Experienced pharmacy professional with clinical skills in managed care pharmacy, community/hospital surgery pharmacy and educational outreach. Detail-oriented professional that possesses superior skills in working with both team-based and independent capacities. Bringing strong work ethic and excellent organizational skills to any setting. Recognized as a resourceful problem-solver who is able to analyze information to find workable solutions. Excited to begin new challenge with successful team.
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- Maintained state Medicaid Pharmacy Preferred Drug List (PDL) which involved a weekly review of new drugs, comparative pricing of new or generic drug agents, recommendations for formulary drug placement based on clinical guidelines/information and cost effectiveness
- Monthly reviewed brand/generic drug pricing to ensure overall formulary cost effectiveness; Ensured formulary decisions or drug initiatives were properly coded within the Point-Of-Sale (POS) system via generation of benefit change control memo document(s) and jointly working with plan administration personnel
- Coordinated, prepared and presented quarterly pharmacy advisory board committee meetings, responsibilities included: drug class reviews, generated general drug class recommendations, prepared meeting minutes and establishment of prior authorization criteria supported by clinically based literature
- Assisted Drug Utilization Review (DUR) Pharmacist with follow-up tasks that required review or approval of the Pharmacy Advisory Committee (PAC) [Pharmacy & Therapeutic Committee]
- Assisted with clinical reviews of provider/member initiated pharmacy drug appeals for the state Medicaid program; Prepared provider notices to inform providers of formulary or prior authorization plan changes
- Served as liaison between the clients ancillary pharmacy departments (e.g. Pharmacy Appeal departments, Pharmacy state/employer call centers )
- Attended weekly meetings with client/other state Medicaid departments to discuss various items regarding the Medicaid pharmacy program, operational and clinical decisions to ensure an effectively and efficiently ran pharmacy program
- Served as clinical liaison for contract and managed client relationship
- Developed, enhanced, and maintained operational functions of the pharmacy program
- Ensured government and federal policies were followed while providing clinical support
- Coordinated, prepared and presented quarterly pharmacy advisory board committee meetings, included: drug class reviews, preferred drug list recommendations and establishment of evidence based prior authorization criteria
- Assisted with clinical reviews of provider/member initiated pharmacy drug appeals for the pharmacy medicaid program
- Created and communicated clinical information to internal/external colleagues
- Provided educational outreach to providers/members regarding specific pharmacy program initiatives (e.g. clinical guidelines, pain/disease management, opioid overuse, etc.)
- Performed scientific based clinical reviews for the Drug Utilization Review Program and evaluated responses from healthcare providers; clinical reviews of pharmacy dispensing patterns and member drug utilization as part of the pharmacy Fraud and Abuse/Lock-In program
- Coordinated and clinically reviewed and assessed provider/member initiated pharmacy drug appeals for the state Medicaid program
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Resume Overview
School Attended
- University of Tennessee Health Science Center
- University of Tennessee At Martin
Job Titles Held:
- PDL Clinical Project Manager
- Clinical Pharmacist
- Pharmacy Educator Coordinator
Degrees
- Doctor of Pharmacy
- Bachelor of Science
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