Robin Katona
Buckeye
Summary
Dynamic PDE Manager at CVS Health with a proven track record of leading a team achieving a 99.5% acceptance rate. Expert in SAS programming and advanced analytics, I foster workforce development while driving operational improvements. Adept at cross-department collaboration, I leverage data insights to enhance performance and customer satisfaction.
Overview
18
18
years of professional experience
Work History
PDE Manager
CVS Health
05.2023 - Current
- Maintain an industry leading average acceptance rate of : 99.5% across all Med-D Clients.
- Migrated reporting from AS400 to a suite of SAS queries that leverages existing data warehouse infrastructure.
- Created canned queries for PDE corrections which provide templates that are then submitted to Prod Support for processing.
- Participate in CSX meetings cross collaborating with different departments, Pharmacy Audit and Adjustment Services to the best practice of reviewing Validation Reports
- Develop tools to analyze and track records related to Acumen Audits initiated by Center of Medicare/Medicaid Services (CMS)
Enablement Manager
CVS Health
09.2022 - 05.2023
- Worked closely with Encounter Operations to gather requirements and translate them into technical specifications for implementation.
- Created dashboards within Salesforce to ensure cases were being tracked and closed timely.
- Created metrics by leveraging benchmarks within Salesforce to identify opportunity for improvement.
- Participated in regular code reviews, ensuring high-quality standards were consistently met across all development efforts.
Encounter Manager
CVS Health
09.2017 - 04.2022
- Managed and motivated a team of six to be productive and engaged for a multitude of different State Medicaids including AZ, OH, DE, AR, TN, MA
- Cross-trained existing employees to maximize team agility and performance.
- Mentored junior team members for career advancement, fostering a pipeline of future leaders within the organization.
- Enhanced customer satisfaction by resolving disputes promptly, maintaining open lines of communication, and ensuring high acceptance rates.
Encounter Advisor
CVS Health
09.2016 - 08.2017
- Maintained up-to-date knowledge on industry trends and regulations, ensuring accurate advice was provided to clients at all times.
- Managed risk effectively by closely monitoring standard reporting and performing timely corrections and/or voids.
- Navigated complex regulatory requirements to ensure compliance in all encounter requirements.
Encounter Sr. Analyst
CVS Health
07.2014 - 08.2016
- Became subject-matter-expert of AHCCCS (AZ Medicaid)
- Collaborated with cross-functional teams to identify areas of improvement, leading to increased operational effectiveness.
- Analyzed encounter data to identify root causes of problems and recommend corrective actions.
Collections Agent
Preferred Homecare
09.2013 - 07.2014
- Created and maintained TPA (Third Party Administer) tool to help maintain contracts, which is still utilized today.
- Built rapport with customers by demonstrating understanding of their situation while seeking fair resolutions.
- Processed payments and applied to customer balances.
- Maintained high volume of calls and met demands of busy and productive group.
Collections Lead
Apria Healthcare
09.2007 - 09.2013
- Collaborated with cross-functional teams to develop comprehensive debt recovery solutions for complex cases.
- Implemented new technology tools for better tracking of collection efforts, increasing efficiency and effectiveness across the department.
- Improved collection efficiency by analyzing customer data and developing targeted action plans.
- Liaised effectively with sales and customer service departments to coordinate efforts for maximizing revenue collection while maintaining client satisfaction.
Education
High School Diploma -
Red Mountain High
Mesa, AZ05-2006
Skills
- Advanced analytics proficiency
- SAS programming
- Data manipulation using SQL
- Advanced Excel proficiency
- Certified Six Sigma Yellow Belt (CVS, 2014)
- Workforce development
Timeline
PDE Manager
CVS Health
05.2023 - Current
Enablement Manager
CVS Health
09.2022 - 05.2023
Encounter Manager
CVS Health
09.2017 - 04.2022
Encounter Advisor
CVS Health
09.2016 - 08.2017
Encounter Sr. Analyst
CVS Health
07.2014 - 08.2016
Collections Agent
Preferred Homecare
09.2013 - 07.2014
Collections Lead
Apria Healthcare
09.2007 - 09.2013
High School Diploma -
Red Mountain High
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