Sheneq Daniels
Atlanta,GA
Summary
Experienced healthcare professional with over 10 years in pharmacy operations and pharmacy benefit management. Expertise in managing complex client accounts, ensuring contract compliance, and resolving member issues. Proficient in Salesforce, RxClaim, and Epic, with a strong focus on delivering customer satisfaction and fostering client relationships in dynamic healthcare environments.
Overview
1
1
Certification
11
11
years of professional experience
Work History
Senior Account Manager
CVS Healthcare
Atlanta, GA
01.2023 - Current
- Manage client accounts while ensuring contractual obligations, service level agreements, and performance expectations are consistently met.
- Build and maintain strong client relationships to drive customer satisfaction, retention, and long term account success.
- Resolve complex member and client issues by coordinating with internal departments and utilizing pharmacy benefit management systems.
- Review and process prior authorizations, overrides, and mail, retail, and, specialty pharmacy requests while ensuring regulatory and contractual compliance.
- Generate and analyze reports to monitor account performance, identify trends, and support operational decision making.
- Leveraged Salesforce, AS400, SPARCS, PeopleSafe, and other company tools to document cases and manage workflows effectively.
- Maintain expertise on new healthcare programs, pharmacy benefit offerings, and operational updates to provide timely and accurate guidance.
- Collaborate with cross functional teams to improve service delivery and resolve escalated client concerns efficiently.
Care Concierge
Humana
Atlanta, GA
11.2022 - 01.2023
- Conducted comprehensive reviews of in home wellness assessments to identify member healthcare needs.
- Managed over 20 member referral processes daily in collaboration with clinical and specialty departments to enhance member access to appropriate follow up care.
- Provided comprehensive support to members in understanding and utilizing healthcare resources and benefits.
- Maintained precise documentation practices to support HIPAA compliance and enhance member satisfaction.
Certified Pharmacy Technician
CVS Pharmacy (CVS Healthcare)
Raleigh, NC
12.2015 - 09.2022
- Processed prescriptions while maintaining compliance with HIPAA and pharmacy regulations.
- Executed entry and verification of insurance information to enhance claims processing accuracy.
- Collaborated with pharmacists to streamline prescription processing and optimize inventory management practices.
- Developed employee schedules to optimize staffing and enhance pharmacy operations.
- Delivered exceptional customer service while resolving prescription and insurance issues.
- Utilized RxConnect, Epic, and pharmacy management systems to maintain accurate patient records and prescription processing.
Education
Psychology
Capella University
Chemistry
Wofford College
Spartanburg, SC05-2013
Skills
- Healthcare & PBM
- Specialty and Non-Specialty Pharmacy Operations
- Contract Compliance
- Implementations
- Software
- Salesforce
- RxClaim
- RxConnect
- Epic
- Microsoft Office
- Professional
- Account Management
- Customer Relationship Management
- Case Management
- Customer Retention
- Reporting
- Data Entry
- Cross-Functional Collaboration
- Communication
- Customer Service
Certification
- CPhT - Certified Pharmacy Technician
Timeline
Senior Account Manager
CVS Healthcare
01.2023 - Current
Care Concierge
Humana
11.2022 - 01.2023
Certified Pharmacy Technician
CVS Pharmacy (CVS Healthcare)
12.2015 - 09.2022
Psychology
Capella University
Chemistry
Wofford College