LORI ANN TSCHINKEL
Kings Park,NY
Summary
Innovative and results-driven pharmacist with extensive experience across managed care, utilization management (UM), care management (CM), and retail pharmacy leadership. Proven ability to optimize medication therapy, enhance quality metrics (HEDIS, CMS Stars), and drive formulary and cost-containment strategies through evidence-based decision-making. Skilled in evaluating high-cost specialty medications, conducting medication reconciliation, and improving adherence through targeted outreach. Adept at regulatory compliance (CMS, NCQA, NYS), clinical audits, interdisciplinary collaboration, and team leadership. Passionate about advancing patient outcomes, operational efficiency, and healthcare equity through pharmacy excellence.
Overview
22
22
years of professional experience
1
1
Certification
Work History
Clinical Pharmacist
Heritage Healthcare Partners IPA
12.2018 - Current
- Serve as a strategic clinical resource across Utilization Management (UM), Care Management (CM), and Population Health teams to improve care transitions and optimize patient outcomes.
- Conduct comprehensive clinical reviews of prior authorization requests to evaluate appropriateness of therapy based on evidence-based guidelines and health plan criteria.
- Collaborated with physicians, nurses, and case managers to ensure safe, effective, and cost-efficient medication use.
- Evaluate pharmacy utilization trends to identify cost-saving opportunities, promote optimal prescribing practices, and implement formulary optimization strategies.
- Assess specialty medications—particularly in oncology and transplant—for appropriateness, adherence, and overall value, collaborating with providers and specialty pharmacies to ensure best-in-class care.
- Ensure regulatory compliance with CMS and NCQA standards related to medication reviews and appeals.
- Lead and support initiatives aligned with pharmacy quality measures, including HEDIS, CMS Stars, medication adherence, and statin use in patients with diabetes.
- Conduct medication reconciliation during transitions of care to prevent medication errors and ensure continuity, collaborating with providers and care teams to resolve discrepancies.
- Attend interdisciplinary clinical rounds and serve as a key pharmacy resource to UM and CM teams, offering expert consultation on medication therapy and management.
- Drive cost-containment efforts by identifying opportunities for generic substitution, formulary compliance, and appropriate specialty medication use.
- Develop and implement targeted outreach strategies to improve member adherence and support chronic disease management.
- Utilize data analytics to evaluate program performance, identify trends, and recommend evidence-based process improvements.
- Ensure regulatory compliance with state (NYS), CMS, NCQA, and health plan requirements; serve as a clinical liaison during audits and performance evaluations.
- Provide education, training, and clinical oversight to internal teams and external providers on best practices in medication therapy management.
- Provide consultations and answered inquiries from patients, healthcare professionals and physicians regarding drugs, potential side effects, and specified use.
Pharmacist
Echo Pharmacy
07.2018 - 06.2021
- Performed accurate and timely data entry of patient and prescription information.
- Provided patient and prescriber consultations, addressing medication inquiries and therapy guidance.
- Led the successful implementation and ongoing maintenance of the practice’s first Electronic Health Records (EHR) system.
- Managed inventory operations, including strategic ordering and loss prevention measures to optimize supply levels and minimize waste.
- Oversaw daily personnel workflow and scheduling, contributing to a well-organized and efficient team environment.
- Administered immunizations (e.g., influenza, pneumonia) to support community health and disease prevention efforts.
- Prioritized and coordinated tasks effectively, resulting in improved operational efficiency and reduced wait times.
- Delivered expert consultations on drug therapies, usage, and potential side effects to patients and healthcare providers.
- Fostered strong patient relationships, consistently achieving high levels of satisfaction and retention through personalized care and support.
- Prepare customized medications by mixing, combining, or altering ingredients to meet specific patient needs based on physician prescriptions.
Pharmacy Manager
CVS Pharmacy
01.2009 - 07.2018
- Directed daily operations of a high-volume retail pharmacy with a focus on patient safety, workflow efficiency, and regulatory compliance
- Recruited, trained, and mentored a team of pharmacists, technicians, and interns, fostering a culture of excellence and continuous improvement
- Implemented corporate and local initiatives to improve medication adherence, enhance patient education, and support chronic disease management
- Conducted performance reviews, managed scheduling and workflow, and contributed to strategic planning for revenue and service optimization
- Collaborated with healthcare providers to resolve complex clinical issues and improve patient outcomes
Staff Pharmacist
CVS Pharmacy
01.2007 - 01.2009
- Counseled patients on proper medication use, side effects, and drug interactions to promote safe and effective treatment outcomes.
- Collaborated with prescribers to resolve therapeutic issues, dosage adjustments, and prior authorization requirements.
- Accurately dispensed and verified prescriptions in a high-volume setting, averaging [insert #] prescriptions per day.
- Managed inventory, ensured adequate stock levels, and minimized medication waste through regular audits and returns.
- Supervised pharmacy technicians and supported training on workflow efficiency, customer service, and compliance.
- Ensured adherence to state and federal regulations, including DEA record-keeping and HIPAA compliance.
- Conducted immunizations (e.g., flu, COVID-19, shingles) and educated patients on preventive care options.
- Identified and resolved insurance billing issues, improving patient access to prescribed therapies.
- Built strong patient relationships and provided exceptional customer service, enhancing pharmacy loyalty.
Pharmacy Intern
CVS Pharmacy
01.2003 - 01.2007
- Provided support in prescription filling, patient counseling, and pharmacy workflow as part of a clinical rotation
- Preceptor: James Murphy, RPh, Pharmacy Manager
Education
Doctor of Pharmacy (Pharm.D.) -
St. John's University College of Pharmacy
Jamaica, NY05-2007
Skills
- Managed Care Pharmacy Operations
- Team Leadership & Development
- Pharmacy Quality Programs (HEDIS, CMS)
- Utilization & Formulary Management
- Strategic Program Implementation
- Regulatory Compliance (NYS, NCQA, CMS)
- Data-Driven Decision Making
- Chronic Disease & Medication Management
- Interdisciplinary Collaboration
- Provider & Member Education
Certification
- Licensed Pharmacist, New York State Board of Pharmacy, 05/01/07
- Pharmacy Intern License, New York State, 05/01/03
- Certified Immunizer, New York State, 05/01/10
Timeline
Clinical Pharmacist
Heritage Healthcare Partners IPA
12.2018 - Current
Pharmacist
Echo Pharmacy
07.2018 - 06.2021
Pharmacy Manager
CVS Pharmacy
01.2009 - 07.2018
Staff Pharmacist
CVS Pharmacy
01.2007 - 01.2009
Pharmacy Intern
CVS Pharmacy
01.2003 - 01.2007
Doctor of Pharmacy (Pharm.D.) -
St. John's University College of Pharmacy
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