Clinical pharmacist with 15 years experience providing care in both hospital and managed care settings. Strong background using clinical knowledge to both create and implement criteria used in the prior authorization process. Extensive work with National Committee for Quality Assurance to ensure optimal clear and simple language for both members and practitioners. Ability to work collaboratively within a team to provide clinically sound and cost-effective treatment options for patients as a part the utilization management program.
Drug therapy management
pharmacy benefit utilization management
Knowledge of healthcare principles
Team collaboration skills
Review prior authorization requests for medical necessity using clinical, analytical, and cost-conscious strategies.
Create criteria policies using currently supported guidelines and drug information focusing on safety and efficacy.
Create and update denial language with focus on compliance with NCQA standards.
Counsel patients on drug interactions and cost-effective alternatives available to them.
Communicate with providers in peer to peer reviews.
Support clinical help desk.
Lead pharmacist on the pharmacy benefit team to collaborate criteria with our HMO team.
Helped implement BCBSM's marketplace pharmacy benefit prior authorization criteria.
Provided overall pharmaceutical care to patients in a 400 bed hospital.
Order entry, therapeutic interchange, and drug utilization review of physician prescribed medications including chemotherapy agents.
Anti-coagulation dosing of warfarin, heparin, lepirudin and argatroban.
Pharmacokinetic dosing and clinical monitoring of vancomycin and aminoglycoside antibiotics.
Lead pharmacist on the hospital wide renal dosing program.
Provide drug information to medical and nursing staff
Worked as a part of the emergency department team.
Academy of Managed Care Pharmacy (2013-present)
Companies Worked For:
Job Titles Held:
Where can I find a Blue Cross Blue Shield of Michigan Clinical Pharmacist resume example in New Baltimore, Michigan ?
This is an actual resume example of a Clinical Pharmacist. LiveCareer’s Resume Directory contains real resumes created by subscribers using LiveCareer’s Resume Builder.
© 2019, Bold Limited. All rights reserved.