Steven Surrette, Pharmd, Mba Email & Phone Number

Steven Surrette, Pharmd, Mba is a Clinical Pharmacist Reviewer at Magellan Health Services. He possess expertise in clinical pharmacy, healthcare, pharmacy, clinical guidelines, disease management and 29 more skills.

Listed skills include Clinical Pharmacy, Healthcare, Pharmacy, Clinical Guidelines, and 30 others.

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  Clinical Pharmacist Reviewer

  Magellan Health Services

  Mar 2013 - Present - Maryland Heights, Mo (Remote Employee)

  Support Magellan’s medical office based prior authorization program for high-cost medical injectables (primarily oncology, autoimmune, and supportive agents) for 12 distinct health plans encompassing over 2 million lives, by determining if requests meet plan guidelines and current standards of care. Work in a fast-paced fluid environment with frequent changes in parameters and workflows, constantly adjusting to new processing requirements set forth by health plans and internal policies.Physician Relations: Collaborate with internal oncologists and rheumatologists to ensure new and ongoing clinical studies are interpreted appropriately when determining a clinical course of action for complex prior authorization requests.Clinical Appeals: Part of a team of appeals pharmacists who are tasked with reviewing first and second level appeals of denied requests by consulting with our specialists for more in-depth analysis.Medicare Claim Reviews: Led post-service, third-party claim reviews to determine if initial reimbursement determination for specialty pharmaceuticals were clinically appropriate per CMS clinical guidelines and available literature. Clinical Expertise: Build and maintain library of supportive literature for the use of specific agents and drug regimens for off-label indications, for use in prior authorization determination process. Internal Support: Provide consultation on pharmacy related queries for teams within the organization (e.g. authorization and claims, etc.) as needed.