Harry L. Howard

*** **** ** *****

Hialeah, FL **010

Cellular 305-***-**** / E-mail: advpjv@r.postjobfree.com

CAREER OBJECTIVE: HEALTHCARE OPERATIONS / MANAGEMENT

PROFILE

Highly self-motivated achiever driven to set and attain goals. Team player with strong interpersonal, time management, organizational and training skills. Able to communicate effectively with various personality types while exhibiting leadership and professionalism.

PROFESSIONAL EXPERIENCE:

May 2017 Conviva Care Solutions Miami Gardens, FL

to Present Center Administrator

Direct supervision of supervisory personnel and ensure adequate staffing levels.

Ensures that work schedules and staffing patterns are implemented and recognizes and promotes teamwork.

Orientation and training of personnel on center policies and procedures.

Evaluate supervision personnel, employee performance and makes recommendations accordingly to leadership.

Counsel and disciplines employees when necessary, monitor productivity levels of personnel.

Planning, organizing, controlling, and scheduling for the daily expected volumes of (Commercial insurances, Medicare, Medicaid) patients, including the efficient and cost effective management of the clinic registration area.

Assist in developing and updating policy and procedures manuals. Process daily cash reconciliation/deposits and other reports to upper management for all center services and departments and experience resolving issues associated with patient financial responsibility accounts.

Develops progressive departmental goals and appropriate measures to ensure timely effective results.

Ensure continuity of care is established when patients are in the hospital and discharged.

Responsible for updating and creating new templates via electronic medical record eCW for staff physicians: Internal Medicine, Family Medicine. Specialists: Pediatrics, otorhinolaryngology (ENT), Dermatology, Neurology, Cardiology, Podiatry, Ophthalmology, Optometry, GYN, Gastroenterology, Orthopedics, Endocrinology and laboratory services.

Responsible of all procurements including capital equipment and modifications necessary for practical economical clinical practice operations.

October 2016 Aetna, Inc. City of Sunrise, FL

to May 2017 Supervisor, Service Operations (Medicare Part D) Call Center

Responsible for the daily activities and supervision of a team of employees supporting business segment functions, including but not limited to customer service, claim, provider services, complaints, grievances, and appeals, implementation, and/or plan sponsor operations.

Responsible for the quality, efficiency and effectiveness of own team, identifying and resolving routine problems. Sets priorities for and coaches employees to meet goals.

Develops, motivates, evaluates and coaches staff on work procedures, proper call handling and teamwork delivering excellent customer service. Is visible and available to staff to answers questions, monitor calls and give ongoing feedback. Utilizes available incentive programs to reward, recognize and celebrate team and individual successes. Assesses individual and team performance on a regular basis and provide candid and timely feedback regarding developmental and training needs; includes completion of monthly and annual scorecards. Establishes clear vision aligned with company values; motivates others to balance customer needs and business success.

Manages and monitors daily workflow and reporting to ensure business objectives are maintained and accurately reported; ensures resources are aligned appropriately across function and/or service center. Develops and maintains strong collaborative relationships with constituents and internal business partners to maintain excellent lines of communication and share resources to meet common service center objectives. Leverages the unit's resources to resolve plan, claim and call inquiries or problems by identifying the issue, obtaining applicable information, perform root cause analysis, and generate and act upon the solutions. Remove barriers to job performance and ensures regulatory compliance. Attracts, selects, and retains high caliber, diverse talent able to successfully achieve or exceed business goals. Builds a cohesive team that works well together. Acts as liaison between staff and other areas, including management, all segments, provider teams, etc., communicating workflow results, ideas, and solutions.

May 2016 Cigna-Healthspring DORAL, FL

to September 2016 Operations Specialist (Audit and Operations) Medicare Part D

Daily/monthly monitoring audits for all Part D operations in the department.

Enhance daily quality assurance review of denial letters and providers outreach to track and trend errors to allow for coaching and retraining as needed as well as modifications in Sanovia monthly loads.

Responsible for review of daily PBM (Optum Rx) prior authorization report to ensure that authorizations are built accurately.

Responsible for daily and monthly coverage determination universes.

Assist with the Preview of the Medication Therapy Management Review and participate with all Prior Authorizations eligibility questions via phone and email from Members, Providers, Physicians or authorized third parties.

