Zandra Calio

About Zandra Calio

Experienced Resolution Specialist Supervisor with a demonstrated history of working in the retail and specialty pharmaceutical industry. Skilled in Disease Management, Billing Process, Operations Management, Microsoft Word, and Retail. Strong business development professional with a Bachelor\'s degree focused in Business Administration and Management, General from Chadron State College.

Experience

1. Supervisor Payer Relations- Specialty Pharmacy

   Walgreens

   Nov 2012 — Present · Pittsburgh, PA, US

   Works with contracting, implementations, and operations to oversee all new pay plan requests; oversees Implementation and maintenance of client requests for new plan set up or plan changes, formulary channeling/NDC not covered, split fill cycle management programs, payer NDC block requests, and Relay Health Edits• Manages web administration for ARxWP employees to enroll, maintain and retrieve passwords for payer/client web sites• Ensures accurate team analysis and resolution of all payer rejections and issues for the division, working with Relay Health and stakeholders as needed for resolution• Coordinates and communicates with stakeholders within the central specialty sites any pertinent payer information that will impact the performance within that location, including payer communication updates/bulletins• Works with implementation and Business Integration on creation of Payer/Client SOP’s for training the Operations staff on procedures for all Specialty sites• Evaluates payer contract requirement requests and impact to claims processing• Works with the Client Management and Implementation Teams to develop communication for all the operations and Reimbursement staff to handle the incoming clients• Participates with contracting team, implementation team, Senior Leadership, Finance, and the Quality team to provide requested data during an implementation• Works with IT to develop and manage processes for ScriptMed plan maintenance and system configuration (making changes to accommodate plan/payer data requirements)• Leads testing and implementation of plan maintenance system updates and new plan implementations, including all new year payer plan changes• Prepares reports for divisional leadership related to plan set up or plan utilization as well as 340B or URAC accreditation Responsible for generating reports for 340B claims.

Education

• Community College of Allegheny County

  AS, Pharmacy

  1991 — 1993

• Chadron State College

  Bachelor's degree, Business Administration and Management, General