Account Manager Project Management

Danielle R. Davis-Polk

*** ****** **. ● Gulfport, MS ● 39503 ● 228-***-****

*******@***.***. LinkedIn: www.linkedin.com/in/danielle-davis-polk-m-s-88768131

Objective Statement

Account Manager with over 5 years of experience in Pharmacy Benefit Management (PBM) client account management, including 3+ years in Medicare and health plan account management. Proven ability to build and maintain strong client relationships, ensuring seamless onboarding and ongoing support while championing clients' operational requirements. Adept at leading cross-functional teams, managing complex implementations, and enhancing service performance to meet and exceed client expectations. Demonstrates strong project management skills, operational readiness expertise, and experience with PBM benefits design setup. Committed to driving customer satisfaction and operational excellence through initiative-taking, problem-solving, and fostering collaboration among diverse stakeholders.

Licensure/Education

Producer – Accident & Health or Sickness, Life - MS Insurance Department

M.S. Organizational Leadership – Walden University, Minneapolis, MN

Bachelor’s General Studies – William Carey University, Gulfport, MS

Knowledge, Skills, and Abilities

•Extensive knowledge of PBM services and Medicare regulations

•Strong project management and operational readiness expertise

•Proficiency in Salesforce CRM principles

•Excellent decision-making and people skills

•Proven track record in enhancing client relationships and operational efficiency.

•Ability to champion new features and product offerings as a Subject Matter Expert

•Comprehensive knowledge of healthcare benefits and product suites

•Skilled in market presentations and client reviews

•Familiar with healthcare-related state and government regulations (Medicaid, CMS)

•Excellent critical thinking skills, focused on conflict resolution and confidentiality.

•Strong people skills, capable of positive client interactions at all levels

•Accountability for achieving service commitments and delivering results under tight timelines.

Experience

Qualexa (Healthy MS – HMI) – Flowood, MS

Community Resource Executive (Temporary)

February 2025 – Present

•Build relationships with community influencers and gatekeepers to venues for Brokers to prospect and educate seniors.

•Collaborate with provider groups to ensure network adequacy or expansion.

•Partner with providers to promote HMI to physician staff and Medicare beneficiaries.

•Ensure adherence to Medicare marketing guidelines and compliance regulations.

•Deliver Medicare educational presentations and engage with community resources at events to support seniors.

•Develop new relationships within medical communities, both within and outside current operational areas.

•Provide HMI resource assistance and services to providers, community associations, and senior communities.

•Assist sales agents in developing marketing plans and strategies.

•Serve as a liaison between the clinical team and provider contracting team.

MedImpact - San Diego, CA

Account Manager - Government Programs

May 2023 – February 2025

•Collaborated with Service, Product, Clinical, Data, and Marketing teams to strengthen business relationships with clients, ensuring alignment with Medimpact’s strategic goals.

•Developed and maintained solid client business relationships, ensuring positive onboarding experience and ongoing operational support for PBM services.

•Championed clients’ operational requirements, including benefit design objectives and pharmacy network composition, ensuring proper service levels.

•Led the implementation process for new business, ensuring timely and accurate documentation and communication of client commitments.

•Utilized project management skills to track milestones, manage risks, and provide regular status updates to internal and external stakeholders via Salesforce.

•Analyzed claims results, identified discrepancies, and proactively recommended solutions for operational improvements.

Optum - Minnesota, MN

Account Manager, Client Services

March 2021 - February 2023

•Managed all aspects of customer relationships, focusing on contract development, operational implementation, and compliance for clients.

•Led cross-functional teams to enhance operational effectiveness, ensuring client support met their needs and deliverables and enhanced operational effectiveness based on project management principles.

•Facilitated meetings with Employer Groups in assigned book of business to build relationships and promote other product opportunities; assisted with necessary follow-up with clients.

•Documented interactions with assigned accounts and input into Salesforce, including but not limited to meeting agendas and notes, key decisions and outcomes, next steps, agreed actions, and responsible parties.

•Collected and analyzed data to understand client behavior and identify opportunities for improvement.

United Healthcare - Ridgeland, MS

Community Sales Representative, Medicare, and Retirement

December 2017 – March 2021

•Built relationships with Community Based Organizations to drive awareness and growth of DSNP and Medicare Advantage initiatives, enhanced ongoing support to meet their needs.

•Conducted training and community outreach to educate clients on plans, ensuring they were informed of changes and benefits.

•Maintained up-to-date client (providers, office managers, billing staff, and front office staff) information, as well as outreach, sales events/activities, leads, and interactions in customer relationship management (CRM) tool (Salesforce).

•Analyzed agents and events, proactively recommended solutions, contributing to operational improvements and satisfaction.

United Healthcare - Ridgeland, MS

Community Outreach Specialist – Medicaid/CHIP

June 2015 - December 2017

Established community presence and visibility to drive outreach initiatives for Medicaid eligible individuals.

Developed relationships with key partners and facilitated education on benefits and policies, ensuring effective communication of changes.

Facilitated, educated, and recommended providers of comprehensive policies and procedures involving all phases of the organization’s benefits and contracts via office visit, email, and Webex.

Facilitated the resolution of any issues, enhancements or process changes that arise during the course of day-to-day operations.

Set-up event participation, including setting up booth/table, collateral materials, games, and engagement interactions, and other supplies for exhibits, and meetings with the community.

Maintained up-to-date client (providers, office managers, billing staff, and front office staff) information, as well as outreach, sales events/activities, leads, and interactions in customer relationship management (CRM) tool (Salesforce).

Coastal Family Health Center (FQHC) - Biloxi, MS

Outreach & Enrollment Project Coordinator

September 2013 – September 2014

Assisted in developing outreach enrollment initiatives, tracking successes and barriers to increase community engagement.

Created clear resources to support members in understanding health insurance and Medicaid policies.

Developed accurate and disseminated clear, easy-to-understand resources and materials to support the organization’s members in outreach and enrollment and messaging strategies, and understanding the Health Insurance Marketplace, Health Care Reform, and Medicaid (MSCAN, CHIP) policies and changes.

Engaged with communities to raise awareness of available resources (i.e., Patient Assistance Programs), programs, and services that supported low-income families in managing healthcare costs.

Networked with federal, state, local agencies, and partners to determine the needs and understand infrastructures for outreach and enrollment.

Facilitated the resolution of any issues, enhancements or process changes that arose during the course of day-to-day operations.

MS Select Healthcare – Gulfport, MS

Network/Contracts – Claims

September 1999 – September 2001

Collaborated with teams to enhance health and RX claims processing efficiency and accuracy, ensuring compliance with regulations.

Functioned as a subject matter expert for all claims processing, providing guidance and support to team members.

Addressed provider concerns and issues related to health benefits, pharmacy benefits, claims processing ensuring timely and effective resolutions.

Analyzed and reported on performance of pharmacy benefit plans, including cost savings, OOP reimbursement, utilization, and member satisfaction.

Assisted in negotiating contracts with healthcare providers to ensure favorable terms for the plan.

Ensured provider network met quality, costs, and coverage standards of the plan.

Built and maintained relationships with healthcare providers and resolved any issues that arose.

Assisted with conducting regular reviews and audits of the provider network to ensure compliance with regulatory requirements.

Contributed to design and implementation of programs that built and nurtured positive relations between the health plan, providers, and practice managers.

Responsible for ownership of provider claim projects from initial project contact, identification and resolution of claim payment issue, and communication of outcome to project contact.

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