1. Operations Management
Quality Management
Project Management
Pharmacy Operations
Specialty Pharmacy
Operations
Green Belt Lean Six Sigma
Call Center Management
Supervision/Leadership
Process Improvement
Mergers/Acquisitions
Program Management
Profit and Loss
Responsibility
Client/Vendor
Relationships in Healthcare
Clinical Prior Authorization
Quality Management
Core Competency
BrettRHarvey@gmail.com
Email
407-601-6890
Phone
904-576-5119
Mobile
1624 Dewayne Dr
Belle Isle, FL 32809
Address
Contact
Juris Doctorate of Law
“J.D. Degree Healthcare/Employment Law”
Barry University Dwayne O’ Andreus School of Law, Orlando, FL
2012 – PRESENT
University of Central Florida, College of Health and Public Affairs, Orlando, FL
Bachelor in Criminal Justice “BS Degree” 2009 – 2011
University of Florida, College of Liberal Arts & Sciences, Gainesville, FL
Bachelor in Molecular Biology – “BS Degree Transfer” 2008 – 2009
Florida State College at Jacksonville, Jacksonville, FL
Associate of Arts in Business Management – “AA Degree” 2005 – 2008
EDUCATION
Certifications
Six Sigma Green Belt, Quality Improvement Associate (CQIA), Talent Management
Certification, Project Management Certification, Managing Talent Certification
Memberships
Kappa Delta PI, Sigma Kappa Delta, Phi Theta Kappa, Delta Epsilon Iota
CERTIFICATIONS AND MEMBERSHIPS
Oracle, Compass, APMCAS, Etums, EPDB
AST, EDI, JavaScript
ECHS, EWFM, CCI
CMS Supervisor, Avaya
SQL Server, PowerPoint
Verint, QuickBase, E-Talk, Auto Coder
MS Word, Excel, Access
RTA, Compass, PST
ASD, PST, EDI, MEA,
People Safe, RX Claim
Proficient or familiar with a vast array of systems, concepts and technologies, including:
KEY SKILLS
Seeking an executive leadership position or director position within the PBM or healthcare
industry, which will allow me to utilize my vast experience and expertise for your company. I
have built a proven track record in delivering results, reducing errors, establishing a
client/member-focused service model, and exercising sound judgment with diplomacy. I offer
the guarantee of providing global resolutions, the ability to integrate new synergy through
mergers and acquisitions, the know-how to develop and mentor a staff, a keen understanding
of profit and loss responsibility, and the skill to drive business and quality results.
OBJECTIVE
BRETT R. HARVEY

2. Oversight includes 3 client programs with revenue sources in excess of six million dollars annually combined.
Responsible for the operational components of both programs including the daily departmental operations, reporting, staff
development, KPI metrics, and patient service models.
Program is managed to ensure profitability running at eight-three percent EBIDTA and seventy-six percent EBIDTA to each
respective program.
Serves as the liaison between patients, clients, clinical hubs, payers, physician offices, specialty and limited distribution
pharmacies for the specific client drug programs.
Developed and implemented customized Standard Operating Procedures to accommodate the specific needs of each client.
Resulted in one hundred percent compliance with 24-hour TAT contractual obligations for patient setups and service delivery.
Provides management oversight and direction of Financial Assistance Specialists, supervisors, and Client Service Specialists and
responsible for their development and performance.
Works as needed with operations, reporting, legal, QA, and accounting, and drives process improvements and quality
improvement initiatives within the organization for clients.
Responsible for ensuring execution delivery to goals and performance guarantees established within the General Service
Agreements and Task Orders. This includes the drafting and forecasting of the alike documents.
Brand Support Services Program Manager
Advanced Care Scripts/CVS Health (Full-time job) JUN 2015 – PRESENT
Oversees vendor relationships across multiple sites that support member and provider calls in both the Commercial,
Government, Union, and Medicare D segments.
Oversight for multi-million dollar vendor relationships that support both member and provider constituency.
Accountable for ensuring that the vendors and their agents deliver a consistent and differentiated value service to our
members and providers across all lines of business.
Responsible for leading and driving the creation and development of standard operating procedures, reporting, workflows, and
hiring needs.
Works with operational areas to identify process improvements, training needs, staffing counts, and work force management
initiatives as it pertains to vendor call allocation.
Responsible for overseeing all day-to-day call center operations with vendors and their internal management team.
Manages the ongoing call center operations in conjunction with the vendor leadership team.
Responsible for working with vendor leadership teams to develop strategic business plans and objectives, crafts appropriate
strategies and call workflows as it pertains to all lines of businesses, and identifies/implements operational opportunities and
guidance to meet both quality and call center performance guarantees.
Business Program Manager
Catamaran Rx (Full-time job) OCT 2014 – JUN 2015
Reports on individual and overall quality performance metrics in member services and clinical prior authorization, analyzes
trends, and advises management peers on areas for improvement.
Manages the process for conducting quality monitoring and choosing which trainers, quality analysts, supervisors, and team
leads monitor calls of new and existing staff for quality assurance performance.
Program has lead to renewed 5 STAR CMS rating and a sought after service model for potential clients.
Uses quality performance data and trends to identify areas for retraining, training program improvement, and process and
system enhancements.
Reviews internal departmental processes to identify opportunities to improve quality and efficiency and enhance services.
Creates management functions and controls to ensure that projects stay on course, on schedule, and are completed in a timely,
professional manner.
Oversees Quality Programs for Pharmacy Operations (Member Services) and Clinical Prior Authorization.
Oversees Quality relationships with third-party vendors and clients.
Oversees Quality Department with teams in 5 locations, both exempt and nonexempt employees.
Recommends changes to the training programs and materials. Presents opportunities to use new training techniques, including
technology, as it relates to adult learning.
Develops and maintains a quality monitoring program for reviewing staff performance in the call center and clinical setting.
Establishes individual and overall goals and action plans for achieving those goals.
Re-aligned quality programs and metrics from two companies into one complete program that resulted in 89% of staff meeting
qualitative measures.
Responsible for strategic growth and new clients wanting a better customer service model.
Developed an unsurpassed high-touch service model that has resulted in 99% client retention and best-in-class service model.
Oversees service level and profitability accountability with all 5 sites.
Manager of Member Services Quality & Clinical Prior Authorization
Catamaran Rx (Full-time job) OCT 2013 – OCT 2014
WORK EXPERIENCE

