Anjani Patel, Pharmd, Cpgx Email & Phone Number

• Responsible for processing and documenting utilization management requests such as formulary/tier exceptions, prior authorization, step therapy and quantity limit exceptions for delegated products and services
• Lead clinical evaluation for coverage determination requests for all utilization management programs including consideration of the denial language and appropriateness of the decision pertaining to the clinical content.
• Review HCP prior authorization requests based on client specific criteria using rigorous clinical judgement and best practices centered communication
• Actively collaborate with medical and pharmacy team members to ensure consistency of utilization management decisions to meet monthly, quarterly, and annual client deliverables

• Mentor, train, and delegate tasks to junior pharmacists, interns and pharmacy technicians
• Lead Diabetes Care Coach program
• Responsible for the successful implementation of new clinical programs, complete understanding of clinical product portfolio (i.e. “Opioid to OTC”, “Gaps in Immunization”)
• Manage efficiencies within a high-volume setting (~900 scripts/day) to help create consistent growth in year to date pharmacy revenue while operating under allotted budget
• Practice patient centered care and collaborative practice with health care providers allowed for proven measures of increase in compliance and adherence rates
• Adhere to FDA adverse event reporting system (FAERS) and CVS guidelines using to guarantee accuracy in voluntary and mandatory reporting of patient adverse event reports, medication error reports, and product quality.

• Demonstrated knowledge of state and federal laws related to handling of controlled and non- controlled substances
• Assisted pharmacist in ensuring proficiency with patient specific data collection for accurate prescription therapy regimen
• Built a greater understanding of inventory management through comparing pricing amongst distributors and insurance rebates to yield highest profits
• Counseled patients on prescription and OTC medications and new drug therapy regimens
• Administered vaccines

• Participated in client implementation meetings and worked with Pharmacy and Therapeutics (P&T) committee to decide which drugs will appear on the drug formulary for the various commercial insurance plans; Recorded.
• Conducted cost effectiveness analysis on the newer drugs coming out versus the drugs already on the formulary
• Participated in client review forums; Developed drug monographs for the P&T committee to use during quarterly evaluations of drug formulary
• Helped pharmacist determine which drugs would need clinical benefit changes before being approved by various healthcare plans based on databases or pharmacoeconomics data and reporting mechanisms
• Analyzed deliverable of new and existing client contracts from a clinically based judgement

• Helped clinical pharmacist identify multi-drug interactions and to reduce risk of medication-related problems using the medication risk mitigation system (i.e., MedWise Advisor)
• Prepared an individualized care plan for patients to include medication-related issues discussed, specific recommendations for medications, and any action items for patients to share with their healthcare providers
• Used the MRM matrix tool to analyze both pharmacokinetics and pharmacodynamics risk including accumulative multi-drug interactions and drug-gene interactions and how they impact drug therapy for patients

• Assisted resident physicians by performing medication reconciliations on patients to improve clinical outcomes
• Presented patient cases to attending physicians
• Provided recommendations to providers on pharmacotherapy related problems
• Helped educate patients on importance of medication adherence
• Participated in the diabetes educational outreach program aimed at helping patients withdiabetes meal plan and better understand their disease

Doctor Of Pharmacy - Pharmd, Pharmacy

Activities and Societies: Kappa Psi Pharmaceutical Fraternity, National Community Pharmacists Association

Bachelor Of Science - Bs, Biology/Biological Sciences, General