Registered Nurse with over 10 years of progressive experience in Utilization Management, Preservice Review, and Clinical Quality Compliance across Medicare Part D pharmacy benefits and clinical precertification programs. Currently supervise a team of 16 Preservice Review Nurses and 1 Subject Matter Expert, having built and led the pioneer team (Wave 1) for the OptumRx Medicare Part D market. Maintained a consistent 98% average quality score annually (2023-present) while surpassing productivity targets at-----------%, contributing to the market's growth from 1 to 7 teams. Skilled in coaching, workforce management, and collaborating with onshore/offshore stakeholders to achieve organizational goals. Dual-licensed Registered Nurse (Philippines and New York, USA).
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