Open to opportunities

Lashorn Carter

@lashorncarter

Message

Specialty pharmacy case manager delivering payer-first PA strategy and adherence support to keep therapies on track.

United States

Message

What I'm looking for

I’m looking for a specialty pharmacy case management role where I can own payer-first prior authorization, coordinate appeals, and keep therapies on schedule. I want a high-urgency team focused on patient access, adherence continuity, and strict HIPAA/SOP compliance.

I’m a specialty pharmacy case manager with 10 years of hub services and patient access experience, currently supporting Dupixent therapy at Cencora. I’m known for a 98% prior authorization approval rate built on payer-specific strategy—not volume.

I serve as the central point of contact for patients, prescribers, and specialty pharmacies throughout the full Dupixent therapy lifecycle, from initiation through fulfillment, adherence, and renewal. I conduct payer-specific benefit investigations, manage PA submissions, and guide peer-to-peer reviews and formal appeals using clinical documentation requirements at each stage.

I also enroll patients in DUPIXENT MyWay®, coordinate co-pay card activation, and connect qualifying patients to free drug programs and financial assistance resources. I’m comfortable in high-urgency workflows, maintain HIPAA compliance and SOP standards on every file, and work across EPIC, Cerner, and Salesforce—plus multiple additional EMR and business platforms.

Experience

Work history, roles, and key accomplishments

Current

Dupixent Hub Case Manager

Current

Cencora

Jan 2022 - Present (4 years 5 months)

Maintained a 98% prior authorization approval rate for Dupixent across commercial, Medicaid, and Medicare payers while supporting sustained, long-term therapy access. Serve as the central liaison for patients, prescribers, and specialty pharmacies, managing benefit investigations, PA submissions, peer-to-peer reviews/appeals, MyWay enrollment, co-pay support, fulfillment logistics, adherence monit

Prior Authorizations Peer Review DUPIXENT MyWay Program HIPAA compliance

Patient Access Representative

Northwell Health

Dec 2020 - Dec 2022 (2 years)

Reduced claim denials by coordinating benefits across multiple payers and strengthening authorization workflows in a high-volume acute care setting. Managed patient intake, insurance verification, and billing documentation across commercial, Medicaid, and Medicare payers, while coordinating bed assignments, transfers, and discharge.

Insurance Verification Denial Management Payer Navigation (Commercial Medicaid Medicare)Patient Intake High Volume Management

Clinic Coordinator

Mount Sinai Hospital

Mar 2013 - Aug 2016 (3 years 5 months)

Coordinated 300+ monthly appointments in a high-volume child psychiatry clinic while managing authorizations, coding, and clinic operations. Performed CPT coding, insurance verification, and prior authorization submissions for behavioral health and psychiatry services, maintaining compliance in EPIC and IDX systems.

Clinic Operations Appointment Scheduling Prior Authorizations Insurance Verification CPT Coding Behavioral Health Child Psychiatry Support Compliance Documentation

Chart Analyst

Family Healthcare Corporation

Jan 2008 - Sep 2012 (4 years 8 months)

Audited medical charts for HIPAA compliance and documentation accuracy, improving chart document retrieval workflows. Updated EMR-related processes and redesigned workflows to strengthen documentation quality and accessibility.

HIPAA compliance EMR Process Support Medical Record Retrieval Process Redesign Compliance Documentation