Julia Maloney is seeking a position that utilizes her almost 20 years of experience in healthcare and pharmacy benefits. She has extensive knowledge of healthcare industries and Medicare programs from roles managing Medicare Part D data and ensuring compliance. Maloney has a proven track record of strategic problem solving and leadership with clients and PBMs.

1. Julia A. Maloney
112 Shirewood Dr. St. Charles, MO 63303 Home (636) 441-6087 Cell (636) 395-1134
Objective
To secure a position in which I am able to capitalize on my experience, expertise, education and creative
abilities.
Knowledge and Skills
 Almost 20 years of experience in Healthcare and Pharmacy Benefits.
 Extensive knowledge of Healthcare benefit industries
 Four years experience working on Medicare retiree programs
 Assisted with Medicare PDP application filings
 Strong HPMS formulary file management creation, submission of formulary, Prior Authorization,
Step Therapy files, analysis and reporting
 Review and submissions of HPMS Part D Reporting elements
 Strategic problem solver with proven leadership qualities
 Success oriented and outgoing with positive attitude
 Strong sense of responsibility and self-motivated
Experience
Independent Pharmaceutical Consultants, Inc.
O'Fallon, Missouri
Data Analysis
October 2007 to Present
 Daily contact for IPC clients and PBM's on all Medicare Part D related management support and
oversight.
 Review for accuracy and compliance as required by CMS for all Medicare Part D formularies,
Step Therapy, Prior Authorization and Medicare Part D Reporting requirements including
submission through HPMS website portal.
 Monitor and review all Medicare Part D ACUMEN reporting and ensure appropriate responses
are addressed and uploaded prior to deadline.
 Assist with fulfillment of Part D plan requirements and CMS contract management including
compliance.
 CMS certified for Part D Data Validation
 Handle all aspects from Account Manager to Designee in Retiree Drug Subsidy (RDS) system.
including eligibility, review and submission of interim and reconciliation reporting and payment
approval.
 Support Clinical team with standard adhoc reporting, queries, Request for Proposal (RFP)
 Manage CoPay Assistance Program
 Manage and delivery of all HPMS communication.

2. Express Scripts (1989 - 2007)
Maryland Heights, MO
Supervisor - Rebates Analyst (Medicare Part D and Market Share
1999 - September 2007
 Setup, implement, calculate, report and pay Clients for quarterly/annual reconciliation rebates
based upon individual contract.
 Support sales with preparing rebate estimates for renewals and perspective clients
 Produce and analyze utilization summary for Client Management, Auditing and Legal
 Business Owner for development of two (2) rebate databases with continually updates for
process improvements
Account Manager (Private Label)
1999 (Requested by Client to return to Account)
 Daily client contact for issue resolution in eligibility, claims, implementation, participant material,
report request and general inquiries.
 Ensure client satisfaction, profitability and renewal process
 Review quality control of account activity and operations
 Maintain and tracking all client performance guarantees
 Assist Account Director on plan implementation for new clients, up sells and expansions.
Formulary Assistant
1999
 Assist with building client specific formularies
 Ensure formularies were compliant for rebate maximization
 Updated quarterly Client formularies as Manufacturer contracts were renewed.
Account Manager / Account Setup Manager (Private Label)
1996 - 1999
 Account Manager duties listed above
 Handled all Client Setup of Plan design benefits (covered drugs, quantity limits, day supply, age
restrictions, prior authorization).
 Group setup
 Pharmacy pricing
Supervisor - Prior Authorization
1992 - 1996
 Developed process and procedures
 Ensured medications were FDA approved for usage
 Worked with Clinical support and Clients to develop criteria
 Produced utilization management reporting bi-annually to clients
 Assisted Pharmacy Help Desk by trouble shooting pharmacies submitting online claims
Unit Leader - Claims Department
1989- 1992
 Started as data entry clerk
 Promoted within six months
 Managed a team that was responsible for all member paper claims and production of member
EOBs.

3. Education
Palm Beach Junior College (general classes) 1985
John Robert Powers School of Modeling 1982 - 1983
Normandy Senior High 1983
Professional Development
 Medicare Part D Validation - Certified
 Human Relations
 Drug Substances Interaction Workshop
 Stress Management Seminars
 Women in the Workforce
 Pharmacology 101 and 102
 Civil Training
 Microsoft Office - All Programs
 MS Access
 Paradox
 SQL
References available upon request