3. Responsible for the direct oversight of 44 member service professionals.
Reviewed and compiled daily and monthly performance metrics and collected this data into a formulated scorecard for
assessing and developing the staff’s performance.
Clearly communicated information to the representatives on priorities, members’ needs, vision, and goals of the company.
Conducted audits within the team to identify and implement improvements to workflow that resulted in reduced turnaround
timeframes, better customer satisfaction, and enhanced reputation for quality service.
Collaborated with peers to initiate a quality-based mentorship program for all segments of the business.
Managed the performance and continual development of team members.
Assisted in hiring and training of all new departmental employees.
Experienced in managing a multifunctional team and working collaboratively with cross-functional partners and
intra-departments.
Participated in quality improvement reviews and evaluations of service delivery.
Acted as a resource mentor for staff regarding client/member issues, documentation, problem solving, and appropriate
customer service behavior.
Supervisor of Member Services and Web Portal Self-Service Tools
Catamaran Rx (Full-time job) JAN 2013 – OCT 2013
Responsible for oversight of the Boeing accounts short-term disability and leave-of-absence claims.
Responsibilities included benefit management pertaining to leave-of-absence and disability claims.
Coordinated the correct applicable laws, worker compensation offsets, and other benefits needed.
Maintained strict turnaround time for department processing and handling to meet performance guarantees.
Worked collaboratively with the client in defining organizational goals and objectives.
Managed group short-term disability benefits, including the liability management of various claim complexities and to ensure
timely and accurate payments.
Developed, implemented and revised comprehensive disability benefit management strategies based on factors such as
claimants’ medical condition, vocational options, applicable policy provisions and limitations, and actual or potential offsets.
Ensured appropriate and detailed claim documentation to meet departmental risk management and regulatory and accreditation
requirements. Ensured reserve liability is accurately established by maintaining accurate claims data and identifying applicable
policy provisions and claim offsets.
Reviewed and determined preliminary legal decisions and gathered information for response to department of insurance complaints.
Short-Term Disability/Leave of Absence Benefit Manager
Aetna Specialty Products and Disability (Full-time job) OCT 2012 – JAN 2013
Conducted up-front analysis of policies, systems, and regulatory changes to manage impact and interdependencies within the
department. Provided feedback and coaching to pharmacy representatives to enhance service to constituents. Resulted in 78%
of staff meeting quality metrics and making decreased errors.
Implemented a quality program for Aetna’s Specialty Pharmacy (ASRX) that is now leading to higher member retention,
increased productivity, and a reduction of costs by $2.3 million since 2008.
Oversaw Aetna’s Mail Order Pharmacy facilities and Specialty Pharmacy Business quality departments.
Initiated proactive guidelines to support and counsel management and staff on employee relations, career development,
quality compliance standards, and internal guidelines; managed and resolved complex employee issues to ensure minimal to
zero grievance exposure.
Managed exempt and nonexempt employees who were remotely located in various offices or telecommuted. Provided on-going
training and development discussions.
Established higher call center standards by redesigning employee performance scorecards to capture essential qualities of
high-level customer service.
Responsible for the development of PNP, SOP, and process flows to improve the quality of service and for accreditation
purposes.
Delivered a best-in-class service model that led to client growth and reduced parts-per-million specialty pharmacy errors by
+15.27%.
Quality Consultant Manager Mail Order and Specialty Rx
Aetna Specialty Pharmacy / National Customer Operations/
Learning Performance (Full-time job)
OCT 2010 – OCT 2012
Identified developing trends impacting service levels and proactively partnered with appropriate parties to recommend process
enhancements or solutions to avoid potential service delivery problems.
Quality Specialist / Inbound Queue Associate / Team Lead/ Call Coach (Medical Precert)
Aetna Inc., Jacksonville, FL (Full-time job) JUN 2005 – OCT 2010

4. Coached customer service staff on work procedures, including but not limited to proper call handling and maintaining call
quality standards; provided on-going feedback and acted as subject matter expert in addressing procedural issues.
Worked to implement a successful quality coaching and feedback improvement program, which led to 75% of total staff
meeting the internal quality metric of 96.25% or better. Trained staff on departmental processes and systems.
Conducted yearly performance reviews and monthly one-on-one assessment with IQA (Inbound Queue Associates) staff of 24
employees.
Managed and comprised call management reports consisting of phone metrics, adherence reports, TSF reports and other call
management reports, and production metrics.
Participated in calibration meetings at the beginning and end of performance period to ensure consistent evaluation of staff
performance and recognition. Implemented a recognition program for the medical precert department, which resulted in higher
employee survey results on key performance metrics and better morale throughout the department. Indirectly led to increased
productivity in calls serviced per interval.
Experience with handling/leading a team that handled home healthcare, DME, hospice, hospitalizations, ambulatory
procedures, LTAC requests, precertification, and care deliverables for members.
Executive Team Lead
Target, Jacksonville, FL (Full-time job) OCT 2003 – JUN 2005
Manager (Call Center)
MCI WorldCom, Niles, OH (Full-time job) PAST EXPERIENCE