David Bollenbacher Email & Phone Number

Cincinnati, Ohio, United States

Cincinnati, Oh

• Provide access and reimbursement education to medial offices and specialty pharmacies to help navigate pathways for obtaining Praluent therapy.• Presentation of information regarding patient support programs, prior authorization/appeal processes, reauthorization requirements, and clinical information for Praulent. • Execute strategic tactical plans for the execution of Praluent access and reimbursement initiatives relevant to the defined needs of each sales colleague and account within the defined customer market.

Cincinnati, Ohio

• Make prior authorization determinations based upon formulary and evidence based clinical data.• Prior authorization determinations, research and synthesize detailed clinical data related to injectable pharmaceuticals.• Experience in Injectable/Specialty Drug oversight including Drug Utilization Management.• Provides evaluation of member RX needs and therapies through review of medication history to determine if medication are appropriate.• Provide injectable drug medical necessity reviews covered under the Medical benefit (Part B).• Ensures that Providers understand appropriate use of current prescription, reimbursement and coverage guidelines per payer policy and appropriate coding to ensure coverage.• Determines potential barriers to compliance and identifies solutions to overcome barriers.• Educates both internal and external stakeholders in coverage compliance and reimbursement requirements.• Guides and educates external customers in obtaining coverage under various payer policies (Medicare, Medicaid, etc.)

Cincinnati Area

• Developing and implementing new prior authorization criteria based on FDA label, off-label indications and review of study based evidence for a multitude of specialty medications.  Oncology: Tablets ( Gleevec, Revlimid, Tamoxifen, Mekinist, Afinitor, Opdivo) Injectable (Topotecan, Prolia) Hepatitis C: Harvoni, Daklinza Cystic Fibrosis: Orkambi• Act as a liaison between medical directors and outside pharmacies to verify the accuracy and adherence to established drug approval criteria and the reimbursement guidelines per payer policy (Medicare, Medicaid, etc). • Presentation of criteria to multi-functional teams and stakeholders.• Working knowledge of adverse events and safety profiles of pharmaceuticals.• Review clinical research data to locate evidence based, off label criteria for specialty medication approval.• Extensive experience with ICD 10 Codes.• Review appropriate billing and coding for products, assist with resolving reimbursement issues, and help ensure appropriate education to avoid future reimbursement hurdles.• Serve as an expert resource to internal and external team members.

Springdale, Ohio

Team Lead 2012 – 2013Supervising Specialty Pharmacist 2010 – 2012Supervising Screening Pharmacist 2010 – 2010Member Services Pharmacist 2008 – 2010 • Multiple positions held with a heavy emphasis on process and people management. • Managed highly intellectual teams ranging in size from 8-15 pharmacists. • Responsible for the unit’s successful completion of multiple pharmaceutical functions associated with specialty drug delivery and patient care counseling.  Oncology: Revlimid, Tykerb Hepatitis C: Pegasys, ribavirin Pulmonary Arterial Hypertension: Tracleer, Letairis Multiple Sclerosis: Avonex, Copaxone Rheumatoid Arthritis: Enbrel, Humira Pediatric Hemophilia: Advate HIV/AIDS: Retrovir• Reported to the FDA to establish drug safety guidelines for highly regulated medications, managed clinical interventions, conducted drug utilization reviews, and worked directly with doctors & patients. Below is a summary of positions held & accomplishments:Accomplishments: Developed utilization management program resulting in savings in excess of $8.5 million dollars in 2011. Developed and implemented new processes (UM Program Tracking, & Hepatitis C Reporting). Developed 24/7 coverage program within the department to meet URAC accreditation. Managed two teams (8 Specialty & 15 Screening Pharmacists) and acted as a subject matter expert regarding policies & procedures companywide.

West Chester, Ohio

• Screened and dispensed standard care medication. • Performed patient consults.• Acted as a liaison between the provider and patient.• Managed prescriptions and provided direction to physicians.

Phoenix, Arizona Area

• Researched clinical trial data to create prior authorization criteria based on outcome findings. • Responsible for educating technicians in pharmaceutical equations to assist in the certification process.• Developed & managed an electronic referencing system used for clinical research.

Bachelor Of Science (Bs), Pharmacy

Education record

Certified Lean Six Sigma Yellow Belt