JONAS TERRY
New Orleans,LA
Summary
Clinical Pharmacist with 18 years of experience in diverse pharmacy benefit environments, including Fee-for-Service, Managed Care, Medicaid, Medicare, Commercial, and Health Insurance Exchange health plans. Proven track record in developing clinical pharmacy policies, and optimizing drug utilization to enhance quality and compliance, while controlling costs. Expertise in cross-functional collaboration with state agencies, health plans, and Pharmacy Benefit Managers, alongside strong skills in drug information and formulary management. Demonstrated ability to advance evidence-based strategies and support clinical programs and initiatives.
Overview
22
22
years of professional experience
1
1
Certification
Work History
Clinical Pharmacist
Elevance Health (CarelonRx)
New Orleans, LA
12.2024 - Current
- Manage pharmaceutical selection, drug formulary strategy, drug utilization review, and weekly Medi-Span coding updates for the Health Insurance Exchange line of business.
- Lead formulary management processes, including compliance with federal and state requirements.
- Update clinical criteria documents, ensure accurate claims adjudication, and oversee member/provider communications on formulary changes.
Clinical Pharmacist Account Manager
Prime Therapeutics (Magellan Health)
New Orleans, LA
12.2022 - 12.2024
- Served as Clinical Account Manager and Project Lead for the Arizona, Idaho, and Florida Medicaid Preferred Drug List (PDL) programs.
- Developed evidence-based PDL recommendations for the client's P&T Committees based on clinical efficacy, safety, and cost-effectiveness.
- Monitored pipeline drugs, modeled financial impact, and contributed to forecasting and budget planning.
Pharmacist
DC Government - Dept. of Health Care Finance (DC Medicaid)
Washington, DC
09.2016 - 12.2022
- Served as DC Medicaid's sole internal pharmacy technical expert, overseeing PBM management, benefit design, claims rules, First Databank/NCPDP standards, PDL updates, UM strategies, rebates, and cost utilization initiatives.
- Determined approvals/denials for medical benefit drug prior authorizations.
- Implemented and managed the DC Medicaid Pharmacy Lock-in Program and Medication Therapy Management Program citywide.
Pharmacy Manager/Staff Pharmacist
Rite Aid Corporation
Washington, DC; Atlanta, GA; New Orleans, LA
09.2003 - 10.2017
- Dispensed medications, conducted DUR, provided immunizations, and delivered MTM services.
- Led clinical decision-making for adverse event assessments, drug interactions, and medication counseling.
- Managed inventory, payroll, productivity, compliance, and pharmacy technician staff.
Pharmacist Consultant
Anthem Blue Cross Blue Shield
Atlanta, GA
04.2015 - 09.2016
- Conducted patient MTM reviews to optimize therapy appropriateness, compliance, safety, and efficacy.
- Communicated with providers to resolve duplications, interactions, and suboptimal therapies.
- Supported quality measures, including HEDIS and Medicare Star Ratings.
Education
Doctor of Pharmacy -
Xavier University of Louisiana
New Orleans, LA05-2007
Bachelor of Science - Psychology Pre-Medicine/Chemistry
Xavier University of Louisiana
New Orleans, LA05-2003
Skills
- Drug Formulary (Preferred Drug List) Management
- Drug Utilization Management (UM)
- Pharmacy Benefit Management Operations and Oversight
- Pharmacy Benefit Design
- Drug Utilization Review (DUR)
- Clinical Pharmacy Policy Writing
- Clinical Pharmacy Program Development
- Medication Therapy Management (MTM)
- Medicaid Pharmacy Benefits
- Medicare Pharmacy Benefits
- Commercial Bharmacy Benefits
- Health Insurance Exchange Pharmacy Benefits
- Pharmacy Claims Adjudication
- Pharmacy Claims Testing
- Prior Authorization Review and Determination
- Regulatory Oversight
- Compliance Oversight
- Quality Assurance
- Performance Improvement
- Pharmacy Trend Analysis
- Program Management
- Retail Pharmacy Management
- Microsoft Office (Word, Outlook, PowerPoint, Excel, NotePad, and Teams)
- NexGen
- Power BI Desktop
- MOVEit
Certification
• Pharmacist Licenses - District of Columbia, Georgia, Louisiana, Maryland, and Virginia
• CPR Certification - American Heart Association (AHA)
• Immunization Delivery Certification - American Pharmacist Association (APhA)
• MTM Certification - American Pharmacist Association (APhA)
• CPR Certification - American Heart Association (AHA)
• Immunization Delivery Certification - American Pharmacist Association (APhA)
• MTM Certification - American Pharmacist Association (APhA)
Timeline
Clinical Pharmacist
Elevance Health (CarelonRx)
12.2024 - Current
Clinical Pharmacist Account Manager
Prime Therapeutics (Magellan Health)
12.2022 - 12.2024
Pharmacist
DC Government - Dept. of Health Care Finance (DC Medicaid)
09.2016 - 12.2022
Pharmacist Consultant
Anthem Blue Cross Blue Shield
04.2015 - 09.2016
Pharmacy Manager/Staff Pharmacist
Rite Aid Corporation
09.2003 - 10.2017
Doctor of Pharmacy -
Xavier University of Louisiana
Bachelor of Science - Psychology Pre-Medicine/Chemistry
Xavier University of Louisiana