Experienced PBM Professional with 23 years in the pharmaceutical insurance industry, includes group health and workers' compensation, with emphasis on pharmacy contracting, plan implementation, formularies, clinical programs, i.e., step therapy, therapuetic interchange, prior authorizations, and formulary design from an operational perspective. Built and developed a workers' compensation Pharmacy Benefits Manager that offers live, real-time adjudication of prescription transactions, a network of contracted pharmacies, formulary management, and pharmacy help desk, that provides significant cost savings to our clients. Knowledgable in pharmacy contracting and pharmacy reimbursement. Account Management experience that includes but is not limited to: plan design and implementation, plan updates and changes in coverage, implementation of cost savings programs, presentations/sales of prescription drug plans, and providing superior customer service to internal and external clients. Knowledgable in workers compensation state fee schedules for pharmaceuticals and experienced in repricing pharmaceuticals according to those fee schedules. Knowledgeable in workers compensation formularies including but not limited to California MTUS, ODG, and New York.Work closely with other departments within the company. Act as a resource for the utilization review department to assist with pharmaceutical certifications and Medicare-Set-Aside submissions. Assist the medical bill review department in repricing and making recommendations on medications as they relate to the work injury and in accordance with fee schedules. Act as a resource for the provider networks team and provide feedback regarding both in and out of network providers. Certified American Red Cross CPR Instructor.Previously: Emergency Medical Technician-Defibrillation