Mercy Greene Resume

Responsible for planning process improvement, organizing, and managing the activities of the Core ReAuthorization department for pharmacies we supported. The department controlled ongoing authorization efforts to ensure patients’ expectations are met, to achieve exceptional client service and business profitability.
Supervised 12-14 direct reports. Lead by providing directions with respect to insurance requirements, authorizations, patient service and pharmacy benefits operations to achieve customer satisfaction through effective communication, problem solving, professionalism and efficient processes.
Hired, trained staff to enhance and improve overall authorization capabilities, and facilitate professional growth. Coached and conducted performance appraisals and disciplined staff as needed.
Used Microsoft Teams tools to streamline clinical outreach processes 60% resulting in increased efficiency in managing the queue volume for the South-East Region pharmacies with direct benefit to patient census clean up rates and case resolution rates for my team. Other duties as assigned.

Assisted with Specialty Authorization QA Audits as well as other EPIC Cutover Specialty Projects assigned including Benefits & Authorization Conversion from the Legacy (HCN/Salesforce) systems to EPIC.
It was on me to train new staff to the department, facilitate and enhance their onboarding experience to their new role. Prepared materials for training, provided timely quality audit checks and coaching to enhance professional growth and overall work performance of team members.
Partnered with leadership and corporate learning consultants to improve and create simplicity of auditing tools for the department to ensure end user success.
Managed the department escalations DL. Resolved and coordinated appropriate corrective actions.

Directed workflow assignments for the team to perform seamless intake procedures related to Home Infusion insurance coverage authorizations for new and existing patients to ensure that patient orders were processed in an accurate and efficient manner.
Provided training of new hires to the department. Provided quality control checks, coaching and feedback to enhance professional growth of team members.
Scheduled and delegated work to staff when covering for my supervisor. Other duties as assigned.

Processed home infusion orders from referral sources to ensure patients received their infusion drugs timely.
Verified patient insurance coverage and obtained authorizations to ensure path to payment for our services.

Performed quality audits for all non-clinical staff in the department and oversaw that performance audit efforts were implemented and completed on schedule, and in accordance with state and federal regulations.
Key achievement includes, developing audit reports on performance assessments with action plan workflows and uploading them to a SharePoint for supervisors and managers to access and communicate quality feedback to their direct reports.

Accountable to ensure performance and effectiveness of the department. Monitored staff operations and productivity to ensure department objectives are met to improve revenue and customer satisfaction.
Functions included, hiring, training, coaching for timely feedback and quality control audit checks to enhance professional development and KPIs. Other duties as assigned.

Coordinator for patient care services of Utilization Management /Ancillary Intake.
Processed intake requests related to medical insurance precertification of discharge planning services.