Gabriela Bejan
Project Manager/ Quality
- Role
- Clinical Quality Assurance Specialist at Elixir
- Location
- Cleveland, OH, US
- LinkedIn followers
- 500 followers
About Gabriela Bejan
A positive individual who can maintain an upbeat atmosphere while getting a high volume of work completed. Excellent problem solving and communication skills. Excellent analytical abilities to grasp the key points from complicated details. A strong leader recognized for solid judgment, critical thinking, and the ability to motivate and develop key personnel. Adept in managing multiple tasks and completing time-sensitive projects.
Experience
Clinical Quality Assurance Specialist
Jul 2017 — Present · Twinsburg, OH, US
Responsible for supporting Coverage Determination Appeals & Grievance (CDAG) function of the company in accordance with the policies and practices of EnvisionRxOptions. Responsible for maintaining quality assurance (QA) for coverage determination and redetermination requests while maintaining the exceptional level of professionalism and customer service standards that Envision has attained within the pharmacy benefit management industry. Development, revision, and management of policies and procedures within the Clinical Operations department. Compile documentation and perform audits of coverage determination and redetermination activities. Provide management with documented quality-related concerns and make recommendations for individual or group training initiatives. Establish and maintain a quality improvement reporting and measurement system for clinical operations. Perform training in all aspects of CDAG quality management systemProvide support for investigations of quality-related customer complaints or compliance activities, including trending activities. Identify and trend potential problems and areas for performance improvement
Education
Villanova University
Certification, Six Sigma Green Belt – Healthcare
2011 — 2011
University GH Asachi
Bachelor Degree, Science in Technology
1986 — 1991
Villanova University
Certification, Mastering Project Management
2012 — 2012
University of Phoenix
Master of Business Administration (M.B.A.), Health/Health Care Administration/Management, 3.82
2010 — 2012
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