Chelsea Amerson PharmD, BCMTMS

Experience

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  CVS Pharmacy

  Aug 2018 - Oct 2019

  Pharmacist

  Awarded (by my District Manager) for being the location with the most vaccinations (30 total) given over a day.Performed a flu vaccination day, as sole pharmacist, at a long term care facility, vaccinating over 50 geriatric patients in a day.

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  Parker's Pharmacy

  Oct 2018 - Oct 2019

  Pharmacist

  Verified 277 prescriptions, the most prescriptions in a day since the start of business.

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  Quality of Life Health Services, Inc.

  Oct 2019 - Nov 2024

  Managed over 11 ancillary staff in 5 locations filling more than 1,500 prescriptions weekly. Performed MTM’s increasing overall performance to over 80%. I was able to generate an extra $5,537 in revenue for the pharmacy department for the fiscal year 2022, $6,508 in revenue for 2023, and over $4,000 by October end 2024. Built and managed a quality assurance report measuring medication synchronization, comprehensive medication reviews, targeted intervention program opportunities, and STAR rating data across all 5 pharmacy locations. Independently trained pharmacist, and 3 technicians at 2 of the 5 pharmacy locations. My pharmacy location was part of an interdisciplinary team seeing a growth of 2,733 patients from 2019-2023. Evaluated by the Joint Commission and was found to be compliant with no derogatory marks upon the visit. Performed biweekly internal pharmacy audits for all 5 pharmacy locations. Independently identified gaps in healthcare (Statin use with diabetic patients, lack of HgA1C draws, and appropriate immunizations) and increased the SUPD CMS Star ratings by 50% going from 25% to 75% and overall medication adherence increased to 75%. Ensured compliance with 340B regulations through manual ordering and audits of 340B drugs for the patient population. Over 5 years of extensive experience with 340B billing and proficiency with Epic. Organized and analyzed large sets of data efficiently, leading to the successful presentation of these data sets to various stakeholders, including but not limited to the Board of Directors. Show less

  • Clinical Pharmacy Manager

    Mar 2021 - Nov 2024

  • Clinical Staff Pharmacist

    Oct 2019 - Mar 2021
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  Optum

  Nov 2024 - now

  Clinical Prior Authorization Pharmacist

  Evaluate and process prior authorization (PA) requests for medications submitted by healthcare providers or patients. Review clinical information, patient history, drug therapy regimens, and relevant documentation to determine if the requested medication meets medical necessity criteria and is in line with formulary guidelines. Utilize clinical knowledge to determine the appropriateness of medications based on evidence-based medicine, drug efficacy, safety, and cost considerations. Make timely and informed decisions on the approval, denial, or modification of PA requests based on clinical guidelines and payer policies. Collaborate with healthcare providers to clarify PA requests, obtain additional clinical documentation, and discuss alternatives when necessary. Act as a liaison between healthcare providers, patients, and insurance companies to resolve any issues related to PA requests. Assist in the preparation of appeals for denied requests by providing clinical justifications, alternative therapy options, and supporting documentation. Advocate for timely access to necessary medications for patients, ensuring the process is as smooth and efficient as possible. Provide patients with information about the prior authorization process, potential delays, and alternative options when applicable. Ensure compliance with all regulatory requirements, including HIPAA, CMS guidelines, and other federal or state regulations related to prior authorization and patient privacy. Participate in quality control processes to ensure that prior authorization decisions meet the highest standards of accuracy and clinical appropriateness. Follow internal protocols and standards for processing prior authorization requests and managing denials or appeals. Keep up-to-date with the latest developments in pharmacy practices, medication therapies, clinical guidelines, and payer policies that may impact prior authorization processes. Show less