Home Nurse Contract Specialist

JESSICA JOHANAN

***************@*****.*** 216-***-****

SUMMARY

oDecades of experience in managed care and customer-facing roles.

oExperienced professional with excellent communication, customer service, project management, and organizational skills.

oAdaptable team player with growth mind-set and high technical aptitude.

SOFTWARE

Model N Flex (2023), Google Suite (2022), MS Office (2022), EPIC (2021), PeopleSoft (2021), Work (2021) Day, ADP, Microsoft Excel and Advanced (2022)

PROFESSIONAL EXPERIENCE

Associate Contract Manager

Genentech (San Francisco, California)

oReads and Understands detailed contract rules and regulations for the proper reimbursement of chargeback credits for pharmaceutical discount programs for eligible clients (wholesalers).

oProcess High Volumes of daily chargebacks for DSH, Apexus, GPOs, and provider discount programs for 2 of 3 large distributors with compliance and attention to detail, ensuring on time processing and accuracy.

oResolve chargeback issues and resubmissions with urgency to maintain excellent customer relations.

Benefits/FMLA Specialist

OneSkyy (Cleveland, OH) 2022 – 2022

oProcess high volumes of daily chargebacks for DSH, Apexus, GPOs, provider discount programs for 2 of Big 3 distributors with compliance and attention to detail, ensuring on-time processing and accuracy.

oResolve chargeback issues and resubmissions with urgency to maintain good customer relations.

Administrative Support and Teaching

Cleveland Municipal School District (Cleveland, OH) 2020 – 2022

oSupported administrators and teachers in providing education to elementary & high school students.

oAs PTA president, led meetings with various stakeholders and exercised diplomacy in resolving conflicts and creating alignment among stakeholders (parents, administration, and teachers).

Contract Specialist

Advanced Recovery Concepts (Beachwood, OH) 2019 – 2020

oProcessed billing to patients and medical claims to insurance companies for mental health clinic services, maintaining highest level of patient confidentiality. Ensured positive cash flow for optimal revenue cycle management. Appealed denials from insurance companies to cover medications.

oExperienced with EPIC electronic medical records system, used for managing Cleveland Clinic referrals. Ensured insurance information is accurately loaded. Inputted complex procedure and medical codes.

oCoordinated contracts between clinic and providers from proposal stage through submission and execution. Reviewed and negotiated contracts. Set up new provider accounts.

Coordinator, Ostomy Care Contracts and Billing

Cardinal Health fka Edgepark Medical Supply (Twinsburg, OH) 2018 – 2019

oProcessed orders, billed insurance and drop-shipped ostomy products to patients’ homes.

oProvided support for new product launches, resolving escalated customer inquiries for complex billing issues and questions.

Sponsored Projects - Grants and Contract Specialist

Case Western Reserve University (Cleveland, OH) 2014 – 2017

oManaged budgets for NIH and other publicly and privately sponsored grants for Principal Investigator (PI) research projects, ensuring allocation criteria were met. Coordinated the accounting and pre-award administration functions, ensuring compliance with federal and other applicable laws.

oOversaw and managed individual contracts and scope of work funded by umbrella grants in PeopleSoft Financial system, ensuring compliance with publicly and privately sponsored grants. Oversaw distribution of grant money to various contracted recipients.

oDevised and implemented policies and procedures for grant and contract process. Analyzed and resolved issues.

Alumni Relations & Development Coordinator

Case Western Reserve University (Cleveland, OH) 2013 – 2014

oDisplayed growth mind-set and high technical aptitude working with IT to master Case Western’s proprietary Ellucian Advance alumni database in order to manage alumni relations and mailings.

oCreated fundraising events for nursing school expansion projects and scholarship program.

oInterviewed, hired and supervised student workers for nursing school jobs. Managed task assignments, timesheets and payroll.

oPrepared annual report data for donors and other stakeholders. Provided input for retrospective debriefs with the goal of improving fundraising efficiency.

oContributed to community building, supporting university culture and next generation of healthcare workers.

Program Case Management Specialist

Clinical Specialties Inc. fka Optum (Brecksville, OH) 2013 – 2014

oMarketed preventive transition care program to senior and critically ill patients, in order to reduce hospitalization rates and reduce healthcare costs.

oScheduled in-home nurse visits to increase patient adherence to treatment regimens and avoid missed clinic appointments.

Absence Management Specialist

CareWorks USA (Dublin, OH) 2012 – 2013

oProcessed FMLA cases for HR departments for companies in California.

Medicare Billing

BioScrip (Columbus, OH) 2011 – 2012

oBilled Medicaid and Medicare for enteral and parenteral drug therapy for critically ill and senior patients unable to ingest solid food.

Facilities Manager

Indiana Wesleyan University - part-time (Mayfield Heights, OH) 2010 – 2012

oProvided community with services to support instruction and learning.

oManaged Cleveland satellite location providing on-site students with laptops, user account assistance and miscellaneous needs.

oProvided tech support services and equipment setup for instructors.

Customer Service

Boehringer Ingelheim fka BenVenue (Bedford, OH) 2010 – 2011

oSupported pharmaceutical sales reps with product inventory inquiries for new business.

Program Support; Clinical Services Specialist

MemberHealth (Solon, OH) 2007 – 2010

oUpdated formulary product list and coverage levels per P&T committee decisions. Compiled paperwork for insurance appeals process. Helped pharmacists troubleshoot billing errors in order to ensure coverage for patients.

IV Technician

Medical Service Company (Oakwood Village, OH) 2006 – 2007

Hillcrest Hospital (Mayfield Heights, OH) 2005 – 2006

oCompounded medicine. Prepared and delivered single dose treatments of IV bag infusions, oral suspensions, creams and suppositories. Packaged comfort care supplies for hospice patients.

Pharmacy Technician

Walgreens Pharmacy (University Heights, OH) 2005 – 2005

CVS Pharmacy (Cleveland Heights, OH) 2003 – 2005

oFilled prescriptions, billed insurance companies, processed payments and managed weekly inventory.

oManaged inventory for expiring and unclaimed prescriptions.

oProcessed chargebacks for returns of expiring product.

EDUCATION

Bachelors of Science in Health Science, Cleveland State University

Masters of Science in Legal Studies, Purdue University Global

VOLUNTEER EXPERIENCE

Cuyahoga County Men’s Shelter 2018/2019 (Lakeside/Cleveland, Ohio)

PTA – President – 2021/2022 Academic Year (Cleveland Heights, Ohio)

PTA – Bylaws Committee Chair – 2022/2023 Academic Year (Cleveland Heights, Ohio)

NAMI – Member – 2023 (Cleveland, Ohio)

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