Amy Cully, Pharm D
Eden,NY
Summary
Veteran managed care clinical pharmacist, known for high productivity and efficient project management. Specialized in formulary development/maintenance, prior authorization, drug utilization, clinical drug information content, and data analysis. Excel at communication and teamwork to provide cost-effective, evidence-based care and outcomes.
Overview
21
21
years of professional experience
1
1
Certification
Work History
Clinical Pharmacist, Director Drug Utilization
Conduent
Remote
05.2015 - Current
- Develop clinical criteria documents utilizing FDA drug approvals, treatment guidelines and peer-reviewed literature.
- Review internal reports and data, and identify areas of intervention or potential cost savings.
- Review the weekly First Data Bank (FDB) file for new drugs on the market and update or create new clinical material.
- Make updates to automation tools using clinical criteria or weekly drug files.
- Present clinical materials and recommendations at multidisciplinary drug utilization board meetings.
- Clinical resource within the company, as well as for clients.
- Conduct regular meetings with department heads to review progress on strategic initiatives.
- Maintain up-to-date knowledge of pharmacology, therapeutics, and new drug developments.
- Direct the organization's clinical operations, ensuring compliance with applicable laws, regulations, and contract agreements.
- Recruit, train, supervise, evaluate, and mentor staff members.
Sr Clinical Formulary Pharmacist
Emblem Health
Remote
11.2020 - 08.2022
- Develop and maintain Commercial, Exchange, Medicare, and Medicaid formularies.
- Create and review pharmacy, step therapy, and medical prior authorization criteria for use by utilization pharmacists during the prior authorization process.
- Utilize FDA-approved indications, national treatment guidelines, compendia drug databases, and peer-reviewed literature when making clinical decisions and recommendations for clinical criteria and formulary placement.
- Review new pharmaceuticals to determine the appropriate placement on the formulary, PDL, and drug policies.
- Lead and present formulary recommendations, prior authorization criteria, and new drug reviews to the Pharmacy and Therapeutics (P&T) Committee.
- Provide comprehensive medication review and adherence education for Medicare members to enhance STAR and HEDIS ratings.
- Contact providers regarding therapy change recommendations after reviewing a member's pharmacy and medical history.
- Maintain and develop departmental policies and procedures.
- Participate and provide clinical support during audits.
- Update staff, other departments, providers, and members on changes to formularies and prior authorization criteria.
Clinical Pharmacist
Blue Cross Blue Shield of WNY
Buffalo, NY
01.2013 - 05.2015
- Review pharmacy and medical prior authorization requests (Medicare, Medicaid, Commercial, and Exchange) according to timelines.
- Utilize company drug policies, treatment guidelines, peer-reviewed literature, drug indications, and formulary to make clinical decisions for utilization management.
- Present a summary of relevant clinical information, member medical history, and recommendation to the reviewing medical director for appeals.
- Prepare and present clinical materials to the Pharmacy and Therapeutics (P&T) committee.
- Develop new and maintain existing clinical criteria.
- Review feedback and efficacy of the coverage determination process for outcome reporting.
- Oversee pharmacy technicians.
Staff Pharmacist
Lake Erie Regional Medical Center
Irving, NY
08.2003 - 04.2013
- Process, prepare, and dispense medication orders.
- Provide patient counseling on admission and at discharge.
- Participate in daily patient rounds with healthcare staff.
- Develop treatment plans for admitted patients.
- Provide drug-related information to the medical staff.
- Recommend adjustments to drug therapy based on patient demographics and medical history.
- Prepare I.V. admixtures and TPNs.
- Perform drug therapy monitoring.
- Attend various interdisciplinary team meetings.
- Supervise and direct pharmacy interns and technicians.
Education
Doctorate of Pharmacy -
UNIVERSITY AT BUFFALO COLLEGE OF PHARMACY
Buffalo, NY05.2003
Skills
- Formulary Maintenance
- Prior Authorization/ Criteria Development
- Pharmacy and Therapeutics (P&T)
- MTM/Comprehensive Medical Review
- Clinical Recommendations
- Specialty Drugs
- Drug Utilization Review
Certification
Registered Pharmacist, New York 049322
Timeline
Sr Clinical Formulary Pharmacist
Emblem Health
11.2020 - 08.2022
Clinical Pharmacist, Director Drug Utilization
Conduent
05.2015 - Current
Clinical Pharmacist
Blue Cross Blue Shield of WNY
01.2013 - 05.2015
Staff Pharmacist
Lake Erie Regional Medical Center
08.2003 - 04.2013
Doctorate of Pharmacy -
UNIVERSITY AT BUFFALO COLLEGE OF PHARMACY