Shannon Sutton
Healthcare Professional
Louisville,KY
Summary
Professional with strong background in care coordination. Skilled in patient advocacy, healthcare planning, and resource management. Known for effective team collaboration and achieving measurable results. Adaptable to changing needs with robust communication and organizational skills. Reliable and focused on delivering high-quality care outcomes.
Overview
12
12
years of professional experience
1
1
Certification
Work History
CARE COORDINATOR SR
CVS Caremark
03.2025 - Current
- Developed and standardized, SOP’s and documentation that aligned with organizational goals, supported training initiatives and enhance audit and regulatory readiness.
- Monitor daily workflow, assign tasks, and balance workload across the team to meet performance and turnaround goals.
SPECIALTY PHARMACY LIAISON
PharmaCord Specialty Pharmacy
04.2023 - 03.2025
- Conduct regular outreach to promote services, address provider needs, and foster collaboration.
- Serve as the primary point of contact for provider inquiries and concerns.
- Troubleshoot and resolve provider issues related to referrals, authorizations, claims, or patient care coordination.
PHARMACY CARE COORDINATOR
AmeriSourceBergen
06.2021 - 04.2023
- Served as the primary point of contact for patients, healthcare providers, and insurance companies to ensure seamless coordination of pharmacy services.
- Participated in quality assurance initiatives, helping to identify and implement process improvements that enhanced operational efficiency.
- Contributed to achieving departmental performance metrics, including increased medication adherence and improved patient satisfaction.
UTILIZATION MANAGEMENT COORDINATOR IV
Humana
12.2013 - 01.2020
- Processed and reviewed insurance claims for Medicare and Medicaid members, ensuring compliance with federal and state regulations.
- Conducted detail audits of claims to resolve claim discrepancies and ensure timely reimbursement, reducing claim processing delays by 15%.
- Monitored and maintained records of prior authorization requests, ensuring proper documentation for claims approval.
Education
Some College (No Degree) -
University of Kentucky
Lexington, KY01-2011
High School Diploma -
Central High School
Louisville, KY01-2009
Skills
Organization and Time Management
Problem-Solving and Critical Thinking
Patient Advocacy
- Cross-Functional Collaboration
Attention to Detail
- Problem-Solving & Advocacy
Multitasking
- Customer Service Excellence
Certification
Registered Pharmacy Technician - PT00369497
Timeline
CARE COORDINATOR SR
CVS Caremark
03.2025 - Current
SPECIALTY PHARMACY LIAISON
PharmaCord Specialty Pharmacy
04.2023 - 03.2025
PHARMACY CARE COORDINATOR
AmeriSourceBergen
06.2021 - 04.2023
UTILIZATION MANAGEMENT COORDINATOR IV
Humana
12.2013 - 01.2020
Some College (No Degree) -
University of Kentucky
High School Diploma -
Central High School