUM processes within the IT Team

ERX NETWORK (Formerly CHANGE HEALTHCARE/EMDEON) September 2009 – May 2018

FORT WORTH, TX (Remote)

Our high-speed pharmacy network provides comprehensive, flexible solutions for pharmacies that are designed to integrate into existing workflows for maximum efficiency. The claims switching service provides access to all U.S. third party processors. Comprehensive services include claims processing and editing, real-time insurance verification, e-prescribing, medical and vaccination claims billing and other services. Innovative solutions such as targeted messaging and electronic co-pay programs are available as well as web-based tools that provide transparency into claim information for analysis and reporting.

TECHNICAL PRODUCT MANAGER IV

Day to day management and ownership of several pharmacy products; including Pre and Post Edit, Payer Compliance (real-time AWP resubmission), Web Service Solutions, Electronic pharmaceutical coupon programs and Risk Evaluation and Mitigation Strategy (REMS)/ electronic eligibility verification programs

Translate business requirements into User stories and acceptance criteria for development team

Provide technical product support and training to internal and external customers

SELECTED ACCOMPLISHMENTS:

Instrumental in the Design of the industry’s first electronic process for validating pharmacy, prescriber and patient enrollment in a manufacture’s REMS program

Successfully implemented new processes to improve manufacturer program setup process and improve implementation times for new programs

Assisted in implementation of Agile/SCRUM processes within the Product Management Team

BRIGHTREE, LLC April 2014 – September 2014

LAWRENCEVILLE, GA (Remote)

Leading provider of innovative technology solutions to improve clinical and business performance to the post-acute healthcare industry

PHARMACY PRODUCT MANAGER

New Product development and day to day management of Pharmacy Software platforms

Manage Product Backlog for development and design of new Infusion platform

Day to day management of integrated HME Pharmacy platform

SELECTED ACCOMPLISHMENTS

Implemented and standardized NCPDP Telecommunications Standards within Infusion system

Implemented backlog and Roadmap review processes with development manager

LONGS DRUG STORES August 2002 - July 2009

WALNUT CREEK, CA

Leading regional pharmacy chain store with 500+ stores in California, Hawaii, and Nevada with approximately 22,000 employees and $4.7B in annual sales.

MANAGED CARE REIMBURSEMENT MANAGER

Successful business manager of a centralized Pharmacy Audit program that results in a $200,000 annual savings to the company

Monitor and analyze all aspects of pharmacy reimbursements and recommend solutions for improvement

Formulate, develop, and implement Point of Sale Edits resulting in maximized third party reimbursements

Provide third party plan payer performance reports to senior management in support of their decision making and contracting efforts

Manage a team of Help Desk Representatives who support 500+ pharmacies

Manage claim rebilling activities for the entire chain

Selected Accomplishments:

Centralized third party audit activities resulting in a savings due to audit paybacks of over $200,000 per year

Manage AWP Resubmission program resulting in an annual increase in pharmacy claim reimbursement of over $550,000 annually

Designed and developed POS Edits that increased margin by insuring that all pharmacy claims are processed and reimbursed correctly

BLUE SHIELD OF CALIFORNIA September 1998 – August 2002

SAN FRANCISCO, CA

Not-for-profit health plan with over 3.2M covered lives, 4,500 employees and $7.5B in annual sales.

PHARMACY NETWORK MANAGER January 2001 – August 2002

Successfully managed and contracted a network of 50,000 pharmacies nation-wide

Developed, implemented and managed a pharmacy audit program resulting in plan and member savings

Managed MAC reimbursement program resulting in plan savings on generic prescriptions filled by network pharmacies

Liaison between the plan and the processor on issues related to prescription claims processing and adjudication; main point of contact for network pharmacies

SENIOR PRIOR AUTHORIZATION TECHNICIAN September 1998 – January 2001

Supervise, train and monitor 10+ junior level prior authorization technicians in a call center environment

Review and research drug treatment history in support of formulary coverage criteria

Selected Accomplishments:

Developed Desk Audit program which resulted in a decrease in per-member-per-month pharmacy costs to the health plan and to members

Managed a MAC reimbursement program which decreased generic prescription costs to the plan by an average of $10.00 per prescription

CORAM HOME INFUSION PHARMACY September 1997 – September 1998

HAYWARD, CA

Closed-door home infusion pharmacy and home health agency

INTRAVENOUS PHARMACY TECHNICIAN

Intravenous admixture compounding

Home infusion therapy supply order entry

Selected Accomplishments:

Managed clean room sterility protocols and documentation which led to ongoing OSHA accreditation of the facility

OLSTEN HEALTH SERVICES December 1996 – September 1997

ALAMEDA, CA

Closed-door home infusion pharmacy and home health agency

INTRAVENOUS PHARMACY TECHNICIAN

Intravenous admixture compounding

Home infusion supply ordering and inventory

PAYLESS PHARMACY December 1995 – December 1996

EL CERRITO, CA

Retail pharmacy (now Rite Aid)

PHARMACY TECHNICIAN

Customer service

Order entry and filling

Inventory management

VALLEY MEDICAL CENTER January 1995 – December 1995

RENTON, WA

Retail pharmacy (now Rite Aid)

PHARMACY TECHNICIAN

Customer service

Order entry and filling

Inventory management

NMC HOMECARE July 1993 – January 1995

SACREMENTO, CA AND BELLEVUE, WA

Closed-door home infusion pharmacy and home health agency

INTRAVENOUS PHARMACY TECHNICIAN

Intravenous admixture compounding

Home infusion supply ordering and inventory

EDUCATION AND TRAINING

MASTER OF BUSINESS ADMINSTRATION October 2000

UNIVERSITY OF PHOENIX Walnut Creek, CA

BACHELOR OF SCIENCE – HEALTH SCIENCE September 1998

Concentration: Health Care Administration

CALIFORNIA STATE UNIVERSITY – EAST BAY Hayward, CA

SPECIALIZED TRAINING AND CERTIFICATIONS

Certified SCRUM Product Owner (CSPO), SCRUM Alliance

Optimal Product Management Certification, 280 Group

Agile Certified Product Manager (ACPM), American Institute of Product Management and Marketing

Technician Product Verification Certification, National Pharmacy Technician Association (NPTA)

Technician Medication History Certification, National Pharmacy Technician Association (NPTA)

Technician Hazardous Drug Management Certification, National Pharmacy Technician Association (NPTA)

Monitoring Clinical Studies, Clinical Research Training

Project Management Certification, Villanova University, Independent Study

Pharmacy Technology Certification, Western Career College, Sacramento, CA

Hospital Unit Coordinator, Sierra Vista Regional Medical Center, San Luis Obispo, CA

PROFESSIONAL AFFILIATIONS/ ACCOMPLISHMENTS

Advanced CERTIFIED PHARMACY TECHNICIAN (CPhT-Adv) in progress

NORTH CAROLINA STATE LICENSED PHARMACY TECHNICIAN

CERTIFIED PHARMACY TECHNICIAN (CPhT)

Member, National Council for Prescription Drug programs (NCPDP)

MEMBER, NATIONAL PHARMACY TECHNICIAN ASSOCIATION (NPTA)

ACADEMY BOARD MEMBER (2005 – 2008), CALIFORNIA PHARMACISTS ASSOCIATION

ITEM WRITER (2004), PHARMACY TECHNICIAN CERTIFICATION BOARD

Co-author of CE program on third party audits for cpha outlook 2009

References Available Upon Request

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