October 2013 Larkin Community Hospital South Miami, FL

to Present Pharmacy Technician

Prepares prescriptions for dispensing by the pharmacist by retrieving, counting, pouring, weighing, and at times mixing medication

Makes requisitions for drugs and supplies with professional guidance from the pharmacists

Orders, receives, and maintains inventory of drugs and chemicals, and ensures their security

Verifies that information on the prescription is complete and accurate

Enters data in computer system, recording all the prescriptions, purchase orders, requisitions, and disbursements

Prepares insurance claim forms

Performs general clerical duties, such as answering phones, operating cash register, etc.

Performs other position-related duties as assigned, depending on assignment setting Additional Responsibilities for the Hospital Pharmacist.

August 2012 University of Miami MIAMI, FL

to April 2016 Patient Access Supervisor

The Mailman Center for Child Development: Pediatrics, Vascular Surgery, Cardiothoracic Surgery, Plastic Surgery & Orthopaedics

Ensures that all patients, customers, visitors, and staff are well served by providing a pleasant and organized atmosphere of operations that is appropriate for the requirements of all age groups, ethnic groups and physical handicaps.

Assists Practice Manager with the management functions of planning, organizing, controlling, and scheduling for the daily expected volumes of (Commercial insurances, Medicare, Medicaid, Exchange, Workers Comp.) patients, including the efficient and cost effective management of the clinic registration area.

Ensures all staff members adhere to all established policies and procedures related to the front desk business operations and continuously monitors compliance.

Monitors patient flow and communicates to Practice Manager of any issues, including wait times, in the registration and clinical areas throughout the day.

Conducts routine meeting with physicians, nurses and business operations staff in an effort to assist the Practice Manager in identifying performance improvement initiatives.

Provides needed coverage to other clinics as volumes dictate employing team collaboration and spirit.

Controls ordering and distribution of office supplies, patient care supplies, pharmaceuticals and equipment.

Motivates employees through the use of positive reinforcement and recognition of employee problems with efforts to resolve these problems.

Assists in completion of employee time bi-weekly payroll records in the Workday System to process payroll

Assists in monitoring staff productivity and quality of work through proactive reviews of attendance, data entry, scheduling accuracy.

Refers the patient to Financial Counselor when all attempts to collect fail or other financial matters need to be addressed with or by the patients and coordinate with bookkeeper all transactions entered in the system.

Runs all end of day reports from the EPIC/ UChart and credit card machines. Ensures that all is accounted for and balanced deposits monies collected from clinic operations for daily, weekly and monthly reconciliations.

March 2012 MOLINA HEALTHCARE of FL DORAL, FL

to April 2012 Pharmacy Services Supervisor

Under the direction of the Director, Pharmacy Services supervises the Pharmacy Technicians who support the processes involved with the review of non-formulary or prior authorization drugs. Also participates in the daily work flow of the department. Responsible for assuring that activities and functions are in accordance with Molina Healthcare Plan policies and procedures.

Assist with claim requests, notification, preauthorization and eligibility questions via phone and email from Members, Providers, Physicians or authorized third party for assigned region; handles within given deadline and service objectives.

November 2010 Optum Rx ( former Catamaran)

to March 2012 Pharmacy Benefit Management, MIRAMAR, FL

Supervisor, Pharmacy Technician & Failed Claims, (Front and Back Operations.)

Manages department function and daily operations of Technician Translation and Failed Claims pharmacy technicians (including prior authorization issues).

Monitors pharmaceutical care and priorities through productivity, quality, adherence and average handling time per script.

Assists operations manager, supervisors and other departments in day-to-day pharmacy operations organizing, scheduling and managing personnel.

Implement new procedures to ensure that the accurate and timely dispensing of quality pharmacy services is consistently delivered to all customers/residents using effective service leadership and customer skills.

Works with pharmacy management to control operating expenses by effective utilization of personnel, equipment and supplies to maintain and improve services within approved budget including inventory management, and materials handling.

Provide orientation, training, coaching, and feedback to all team members, including formal corrective actions.

Knowledge of warehousing and distribution configuration.

Knowledge of NCQA, URAC, FDA, DOT, OSHA, state, county and city regulatory specifications.

January 2009 WALGREEN COMPANY MIAMI, FL

to November 2010 Operations Group Manager, Central Pharmacy Operations,

(Call Center working environment)

Manages department function and daily operations of specified Group at the Central Utility Department.

Delivers the performance results for specified group; resolves operational issues. Administers company and divisional operation policies; assures the groups programs and procedures are in adherence.

Planning of operations, organizing and scheduling and management or personnel.

Monitors the quality of pharmaceutical care and customer service standards. Develops group employees through orientation, training and communication of rules, standards of performance.

