Noel Thomas

Led, designed, and implemented strategies for OptumRx national formularies impacting approximately 15 million lives. Provided trend insights, identified areas for improvement, and optimized formulary strategies by presenting clinical and financial analysis to support recommendations.

Led, designed, and implemented strategies for OptumRx national formularies impacting approximately 15 million lives. Chaired the formulary adherence cross-functional workgroup, providing trend insights and identifying areas for improvement to optimize formulary strategies. Analyzed claims data and rebate information to identify cost-saving opportunities and facilitated robust modeling to support f

Managed customer relationships and served as the primary point of contact for the sales team, supporting various business types including health systems and employer groups. Reviewed pharmacy and medical data to identify actionable trends, developed clinical program goals, and presented key performance indicators.

Functioned as a field clinical liaison, managing customer relationships and collaborating with sales on new business opportunities. Reviewed pharmacy and medical data to assess customer needs, identified actionable trends, and discussed strategies to manage total cost of care. Led discussions with key opinion leaders on formulary updates focusing on clinical evidence and health outcomes.

Managed customer relationships and served as the primary point of contact for the sales team, collaborating on new business opportunities and delivering finalist presentations. Reviewed pharmacy and medical data, assessed customer needs, and identified actionable trends to develop strategies for managing total cost of care. Established achievable clinical program goals and presented key performanc

Functioned as a field clinical liaison, managing customer relationships and supporting new business opportunities across various business types. Reviewed pharmacy and medical data to understand top disease states and drugs driving costs, developing strategies to manage total cost of care. Led discussions with Key Opinion Leaders on formulary updates and collaborated on launching new clinical offer

Achieved a 4.5-star rating by meeting set targets for HEDIS, NCQA, and PQA quality measures, including comprehensive medical reviews and generic substitution rates. Established and maintained strong relationships with physician groups, educating them on quality measures and payer/PBM requirements.

Achieved a 4.5-star rating by meeting set targets for HEDIS, NCQA, and PQA quality measures, including comprehensive medical reviews and generic substitution rates. Established and maintained strong relationships with physician groups, educating them on quality measures and payer/PBM prior authorization requirements. Analyzed health plan data to determine market and individual physician group perf

Performed Prior Authorization and Appeals reviews for Medicare Part D beneficiaries, utilizing CMS and clinical practice guidelines in a call center environment. Educated healthcare providers and plan members about formulary medications, coverage requirements, and potential lower-cost alternatives. Provided support for internal team member inquiries, conducted quality analysis on completed cases,

Performed Prior Authorization and Appeals reviews for Medicare Part D beneficiaries, utilizing CMS and clinical practice guidelines in a call center environment. Educated healthcare providers and plan members about formulary medications, coverage requirements, and potential lower cost alternatives.

Prepared patient profiles and interpreted medication orders, reviewing them for errors and clinical concerns to ensure therapies were safe and appropriate for each patient. Communicated effectively with healthcare providers to address medication-related inquiries and identified clinical concerns.

Performed Prior Authorization and Appeals reviews for Medicare Part D beneficiaries, utilizing CMS and clinical practice guidelines in a call center environment. Provided support for internal team member inquiries, quality analysis on completed cases, and training for new hires.

Performed Prior Authorization and Appeals reviews for Medicare Part D beneficiaries, adhering to CMS and clinical practice guidelines. Educated healthcare providers and plan members on formulary medications, coverage requirements, and lower-cost alternatives based on insurance plans. Provided support for internal team inquiries and conducted quality analysis on completed cases.

Prepared patient profiles and interpreted medication orders, reviewing for errors and clinical concerns to ensure safe and appropriate therapies for each patient. Communicated effectively with healthcare providers to address medication-related inquiries and identified clinical concerns. Ensured compliance with medication protocols and patient safety standards.

Oversaw the daily activities of a team of five pharmacy technicians and customer service associates, filling an average of 1,400 prescriptions each week. Dispensed drugs according to physician orders, performing comprehensive reviews to ensure appropriate medications were dispensed in the correct dosage. Counseled patients about the management of acute and chronic diseases, discussing information

Oversaw the daily activities of a team of five pharmacy technicians and customer service associates, filling an average of 1,400 prescriptions each week. Dispensed drugs according to physician orders, performing comprehensive reviews to ensure appropriate medications were dispensed in the correct dosage. Counseled patients about management of acute and chronic diseases, discussing information gath

Completed a Doctor of Pharmacy degree. This program prepared me for a career in pharmacy, focusing on patient care and medication management.