Montgomery Street, San Francisco, CA94105(555) 432-1000, resumesample@example.com
Summary
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.
Skills
Planning and coordination
Problem resolution
Good listener
Clinical experience
Leadership experience
Industry policies
Team collaboration
Project management organization
Experience
06/2013 to 12/2019PDL Clinical Project ManagerProvidence Health & Services | Mukilteo, WA,
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
02/2011 to 05/2013Clinical PharmacistCatamaran, Formerly SXC Health Solutions, Inc | City, STATE,
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
10/2008 to 02/2011Pharmacy Educator CoordinatorSXC Health Solutions, Inc | City, STATE,
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
Education and Training
Expected in 06/1997Doctor of Pharmacy | PharmacyUniversity of Tennessee Health Science Center, Memphis, TN, GPA:
Expected in 05/1993Bachelor of Science | General ScienceUniversity of Tennessee At Martin, Martin, TN, GPA:
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