Humana Specialty Pharmacy serves members requiring medications to treat genetic, rare, chronic or complex health care conditions. Services include patient education, one-on-one coaching, benefits verification, coordination with members’ health care provider team and therapy counseling to assure medication adherence. Clinical Pharmacist (November 2013 – Present)• Supervise technicians and other support staff.• Consult with prescribers, nurses and other health care professionals.• Counsel patients regarding common side effects, proper dosing and administration, potential drug-drug or food-drug interactions, proper storage/stability, and techniques for self-monitoring of drug therapy.• Research patient concerns.

BioRx specializes in the following disease states and associated therapies: Hemophilia and related bleeding disorders, immunoglobulin therapy (IVIG and SCIG) for primary immunodeficiency disease, augmentation therapy for alpha-1 antitrypsin deficiency, hereditary angioedema (HAE) and enteral/parenteral therapies for nutritional deficiencies/digestive disorders.Clinical Pharmacist (May 2013 – November 2013)• Created and maintained patient charts, progress notes and care plans. • Supervised technicians and other support staff. • Consulted with prescribers, nurses and other health care professionals.• Counseled patients regarding potential side effects, proper dosing and medication storage.• Responsible for dose calculation/drafting of orders for primary therapy and ancillary medications.

Clinical Affairs:• Contributed to development of innovative clinical programs that saved $360M ($2.84 PMPM) for Commercial Business in 2012.• Prepared and presented clinical edit summaries to the Drug Utilization and Policy Review Committee, a subcommittee of the Anthem/WellPoint National Pharmacy and Therapeutics Committee (P&T).• Developed new process for organizing/tracking various utilization management programs across all lines of business – Commercial, Medicaid and Medicare Part D.Benefit Administration/Operations:• Assisted in the migration of pharmacy business from Anthem/WellPoint NextRx legacy systems to current PBM, with a focus on accurate transfer of benefit, formulary and clinical edit data. • Developed process and procedure documentation to support formulary comparisons/disruption analysis, step therapy and grandfathering authorizations. • Consulted for build-out of formularies, UM programs/clinical edits and test plans for integration of new business. • Assisted in the development of process and procedure documents to support vendor data transfer file (VDTF) processes for prior authorization, open refill and claims history.

Prior Authorization: • Reviewed claims rejects tied to utilization management programs and provided consultation to members, prescribers and internal stakeholders. • Supervised technicians and other support staff.Clinical Formulary Management: • Ensured timely and efficient implementation of P&T decisions including formulary changes and utilization management programs.• Provided support for implementation and maintenance of commercial, Medicaid and Medicare Part D products.• Communicated and consulted with both internal and external stakeholders.• Supervised technicians, business analysts and other support staff.

• Developed custom utilization management programs for a Fortune 10 company.• Provided clients with clinical, operational, financial and regulatory information to assist them in making informed decisions regarding benefit design.• Participated in RFP process for renewing clients.

• Counseled members regarding food/drug interactions, potential side effects, proper dosing and medication storage. • Served as integral member of a team of pharmacists and technicians responsible for administering two custom managed care programs – Seniors Drug Utilization Review and Digestive Health Pharmacotherapy.

• Served as a preceptor for pharmacy students and graduate pharmacy residents.• Responsible for pharmacokinetic monitoring and dosage adjustments/recommendations; primarily monitored aminoglycoside and vancomycin therapy. • Performed quality assurance activities and ensured compliance with policies/procedures. • Provided a series of lectures on pharmacology, anatomy and physiology to pharmacy technicians preparing for the national certification exam (CPhT).• Served as a member of the nutritional support subcommittee.