Samantha Griffith
Billerica,MA
Summary
Proactive and goal-oriented pharmacist with excellent time management and strategic thinking skills. Extensive experience with Medicare, Medicaid, and Commercial pharmacy benefit management with emphasis on rare disease and specialty medications. Experience with managing various stakeholders within a complex healthcare setting. Experienced in developing talent and elevating team productivity and capabilities to exceed company goals. Committed to leveraging these qualities and experience to drive team success and contribute to organizational growth.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Clinical Pharmacist
Point32Health
02.2022 - Current
- Serve as point of contact for any pharmacy-related-member or provider concern, including but not limited to: pharmacy access, affordability, utilization management requirement, or medication education.
- Contribute to interdisciplinary team meetings, providing valuable insights on patient-specific pharmaceutical care needs.
- Reduce hospital readmissions of medically complex members at high risk for readmission by providing medication reconciliation services upon discharge with specific emphasis on members with Congestive Heart Failure (CHF) and Chronic Obstructive Pulmonary Disease (COPD).
- Develop and maintain strong relationships with external stakeholders such as provider groups to ensure efficient coordination of care for mutual members and decrease overall Total Cost of Care (TCOC).
- Collaborate with healthcare providers to optimize drug therapy for improved patient care.
- Provide education to healthcare providers on new drugs, guidelines, and best practices in pharmacotherapy.
- Conduct clinical interventions to prevent drug-related problems, ensuring patient safety and cost-effectiveness in treatment plans.
Supervisor, Pharmacy Utilization Management
Point32Health
02.2019 - 02.2022
- Led a high performing team of clinical pharmacists and pharmacy technicians through company integration and change while continuing to maintain high quality standards and efficiencies.
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
- Developed policies and procedures to minimize member disruption during the company integration between Tufts Health Plan (THP) and Harvard Pilgrim Health Care (HPHC).
- Presented and represented the Pharmacy Utilization Management department in the 2019 CMS Program Audit which resulted in no significant program findings for pharmacy.
- Contributed to the Five-Star rating received from CMS for all three years of tenure as pharmacy supervisor.
- Provided strategic thought to leadership as part of the planning and execution phase of the integration to a new pharmacy benefit manager (PBM) system and single pharmacy benefit processing system.
Clinical Pharmacist
Tufts Health Plan
11.2013 - 02.2019
- Reviewed prior authorization requests for specialty medications with a specific emphasis on high cost regimens, ensuring appropriate criteria were met before approval or denial decisions were made.
- Ensured the timely processing of all pharmacy benefit requests for all lines of business, including Medicare, Medicaid, and Commercial products.
- Researched drug information and disease state understanding to maintain knowledge for application to prior authorization reviews with particular emphasis on new emerging therapies and rare disease.
- Provided clinical guidance and support to pharmacy technicians.
- Supported and led the documentation preparation for multiple pharmacy audits for Medicare, Medicaid, and Commercial products.
Staff Pharmacist
CVS/Pharmacy
07.2012 - 10.2013
- Processed and verified medications for content, accuracy and completeness of all drug packaging and labeling in a high volume, high performing retail pharmacy location.
- Counseled patients on drug therapies, potential drug interactions and side effects, proper dose timing and medication storage.
- Administered immunization services to patients.
- Provided medication management therapy to patients by collaborating with other health care providers.
- Maintained accurate and detailed records of all medication processed through the pharmacy.
- Managed pharmacy technician payroll and pharmacy scheduling.
Education
Doctor of Pharmacy -
Massachusetts College of Pharmacy
Boston, MA05.2012
Skills
- People Management
- Problem-Solving
- Time Management
- Organizational Skills
- Self Motivation
- Critical Thinking
- Detail Oriented
- Strong Verbal and Written Communication
- Pharmacy Formulary Benefit Design
- Medicare STARS/HEDIS Quality Measures
- RXClaims
- PA Logic
- Medhok
Certification
Board Certified Geriatric Pharmacist (BCGP)
Credential# 99108872
Expires 12/31/2030
Massachusetts Registered Pharmacist (RPh)
License# PH234089
Expires: 12/31/2024
Timeline
Clinical Pharmacist
Point32Health
02.2022 - Current
Supervisor, Pharmacy Utilization Management
Point32Health
02.2019 - 02.2022
Clinical Pharmacist
Tufts Health Plan
11.2013 - 02.2019
Staff Pharmacist
CVS/Pharmacy
07.2012 - 10.2013
Doctor of Pharmacy -
Massachusetts College of Pharmacy
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