Experience

IngenioRx

• United States
• Insurance
• 100 - 200 Employee

• Clinical Pharmacist

  • Dec 2021 - Present



CareMore Health

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Clinical Pharmacist

  • Dec 2012 - Nov 2021

  •Extensive disease state management of diabetes, COPD, CHF, and hypertension. Clinical skills sharpened as a Board Certified Geriatric Pharmacist (BCGP) following certification in July 2019. Work in collaboration with providers to manage patients in person, virtually, and telephonically •Knowledgeable of Medicare (including Medicaid) and assist the team in closing CMS STARS/HEDIS Measures (Adherence, Statin-SUPD/SPC, MRPs, and MTMs in Mirixa, SinfoniaRx, and HIP, Healthy Innovations Platform) •Instrumental in medication adherence improvement with resolution of patient Rx cost barriers due to the Coverage Gap (Donut Hole) with manage care interchanges to same class, lower cost alternatives helping to reduce a key market performance metric (Part D Rx drug spend) •Spearhead my own initiative of MAPD patients who can qualify for a plan change to DSNP which not only provides better patient benefits but has reduced market MAPD drug spend (well in excess of 500k) •Augment market revenue by working extensively with Anthem Sales benefit consultants and Medicare brokers with new patient enrollments •Engage network providers with office visits, luncheons, and quarterly JOC meetings to discuss co-management strategies for reductions in cost of care and improvements in Medicare STAR/HEDIS measures •Serve on the VA CareMore Senior Leadership Team (SLT) offering insights on patient management, cost reduction, and identifying potential streams of revenue to strengthen our market •Work with Anthem Special Investigation Unit (SIU) upon identifying Fraud, Waste, and Abuse (FWA) activity by pharmacy providers, which result in significant company savings following termination of fraudulent pharmacy providers •Dedicated to the pharmacy profession by serving as a preceptor at Virginia Commonwealth University School of Pharmacy working with 4th-year pharmacy students and was awarded the Outstanding Preceptor Award by the VCU School of Pharmacy (2017 – 2018 academic year)



Express Scripts

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Regional Consulting Pharmacist

  • Jul 2006 - Aug 2012

  • Conducted office visits/luncheons with provider offices to discuss the use of Preferred Drug List (PDL) which resulted in greater prescriber adherence to the PDL • Reduced prescription costs by initiating telephonic calls to provider offices that resulted in medication changes to the PDL, which lowered patient and plan costs • An integral member of a PDL clinical team which provides clinical consultation to patients on the use, dosage, side effects, and therapeutic incompatibles which resulted in increased patient knowledge and greater patient adherence with medication changes • Prepared and presented training concerning disease states and the medications used to treat to employees at plan sponsor corporations • Helped secure new accounts by assisting the sales team with the development and production of videos/tools to distribute to potential clients • Controlled drug spend for the Commonwealth of Virginia and a major benefit plan in the state of North Carolina by serving as the primary pharmacist consultant • Implemented formulary coverage reviews and prior authorizations (PAs) with provider offices which facilitated prescription processing



Virginia Department of Health

• Government Administration
• 700 & Above Employee

• Epidemiology Pharmacist

  • Feb 2005 - Jul 2006

  • Ensured timely response to requests for drug information, therapeutic appropriateness, clinical, and financial reviews of individual drugs or current pharmacotherapy for specific diseases • Performed services related to the preparation and dispensing of drugs and other pharmaceutical supplies in accordance with prescriber prescriptions • Dispensed vaccines and other medications to ensure the reduced risk of epidemics • Ensured timely response to requests for drug information, therapeutic appropriateness, clinical, and financial reviews of individual drugs or current pharmacotherapy for specific diseases • Performed services related to the preparation and dispensing of drugs and other pharmaceutical supplies in accordance with prescriber prescriptions • Dispensed vaccines and other medications to ensure the reduced risk of epidemics



Commonwealth of Virginia

• United States
• Government Administration
• 700 & Above Employee

• Hospital/Outpatient Pharmacist

  • Apr 1998 - Feb 2005

  • Supervised clinical and distributive services in both inpatient and outpatient pharmacies which resulted in the timely delivery of medications • Implemented managed care strategies by identifying clinically appropriate programs which reduced prescription costs • Reorganized a tracking system for clozapine monitoring and dispensing which greatly reduced the prescription dispense time • Successfully trained pharmacy technicians on a multitude of pharmaceutical requirements prior to board examinations



Caremark Prescription Services (now CVS Caremark)

• Managed Care Pharmacist

  • 1993 - 1997

  • Advised and assisted providers concerning drug choices, dosages, and directions when making changes to the preferred drug list (PDL) • Pioneered and implemented Caremark’s patient formulary education department. This newly created department streamlined operations by allowing patients to call directly into a designated department to discuss the use of formulary medications which resulted in greater patient adherence following medication changes • Studied and monitored pharmaceutical costs and utilization plus various trend analysis • Conducted clinical drug reviews and monitored the impact of Preferred Drug List (PDL)



NMC/American Homecare

• Clinical/Home Infusion Pharmacist

  • 1991 - 1993

  • Reduced healthcare costs by providing IV medication therapies such as TPN, pain management, chemotherapy, and antibiotics to patients receiving care at home • Helped support company operations by coordinating medication orders between providers and home care nurses as it related to patient care • Assisted in clinical functions (aminoglycoside dosing and TPN lab monitoring) as part of a clinical homecare pharmacy team • Trained PRN pharmacists, pharmacy technicians, and pharmacy students in appropriate home IV care applications and practices • Focused on strategies to reduce pharmacy expenses