Briana Montalvo
Fitchburg
Summary
Program Manager with more than eight years of progressive leadership experience in specialty pharmacy, patient support services, reimbursement, and healthcare operations. Proven success managing client-focused programs, leading cross-functional teams, overseeing call center operations, and optimizing workflows to improve patient access and service quality. Experienced in staff development, SOP management, quality assurance, insurance reimbursement, audit readiness, and client relationship management. Recognized for building collaborative partnerships, driving process improvements, and delivering operational excellence in highly regulated healthcare environments.
Overview
10
10
years of professional experience
Work History
Associate Program Manager
AllCare Plus Pharmacy
02.2024 - Current
- Lead day-to-day operations across two manufacturer-sponsored patient support programs, balancing competing priorities while ensuring each program meets client expectations, service level agreements, and operational goals.
- Manage onboarding, coaching, and ongoing development of pharmacy staff, fostering accountability, compliance, and continuous performance improvement.
- Utilize Salesforce CRM to document program activities, monitor case progress, track patient and provider interactions, manage escalations, and support accurate reporting.
- Monitor call quality and compliance through call reviews, coaching sessions, and audit preparation to ensure adherence to client and regulatory requirements.
- Develop, update, and maintain Standard Operating Procedures (SOPs) and workflow documentation in response to client requests, operational changes, and evolving program requirements.
- Partner with leadership and cross-functional teams to streamline workflows, improve patient access, and enhance operational efficiency across both programs.
- Serve as the primary escalation resource for complex patient, provider, and specialty pharmacy issues, ensuring timely resolution and a high level of client satisfaction.
- Prepare operational reports, analyze program performance, and present quality findings and recommendations to leadership to support continuous improvement initiatives.
Reimbursement Coordinator
AllCare Plus Pharmacy
06.2021 - 02.2024
- Served as Interim Manager, overseeing daily workflow, employee performance, productivity, and client escalations while maintaining service quality.
- Coordinated insurance verification, prior authorizations, reimbursement activities, and patient enrollment into copay and financial assistance programs.
- Used Salesforce to document patient cases, monitor reimbursement activities, maintain accurate records, and support communication between providers, patients, and internal teams.
- Collaborated with providers, payers, specialty pharmacies, and internal departments to resolve reimbursement barriers and improve patient access to therapy.
- Supported audit readiness through documentation reviews, compliance reporting, quality assurance activities, and call monitoring.
- Designed and delivered training programs that improved employee knowledge, operational consistency, and overall service quality.
Accounts Receivable Coordinator
iPromoteu.com
11.2019 - 05.2021
- Managed accounts receivable activities including payment reconciliation, collections support, account analysis, and repayment scheduling.
- Improved cash flow through timely account follow-up and customer communication.
- Resolved complex billing issues while collaborating with clients and internal departments to improve payment resolution.
- Prepared financial documentation and reconciliations supporting operational reporting and business decisions.
Accounts Receivable Supervisor
Boston Behavioral Learning Center
01.2019 - 11.2019
- Supervised Accounts Receivable staff responsible for billing, collections, insurance authorizations, and payment processing.
- Coached employees through performance improvement and workflow optimization.
- Developed training materials that improved billing accuracy and compliance.
- Collaborated with leadership to resolve complex reimbursement and collection issues.
Reimbursement Specialist I
Boston Heart Diagnostics
03.2016 - 05.2018
- Investigated reimbursement and payment issues while working directly with insurance carriers.
- Supported appeals and collections activities by maintaining detailed financial documentation.
- Trained new employees on reimbursement procedures and departmental workflows.
- Assisted with process improvements that increased operational efficiency.
Education
Political Science Coursework
New England College
Coursework
Mount Wachusett Community College
Skills
- Accounts Receivable Operations
- Collections & Payment Resolution
- Team Leadership & Performance Management
- Employee Coaching & Development
- Credit & Reimbursement Operations
- Process Improvement
- Workflow Optimization
- Standard Operating Procedures
- Cross-Functional Leadership
- Audit Preparation & Compliance
- Financial Reconciliation
- KPI Tracking
- Escalation Management
- Quality Assurance
- Customer Relationship Management
- Operational Reporting
- Change Management
Timeline
Associate Program Manager
AllCare Plus Pharmacy
02.2024 - Current
Reimbursement Coordinator
AllCare Plus Pharmacy
06.2021 - 02.2024
Accounts Receivable Coordinator
iPromoteu.com
11.2019 - 05.2021
Accounts Receivable Supervisor
Boston Behavioral Learning Center
01.2019 - 11.2019
Reimbursement Specialist I
Boston Heart Diagnostics
03.2016 - 05.2018
Coursework
Mount Wachusett Community College
Political Science Coursework
New England College