Ahmed Albasher

Under the Account of Cigna:

• Managed pre-authorization processes for prescription medications, ensuring timely and accurate approvals for patients.
  
• Collaborated with healthcare providers to facilitate pre-authorization requests and resolve any issues.
  Processed a high volume of pre-authorization requests daily, maintaining a meticulous and organized approach to ensure efficiency.
• Evaluated medical documentation and reviewed clinical criteria to determine the appropriateness of medication pre-authorization.
  Achieved a 15% reduction in pre-authorization processing time through streamlining procedures and implementing automation tools.
  
• Improved approval rates by 20% through accurate documentation and effective communication with healthcare professionals.
  Demonstrated strong knowledge of pharmacy benefit management systems and stayed up-to-date with changes in insurance regulations.
  
• Utilized medical terminology effectively to facilitate clear communication between medical staff and insurance representatives.
  Skills:
  
  Pharmacy Benefit Management (PBM)
  Pre-Authorization Processing
  Insurance Regulations
  Medical Terminology
  Communication
  Attention to Detail

• Claims Management | Medical Queries | Insurance Policy Terms & Conditions |
• Pre-Authorization | Report Analysis
• Currently handling Cigna insurance policies ensuring strict adherence to regulations provided by local health authorities, and following up on all updates
• Handling all medical-related queries/concerns from both members as well as providers via telephone, email, etc
• Responsible for evaluating and processing claims in line with insurance policy terms & conditions, company policies & processes, and productivity & quality standards
• Rendering support to the Approval team by providing pre-authorization for services as per company protocol and alignment with local UAE regulations through the
• Ntouch system and Pharmacy Benefit Management System
• Ensuring all department targets for TAT, quality, and productivity are met/exceeded
• Skillfully identifying and reporting back defective claims/issues that may affect the process
• Thoroughly analyzing reports from the administrative software for providers and members' utilization
• Maintaining confidentiality on information being processed, stored and accessed
• Steering efforts towards improving the claims processing quality standards and productivity by collecting & analyzing claims data, identifying and resolving errors, delayed claims, processing issues and providing recommendations
• Minimizing fraudulent cases by supporting the Team Lead/Manager in implementing effective quality assurance programs and maintaining standards of quality
• Capably handling all medical-related call queries from both members and providers.

• Strategic Planning & Execution | Leadership | Relationship Management |
• Digital Transformation | Product Positioning
• Dual role as a District Sales Manager and Sr
• Medical Representative for
• Cardiovascular line in the Sudan territory
• Played a key role in executing strategic and tactical plans for the product line
• Provided leadership and guidance to 2 Medical Representatives to achieve their business objectives
• Supervised the team's reporting in the Iqvia CRM system
• Sustained and maintained strong relationships with the National Medical Supply Fund (main distributor of Plavix and Epilim in Sudan) by partnering with the Key Accounts team
• Managed relationships with Alpha Medical (local business partner and distributor of Epilim in Sudan)
• Reported all activities related to the digital communication transformation to the leadership team
• Devised effective plans and strategies to maintain the leadership position of Plavix products in the Sudan market, among other anti-platelet, with an
• MS of 53% (MAT Q2.20)
• Ranked the product amongst the top 20 products across Sudan
• 71% growth in value in sales-in value, and 46% growth in sales-out
• Also maintained leadership position of Epilim product in the Sodium
• Valproate market, placing it amongst the top 20 products in Sudan
• Developed the team's capability to fulfill customers' needs by enhancing field force effectiveness and motivation
• Efficiently managed 3 key projects - Act for Life, PACE, and Leading &
• Development project in Sudan
• As part of the leadership, significantly contributed to the transformation into digital communication with customers via multichannel engagement tools like Zoom, WhatsApp, and email campaigns to improve communication in coordination with the Marketing team.

• Project Management | Database Management | Stakeholder Communication |
• MIS Reports | Liaison | Promotions
• As part of Iqvia's local partner in Sudan, project managed the building of a
• Sudan database comprising of pharmaceutical sales to provide real-world data for all stakeholders in the health sector
• Explained the data sharing agreement to all customers and stakeholders
• Prepared and shared relevant reports with stakeholders and participated in planning future projects in Sudan market/s
• Established lasting relationships with pharmaceutical companies and government entities by engaging them in the project and providing them with sales data while encouraging them to be part of the comprehensive
• Sudan Pharmaceutical database
• Liaised with Iqvia regional offices to ensure that the provided data matched the standard dataset in Iqvia's IT systems
• Proactively promoted Iqvia's other solutions and services, such as CRM and patient support pregame management projects.

• Product Promotion | Sales & Marketing | Presentations | Cold Calling | Clinical
• Data Management | Strategy Planning
• Role involved promoting a variety of Ophthalmology pharmaceutical products encompassing anti-infectives, anti-glaucoma, anti-allergy, and dry-eye syndrome eye drops for Ophthalmology doctors in Sudan
• Arranged appointments with doctors, pharmacists, and hospital medical teams through pre-arranged appointments or regular cold calling
• Cultivated strong business relationships with medical staff and supporting administrative staff
• Maintained an accurate and detailed list of all contacts
• Worked with the Area
• Sales Manager/Sales team in planning work schedules, monthly/weekly timetables, and discussing future targets
• Maintained up-to-date knowledge on the latest clinical data supplied by the company and interpreted, presented, and discussed the same with health professionals during presentations
• Motivated the Sales team in achieving planned and forecasted quarterly targets
• Demonstrated products to doctors, practice staff, and nurses in GP surgeries, hospital doctors, and pharmacists in the retail sector
• Made impactful presentations in medical settings during daytime or evenings at local hotel/s and conference venues
• Lend presence in company meetings, technical data presentations, and briefings regularly
• Increased opportunities to meet and communicate with contacts in the medical and healthcare sector by developing effective strategies
• Imparted great contribution in branding, surveys, measuring brand equity, and its competitive value supporting the company's vision of new markets and targeted growth
• Traveled extensively to different regions throughout Sudan for sales and promotional activities.