Amanda McLellan
Scottsdale,AZ
Summary
Detail-oriented Clinical Pharmacist licensed in North Carolina, Arizona, New Mexico, and Oklahoma with a strong commitment to patient safety and optimal therapeutic outcomes. Recognized for exceptional accuracy, quality, efficiency, and adaptability in high-volume case review environments. Applies evidence-based clinical judgment to evaluate prior authorization requests and support safe, clinically appropriate, patient-centered medication therapy.
Overview
22
22
years of professional experience
Work History
Coverage Determination Clinical Pharmacist
Centene Pharmacy Services
Tempe, AZ
01.2020 - Current
- Demonstrated proficiency reviewing Coverage Determination cases across multiple lines of business, specializing in Medicare, California Commercial, North Carolina Medicaid, and Arizona Medicaid; cross-trained to support South Carolina, Illinois, Michigan, Washington, Oregon, and Oklahoma Medicaid plans for evening and weekend coverage.
- Expanded responsibilities to include experience in Health Insurance Marketplace, Technician Review, and Redetermination/Appeals workflows to provide flexible support during high-volume review periods.
- Consistently exceeded daily production targets and monthly quality benchmarks through efficient, high-volume case review.
- Achieved 100% quality scores in 7 of 12 months, maintaining an overall annual quality score of 99.67% in 2025.
- Provided training support and mentorship for newly hired Medicare pharmacists and newly licensed pharmacists reviewing North Carolina Medicaid coverage determinations.
Clinical Pharmacist: Medication Therapy Management
CVS/Caremark
Phoenix, AZ
02.2016 - 01.2020
- Conducted Comprehensive Medication Reviews (CMRs) for Blue Cross Blue Shield Federal employees within a URAC-accredited Medication Therapy Management program.
- Evaluated medication regimens for appropriateness, effectiveness, safety, and adherence, identifying opportunities to optimize therapy.
- Identified gaps in therapy and provided patient education and disease state management counseling.
- Counseled patients on prescription and over-the-counter medications, developing individualized medication action plans and written care plans.
- Communicated medication-related concerns and therapeutic recommendations to healthcare providers through verbal and written interventions.
- Provided timely patient follow-up to address therapy concerns, answer questions, and reassess medication outcomes.
- Reviewed laboratory values and clinical parameters to support safe and appropriate medication use.
- Developed patient-specific strategies to improve medication adherence, addressing complex regimens, adverse effects, and cost barriers.
- Completed 8–14 Comprehensive Medication Reviews daily while maintaining high patient satisfaction and clinical intervention acceptance.
Clinical Pharmacist: Patient Support Center
CVS/Caremark
Phoenix, AZ
11.2015 - 01.2016
- Provided exceptional patient and provider support for high-volume inbound pharmacy calls.
- Verified prescription accuracy, corrected errors, and ensured compliance with state and federal regulations.
- Counseled patients on medication use, safety, side effects, and adherence, including formulary alternatives.
- Consulted with healthcare providers to optimize drug therapy based on patient insurance coverage.
- Managed prescription transfers between retail and mail order pharmacies while maintaining confidentiality and accurate documentation.
- Served as a pharmaceutical resource, delivering timely and accurate drug information.
Retail Staff Pharmacist
Walgreens
Raleigh, NC And Rockford, IL
03.2006 - 07.2015
- Verified prescription accuracy from data entry through final product review while managing a high-volume workflow (250–350 prescriptions/day).
- Counseled patients on safe medication use, including prescription, OTC, and medical devices; provided disease state management and blood pressure monitoring.
- Collaborated with nurses, prescribers, and insurance companies to optimize patient therapy and resolve coverage issues.
- Administered immunizations (influenza, pneumonia, shingles) and performed MTM interventions to address suboptimal therapy or medication duplication.
- Assisted in pharmacy operations and compliance, including supervising staff, maintaining inventory, and ensuring adherence to Board of Pharmacy, DEA, and corporate regulations.
Retail Pharmacy Manager
Eckerd Pharmacy
Raleigh, NC
07.2004 - 03.2006
- Supervised four pharmacy staff and rotating students, ensuring adherence to company operations and policies.
- Oversaw daily pharmacy operations, ensuring compliance with state and federal pharmacy regulations and quality standards.
- Managed inventory levels, optimizing stock to minimize waste and enhance availability.
- Delivered timely, patient-centered customer service.
Education
Doctor of Pharmacy -
University of North Carolina At Chapel Hill
Chapel Hill, NC05-2004
Bachelor of Science - Geology And Geophysics
University of Wisconsin, Madison
Madison, WI05-1998
Skills
- Prior Authorization & Utilization Management
- Clinical Decision Making Using Evidence-Based Guidelines
- Formulary & Insurance Navigation
- Therapeutic Optimization & Disease State Management
- High Quality & Timely Clinical Case Review
- Cross-Functional Clinical Collaboration
- Flexible & Efficient Under High Workload
- Medication Therapy Management (MTM)
- Patient Counseling & Education
Timeline
Coverage Determination Clinical Pharmacist
Centene Pharmacy Services
01.2020 - Current
Clinical Pharmacist: Medication Therapy Management
CVS/Caremark
02.2016 - 01.2020
Clinical Pharmacist: Patient Support Center
CVS/Caremark
11.2015 - 01.2016
Retail Staff Pharmacist
Walgreens
03.2006 - 07.2015
Retail Pharmacy Manager
Eckerd Pharmacy
07.2004 - 03.2006
Doctor of Pharmacy -
University of North Carolina At Chapel Hill
Bachelor of Science - Geology And Geophysics
University of Wisconsin, Madison