Misbah Qureshi
Bloomingdale,IL
Summary
Dedicated Pharmacist skilled with providing clients with optimal clinical support. Excellent interpersonal, communication and training skills developed over 2 years of progressive experience. Well-versed in formulary and utilization management standards and pharmacy regulations. Driven to growing as a clinician and continuing to provide clinical counsel to clients.
Overview
10
10
years of professional experience
Work History
Clinical Operations Advisor
CVS Health
Remote
05.2023 - Current
- Complete clinical analysis to determine optimal formulary development and utilization management for health plan
- Collaborate with team members to clarify and set expectation to design and meet client intent
- Apply procedures, use tools for analysis and evaluate date to check accuracy of client clinical requirements
- Review defects during coding and testing processes and help resolve these defects, including consulting with client to clarify the clinical requirements
- Collaborate with Account Management regarding clinical projects and program support.
- Conducted regular audits of pharmacy operations to ensure compliance with state regulations and accreditation standards.
- Monitored the quality of care provided by network pharmacies in accordance with contractual agreements.
- Researched new pharmaceutical products, technologies, treatments, procedures., to stay current in the field.
- Facilitated resolution of disputes between providers and payers regarding reimbursement rates or coverage decisions.
Resident Pharmacist
Express Scripts
Remote
05.2022 - 05.2023
- Meet with account management team weekly to discuss updates with client accounts and discuss clinical trends
- Advise on cost analysis and report interpretation
- Support account strategist to build and execute a tactical plan specific to client needs
- Participate in claims processing, coverage reviews, formulary and utilization management
- Monitored current literature sources to keep informed about new developments in pharmacy practice and the pharmaceutical industry.
- Present clinical programs tailored to client populations.
Insurance Analyst
AbbVie Endocrinology
North Chicago, IL
08.2020 - 06.2021
- Communicated with pharmacy benefits managers regarding prescription coverage
- Entered clear and accurate documentation of calls and benefit information in the company system
- Communicated with health care providers and patients regarding benefits and coverage
- Assisted patients in finding solutions to barriers in filling high-cost medication.
Clinical Pharmacy Technician II
CVS Caremark
Mount Prospect, IL
12.2017 - 02.2019
- Answered telephones and responded to inquiries from patients, healthcare providers, pharmacies, insurance companies and other customers.
- Collaborated with healthcare practitioners to optimize patient therapies
- Assisted pharmacists in providing pharmaceutical care services to patients including medication reconciliation and therapeutic interchanges.
- Entered data into computer systems to maintain accurate records of medications prescribed and dispensed.
Pharmacy Technician
Walgreens Pharmacy
Glenview, IL
09.2014 - 12.2017
- Maintained daily inventory of pharmaceuticals and ensured proper storage conditions.
- Prepared medications for dispensing by counting, pouring, labeling, and verifying doses.
- Performed data entry for patient profiles, billing information and prescription orders into the pharmacy software system.
- Managed filing of prescriptions, both electronically and manually.
- Ordered drugs from wholesalers as needed and maintained records of incoming shipments.
Education
Doctor of Pharmacy -
Midwestern University
Downers Grove, IL02.2022
Bachelor of Science in Biology -
Northeastern Illinois University
Chicago, IL12.2017
Skills
- Regulatory Compliance
- Overseeing pharmacy operations
- Data Management
- Decision-Making
- Critical Thinking
- Interdisciplinary Collaboration
- Utilization review
- Audit Support
- FDA Drug Safety Guidelines
Licensing
RPh, Illinois Department of Financial and Professional Regulation, 01/01/23
Timeline
Clinical Operations Advisor
CVS Health
05.2023 - Current
Resident Pharmacist
Express Scripts
05.2022 - 05.2023
Insurance Analyst
AbbVie Endocrinology
08.2020 - 06.2021
Clinical Pharmacy Technician II
CVS Caremark
12.2017 - 02.2019
Pharmacy Technician
Walgreens Pharmacy
09.2014 - 12.2017
Doctor of Pharmacy -
Midwestern University
Bachelor of Science in Biology -
Northeastern Illinois University