Carelon, Austin, TX 04/2021 - CurrentClinical PharmacistPrior authorization pharmacist for Medicare. Experience in injectable specialty drugs including Drug Utilization Management, PaHub, Facets, Medicare Part B, LCD/LCA, GLP-1 determinations, peer-to-peer consultations, research and synthesis of detailed clinical data related to pharmaceuticals per authoritative compendia. Review and approve or deny coverage for pharmaceuticals based on medical necessity criteria. Previous clinical experiences:Accredo Specialty Pharmacy, Phoenix, AZ Specialty PharmacistAutoimmune Disease specialist with expertise in various diseases including Rheumatoid Arthritis , Psoriasis, UC, and Crohn’s disease. Experience in prospective drug utilization review pertinent to injectable biological drugs. Cigna Specialty Pharmacy, Phoenix, AZ Lead Specialty Pharmacist and Clinical TrainerLead pharmacist and clinical trainer for 40+ pharmacists across three sites in different states. Resolved conflicts in order processing and drug safety case entry, coached pharmacists on executing company procedures, implemented internal projects assigned by management, and led weekly team meetings. Experience in prospective and retrospective DUR per URAC standards. Served as a clinical resource for drug dosing, off-label use determination, REMS, compliance gaps and adverse event counseling. Successful development and implementation of a pharmacist training manual for all newly-hired pharmacists. Trained pharmacists in injectable and oral Specialty drugs used in Oncology, HIV, PAH, Hemophilia, Immunoglobulin deficiencies, and other rare diseases. Utilized pharmacovigilance knowledge in identifying, assessing, and reporting adverse events and product complaints to various manufacturers such as Roche, Pfizer, Biogen, and Sanofi. Experienced in the ARGUS system.Safeway Pharmacy – Phoenix, AZ