Tom Grigowski Email & Phone Number

Detroit, Mi, Us

Greater Detroit Area

In my experience as a Fraud Waste & Abuse (FWA) Pharmacist, I've revised my personal scope of pharmacy practice by integrating clinical knowledge with business acumen and utilization of big data to protect the health, safety, and wallets of patients.Primary responsibilities include:- Utilizing robust data analytic tools to use a multivariate approach in identifying aberrancies in dispensing and prescribing patterns among pharmacies and prescribers in BCBSM networks- After confirming common trends and collaborating with internal investigators and external law enforcement, presenting factual information to multi-disciplinary committee that serves as the basis for decisions about pharmacy and prescriber participation in BCBSM networks- Documenting and clearly communicating committee decisions to internal stakeholders and third-party vendors to ensure continuity of business processesKey accomplishments include:+ Recommendations based on my analyses of at least five high-risk medications resulted in implementation of utilization management criteria to mitigate risks to patients+ FWA program directly responsible for significant savings in FY2018+ Facilitated pharmacy network transition to third-party vendor in 2019

Troy, Michigan

Greater Detroit Area

This role was a temporary contract with Blue Cross Blue Shield of Michigan.Key responsibilities and functions included: • Providing education to members regarding the coverage gap in Medicare Part D plans • Suggesting strategies to decrease cost-burden for members, and • Recommending optimal and economical pharmacotherapy regimens