Clinical Pharmacist with managed care and PBM experience supporting formulary configuration, utilization management, and clinical program implementation. Experienced in cross-functional collaboration to ensure accurate benefit setup and successful client onboarding.
Overview
11
11
years of professional experience
Work History
Clinical Pharmacist
Optum, UnitedHealth Group
Remote
10.2024 - Current
Perform comprehensive clinical reviews to ensure alignment with formulary requirements and utilization management criteria.
Interpret pharmacy benefit designs, formulary tiers, and coverage rules to optimize therapy outcomes.
Analyze claims data to assess utilization trends, adherence risks, and quality measures.
Collaborate with PBM clinical and operations teams to resolve benefit configuration issues.
Support medication optimization initiatives impacting 400+ members monthly.
Execute telephone-based medication consultations, consistently exceeding production and quality benchmarks through proficiency in pharmaceutical regulations and communication.
Senior Mail Operations Pharmacist
CenterWell Pharmacy
Miramar, FL
11.2023 - 10.2024
Ensured clinical accuracy across prescription verification workflows.
Developed SOPs to improve compliance and clinical quality.
Conducted utilization reviews reducing error rates by 20%.
Collaborated with operations and compliance teams on workflow improvements.
Pharmacy Manager
CVS Pharmacy
Lake Worth, FL
09.2020 - 11.2023
Oversaw clinical quality, compliance, and operational metrics.
Improved productivity and profitability by 15% through workflow optimization.
Reduced adverse drug events by 30% using clinical protocols.
Guided pharmacists and technicians in strategic alignment of tasks, enhancing overall team productivity and operational harmony.