Ensures compliance with federal, state, and local pharmacy regulations.

August 2007 PREVALENCE HEALTH PHARMACY DAVIE, FL

to June 2008 Operations Manager

• Responsible for overseeing Florida company facility operations: develops/implements policy, procedures and marketing.

• Plans, supervises personnel, customer service inquiries, financial reports, payroll, collections (hospital claims), hiring, pharmacy and Durable Medical Equipment operations.

• Procurement of supply chain, equipment, procurement of drugs/supplies, inventory performance. Knowledge with OSHA, JCAHO and AHCA regulations.

• Responsible for shrink from employees and daily oversight of shipping/results and provides local contact for shipping Carriers such as USPS, UPS and FED EX.

July 2003 WALGREEN COMPANY MIAMI, FL

to August 2007 Assistant Manager / Pharmacy Technician

• Assist with management and attainment of store sales, marketing, gross profit, expense, income and payroll budget.

• Assist with management and attainment of inventory budgets, which includes selecting and ordering new, promotional and permanent merchandise.

• Assist with company’s shrink goals ensuring accident free environment for both customers and employees.

• Coordinates with Physicians, Pharmacy Managers and Staff members toward the success of the pharmacy operation, including local Doctor Detailing (B2B) Respiratory Equipments, customer service and maintaining a working knowledge of the pharmacy functions including Managed Care, Medicare Part D reimbursements.

January 2003 MIAMI-DADE COUNTY DEPARTMENT OF HUMAN to April 2003 SERVICES, ELDERLY (TEMPORARY) MIAMI, FL

Social Worker I / Case Manager

• Responsible for a caseload of 65 or more clients who are in need of long-term care planning and service coordination. Responsible for assisting the client/caregiver in obtaining a valid, completed medical statement (3008) necessary for establishing program eligibility.

April 2001 AGENCY FOR HEALTH CARE ADMINISTRATION MIAMI, FL

to December 2001 Health Facility Evaluator II, M.CARE & HEALTH QUALITY DIVISION

• Coordinated and conducted survey and investigations of health care and residential facilities for state licensure and federal certification of the Medicare and Medicaid programs. Trained staff in methods for performing surveys and complaints investigations.

April 2000 DEPARTMENT OF ELDER AFFAIRS, STATE OF FLORIDA

to April 2001 MIAMI, FL Human Service Program Analyst, CARES UNIT

• Identified appropriate clients with diversion potential; coordinates and conducts comprehensive pre-admission screening assessments of applicants for nursing facility placement and home and community-based services; evaluated the level of care and recommended the appropriate placement; counsels applicants and/or responsible parties about the available resources. Identified appropriate clients for transitioning to community placement initiated from a nursing home or hospitals. Maintained accurate and up to date medical information on clients through regular documentation of casework activities.

August 1998 HEALTH MANAGEMENT SYSTEMS, NORTH PALM BEACH, FL

to September 1999 Health Financial Analyst

• Reviewed and evaluated managed care contracts. Responsible for billing and collection activities from health care providers, facilities, and insurance companies’ underpayments and overpayments. Maintained current, approved protocol and promotional materials to be included in financial and sales/marketing presentations. Managed DSS projects and provide training to hospital staff.

EDUCATION:

UNIVERSITY OF MIAMI, SCHOOL OF BUSINESS CORAL GABLES, FL

MASTER OF BUSINESS ADMINISTRATION DECEMBER 1997

SPECIALIZATION: HEALTH ADMINISTRATION AND POLICY

FLORIDA INTERNATIONAL UNIVERSITY, COLLEGE OF HEALTH AND URBAN AFFAIRS

BACHELOR OF HEALTH SERVICES ADMINISTRATION MIAMI, FL

DECEMBER 1995

CERTIFIED LEAN SIX SIGMA GREEN BELT

UNITED STATES NAVY, HONORABLE DISCHARGED: 07/84-05/88

CERTIFIED PHARMACY TECHNICIAN (CPhT) #3101-0105-0354-891

MARCH 2005

REGISTERED PHARMACY TECHNICIAN LICENSE # RPT 9080

LANGUAGES: FLUENT IN SPANISH (SPEAK, READ, and WRITE)

COMPUTER SKILLS: Strong proficiency with Microsoft Office 2010 (Word, Access, Excel, PowerPoint and Outlook).

Strong proficiency with DRGs, CPT-4, ICD-10, HCPCS, UB92, HCFA 1500.

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