Courtney Damond
Lafayette
Summary
Experienced with managing and implementing system configurations to ensure optimal performance. Utilizes strong analytical skills and attention to detail to identify and rectify configuration issues. Knowledge of industry-standard tools and best practices for configuration management.
Overview
11
11
years of professional experience
Work History
Benefit Configuration Analyst
Prime Therapeutics
05.2023 - Current
- Designs, analyzes, and implements benefit coding change requests and provide recommendations based on frequent monitoring of Louisiana Medicaid pharmaceutical drug regulation legislation
- Collaborates with diverse groups to examine needs and configurations unique to Louisiana MCOs, then converts them into technical design specifications and data flow, which are used to create and code programs.
- Engages in and contributes to team meetings, project/issue resolution, and daily communications.
- Responsible for accurately managing modifications to the plan benefits coding, as well as executing tests and validating requests for new plan benefit designs.
- Audit pharmacy claims to ensure correct dispensing and incentive fee scheduling for Louisiana MCOs
- Verify and make changes to client benefits with internal PBM (Pharmacy Benefit Managers) system as necessary
- Monitor and create adjudication rules for prevention of overuse of scheduled drugs and unnecessary use.
- Assign accurate ICD-10 codes to drugs to ensure proper step therapy, prior authorizations, and adjudication processes are followed according to Louisiana Medicaid drug regulations
- Run standard reports and hoc reporting with applying analytical skills for appropriate findings
- Manage data to support internal and external audit requests
- Update and verify Gui screens to reflect latest PMB version models
- Research and report various issues such as TPL, provider network issues, prescriber issues, drug authorization issues, and client eligibility issues.
Office Manager
Life Changing Solutions LLC.
01.2023 - 04.2023
- Intake coordinator for programs available
- Verification of insurance and input billable service codes in EHR system
- Maintain files for legal matters and follow up on case scheduling, findings, and results
- Coordinate with IT department on all office equipment
- Manage relationships with referral source for clients, vendors, &, service providers
- Verify healthcare coverage of applicants and approve authorizations for insurance hours for client therapy sessions
- Point person for retention, disposal, retrieval, and transference of client PHI data
- Provide other administrative support as necessary, including scheduling group meetings, maintaining calendars, doing research, and creating reports
Pharmacy Benefits Manager
Aetna
11.2020 - 05.2022
- Responsible for configuration of adjusting pharmacy pos sales, accumulation functionalities of existing benefit plans, adjudication rules, and eligibility.
- Knowledge of MCO’s systems to assist in the development of formulary plans.
- Analyze patients’ healthcare data to locate affordable drugs in the same therapeutic class if step therapy is required for chronic conditions requiring medications not covered under prescription benefits.
- Interpret benefit policies and procedures to address client questions and concerns.
- Knowledge of adjudication rules for various clients to provide a formulary analysis to clients.
- Resolve client requests regarding pharmacy benefits to applicable departments with a follow up ticket to ensure accuracy and timeliness of an issue be settled.
- Application of Health Insurance Portability and Accountability Act provisions in a PBM domain
- Process the integration of benefits systems for clients with multiple coverage.
- Design and manage competitive benefits programs to serve disabled populations, specialty care patients, and rural nations.
- Offer client incentives such as diabetes care, mail order prescription, and auto dispensed medications to differentiate the company from competitors.
- Spearhead negotiations with pharmacies to achieve favorable compensation and benefit use for clients.
Mental Health Technician
Louisiana United Children’s Methodist Home
12.2018 - 10.2020
- Assisted patients develop their interpersonal, social, and work-related skills.
- Delivered first-rate care to mentally ill, emotionally disturbed, and developmentally disabled patients.
- Worked with doctors, psychologists, and rehabilitation therapists to help patients return to their communities.
- Offered direct client services in living center environments and monitored progress against treatment goals.
- Developed therapeutic relationships with assigned patients to foster mental health and alleviate symptoms of mental illness.
- Collaborated with interdisciplinary care team to develop and implement successful care plans.
- Updated clinical documentation and administrative reports with timely and accurate information.
Mental Health Technician
Lake Charles Memorial Hospital
11.2017 - 12.2018
- Worked closely with family members and treatment teams to implement effective support networks and reinforce positive behaviors.
- Maintained case notes to document resident progress and condition.
- Assisted clients with daily tasks such as bathing, dressing, and grooming.
- Tracked medication activities and used care-focused approaches to improve compliance with prescribed protocols.
- Cultivated social interaction through reading, games, and community activities.
Dispatcher
Southwest Call Center
01.2015 - 12.2018
- Monitored automated systems and intervened to help those callers in need of assistance.
- Used in-house paging system to contact floor personnel.
- Served as pleasant and personable point-of-contact for hospice patients and nurses, physicians, burglary alarm system clients, and after hour callers.
- Coordinated conference calls and assisted participants in telephone procedures.
- Recorded and relayed accurate messages
- Monitored schedules and resources to prioritize dispatch work orders.
- Maintained database and dispatch logs for daily updates.
Education
Bachelor of Science - Health Systems Management, Minor in Healthcare Management
McNeese State University
Master of Healthcare Administration - Healthcare Administration
Louisiana State University Shreveport
Shreveport, LA12-2025
Skills
- Account Analysis
- Benefit Development, Administration, and Policy Interpretation
- Documentation and Reporting
- Multi-Tasking
- Time Management
- Strong Communicator
- Business process improvement
- Configuration auditing
- Software configuration
- Configuration management
- Task prioritization
- Client relations
Affiliations
- The National Society of Leadership and Success
- Alpha Alpha Alpha Honor Society
Timeline
Benefit Configuration Analyst
Prime Therapeutics
05.2023 - Current
Office Manager
Life Changing Solutions LLC.
01.2023 - 04.2023
Pharmacy Benefits Manager
Aetna
11.2020 - 05.2022
Mental Health Technician
Louisiana United Children’s Methodist Home
12.2018 - 10.2020
Mental Health Technician
Lake Charles Memorial Hospital
11.2017 - 12.2018
Dispatcher
Southwest Call Center
01.2015 - 12.2018
Bachelor of Science - Health Systems Management, Minor in Healthcare Management
McNeese State University
Master of Healthcare Administration - Healthcare Administration
Louisiana State University Shreveport
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