Experience

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  Renaissance ross bridge

  Sept 2011 - Aug 2015

  Golf course outside services personnel
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  Viva health

  Jul 2016 - Jun 2017

  Pharmacy resident

   Integral member of interdisciplinary care team, collaborating with healthcare professionals and care managers and combining clinical and business knowledge to make recommendations that optimize outcomes for both patients and the Company Designed a predictive pricing model to analyze the net costs of specialty medications when run through medical benefits or pharmacy benefits in order to identify cost savings opportunities for the plan Review cases, provide medication recommendations, and coordinate with additional healthcare professionals throughout the Company to identify opportunities for interventions that prevent negative drug interactions, reduce hospital readmissions and improve overall patient care Utilize intricate understanding of benefit designs of various insurance plans and formularies including Medicare Part D and commercial lines of business to ensure optimal cost sharing between patients and the health plan Resolve coverage determination requests by assessing the appropriateness of drug therapy based on clinical judgement and compliance with Medicare rules and regulations Perform claims data analysis and communicate daily with physician offices to resolve third party processing issues on the patient’s behalf Create and update general and specialty drug class medical policies outlining uses, coding and requirements for medical coverage Conduct quality assurance of analysts’ data entry in order to ensure timely completion of prior authorizations and delivery of patient therapy Show less

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  Magellan rx management

  Jun 2017 - Jun 2021

  • Manager, Specialty Clinical Solutions

    Dec 2019 - Jun 2021

  • Manager, Clinical Medical Pharmacist Liaison

    Aug 2018 - Dec 2019

  • Clinical Medical Pharmacist Liaison

    Jun 2017 - Aug 2018
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  Express scripts

  Jul 2021 - Feb 2023

  Director, medical drug strategy
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  Mosaic group | an ipg health company

  Jul 2023 - now

  Director of strategic planning