Joseph Dibiase

About Joseph Dibiase

I am a heath care operations leader with 10 years experience driving compliant, scalable processes across Medicare Part D. I’ve led multiple CMS program audits- data validation, 1/3 financial and targeted—building audit ready controls and cross functional playbook. My background spans end to end Part D claims adjudication and deep expertise in Coverage Determinations, Appeals and Grievances where I have improved turnaround times and accuracy while safeguarding the member experience.I’ve implemented the Medicare Prescription Payment Plan from strategy through go-live, stood up a clinical review platform to strength utilization management and transparency, and managed complex vendor relationships to deliver outcomes on time and within budget. I’m known for pragmatic leadership, clear communication and turning regulatory requirements into repeatable operational excellence.

Experience

1. Senior Director, Goverment Programs Operations

   Prime Therapeutics

   Jun 2023 — Present

Education

• University of Rhode Island

  Bachelor's degree, Biotechnology

  2012 — 2015

• Community College of Rhode Island

  Associate of Science (A.S.), Physical Sciences

  2006 — 2010

Skills

• Medication Therapy Management
• Biotechnology
• Medical Terminology
• Community Pharmacy
• Management
• Hospitals
• Patient Education
• Pharmacy
• Healthcare Management
• Time Management
• Patient Safety
• Microsoft Office
• Sales
• U.s. Health Insurance Portability and Accountability Act (Hipaa)
• Data Entry
• Clinical Research
• Clinical Pharmacology
• Pharmacy Automation
• Medicare
• Patient Counseling
• Managed Care
• Immunization
• Leadership
• Social Media
• Cell Culture
• Microsoft Excel
• Powerpoint
• Laboratory
• Aseptic Technique
• Research
• Teamwork
• Pharmacy Practice
• Pharmacy Benefit Management
• Hipaa
• Pharmaceutical Industry
• Customer Service
• Healthcare
• Microsoft Word
• Compounding
• Inventory Management