Wendi Powell
West Lafayette,IN
Summary
Results-driven pharmacy professional with extensive experience on the payer side, specializing in formulary management, utilization review, and clinical program development. Expertise in strategic drug policy and cost-containment strategies aligns with a new practice area that values collaboration with diverse stakeholders. A strong commitment to advancing patient outcomes and enhancing operational efficiency within managed care drives the pursuit of innovative solutions in partnership with a Pharmacy Benefit Manager (PBM). Eager to contribute to impactful initiatives that improve healthcare delivery and patient care.
Overview
32
32
years of professional experience
1
1
Certification
Work History
Director of Pharmacy
MDwise, Inc., a McLaren Company
09.2014 - Current
- Full oversight of MDwise conversion to the IN Medicaid State Uniform Preferred Drug List (SUPDL) in July 2023, with continued responsibility for all aspects of SUPDL maintenance and adherence.
- Led development and ongoing management of the MDwise neutral drug formulary. Direct the Pharmacy & Therapeutics Committee and provide recommendations grounded in clinical expertise and pharmacoeconomic analysis.
- Prepare communication materials and conduct formal presentations of formulary and utilization management (UM) strategies to the IN Medicaid Drug Utilization Review (DUR) Board and the Mental Health Quality Advisory Committee (MHQAC).
- Monitor drug pipeline and FDA actions to anticipate market shifts, ensuring timely access to new therapies while controlling expenditures.
- Collaborate in workgroups with IN Medicaid Managed Care Organizations, Fee-For-Service Medicaid, and the Office of Medicaid Policy & Planning to ensure adherence to regulations, coverage requirements, and clinical care standards.
- Remain abreast of evolving clinical practice guidelines and professional literature to design programs that maximize health outcomes.
- Work directly with the Pharmacy Benefit Manager (PBM) to implement UM criteria and clinical edits, with comprehensive understanding of benefit configuration in the claims processing system. Lead implementation of new lines of business across both IN and MI with the PBM.
- Provide delegation oversight of pharmacy prior authorization (PA) review and determination by PBM.
- Oversee all functions of the medical drug PA process as well as the pharmacy and medical drug appeals process, ensuring compliance with National Committee for Quality Assurance (NCQA) standards and contractual requirements.
- Conduct retrospective DUR to evaluate and measure the impact of UM approaches, including analysis for fraud, waste, and abuse.
- Analyze trend related to drug expenditures and devise strategies to positively influence plan performance.
- Develop and implement channel management initiatives to ensure cost-effective procurement of physician-administered drugs within the pharmacy benefit, continuously monitoring and refining the program to maximize savings.
- Collaborate with key internal and external stakeholders on decisions regarding drug coverage, cost-saving strategies, and the needs of members and providers.
- Focus on achieving positive health outcomes for plan enrollees with consideration of factors such as social determinants of health and the patient experience in care delivery.
- Design and execute performance and quality improvement activities for clinical service areas.
- Author pharmacy segments of RFP responses and proposals for new business opportunities.
- Clinical Pharmacy Manager (Aug 2015 - Sep 2016)
- Contributed to the development and maintenance of formulary for MDwise Medicaid and Marketplace.
- Developed and presented educational programs regarding disease states, medications or medication class reviews, and clinical guidelines.
- Evaluated and measured the impact of newly implemented utilization management approaches.
- Identified potential technical or member care issues, developing and implementing avoidance strategies.
- Managed the pharmacy appeals process for all lines of business and conducted clinical case reviews for appeals.
- Supported the Pharmacy & Therapeutics Committee by developing meeting agendas, preparing meeting materials, presenting clinical information, and implementing utilization management strategies.
- Proactively evaluated and recommended improvement opportunities to managers and program stakeholders.
- Clinical Pharmacist (Sep 2014 - Aug 2015)
- Assisted with formulary development and maintenance.
- Delivered educational programs on disease states, medications, and medication class reviews.
- Engaged in the assessment of newly introduced clinical and utilization management strategies.
- Assisted in creating and executing performance and quality improvement initiatives, as well as activities focused on member safety within clinical service areas.
- Identified potential technical or member care concerns, collaborating with the Director of Pharmacy to develop and implement avoidance strategies.
Specialty Programs & Implementations Manager
OptumRx
09.2009 - 09.2014
- Reviewed medical literature and utilization of medications to propose new and revised drug policies to the UnitedHealthcare P&T Committee; implemented drug policies and all associated claim edits; directed communications to professional societies and network providers as necessary; and provided clinical oversight for implementation of relevant policies through specialty pharmacies.
- Acted as the clinical Subject Matter Expert for specialty medications, delivering evidence-based support for programs including step therapy, prior notification, supply limits, specialty pharmacy clinical management, adherence initiatives, and the specialty drug list.
- Directed the internal drug information service, supervising pharmacy staff in responding to formal inquiries from UnitedHealthcare Medical Directors.
- Evaluated and updated pharmacy benefit medication lists, including the Self-Injectable Drug List.
Clinical Programs Manager
UnitedHealth Pharmaceutical Solutions
11.2006 - 09.2009
- Organized and facilitated bi-monthly national P&T Committee meetings.
- Supported the design, rollout, and evaluation of clinical programs; provided clinical expertise to guide marketing initiatives.
- Ensured accuracy and consistency of three national Preferred Drug Lists published on Epocrates.
- Reviewed and updated pharmacy benefit medication lists, including the Preventive Medication List and Maintenance Medication List.
- Conducted disruption analyses to aid the transition of employer group membership from Arnett HMO to UnitedHealthcare benefits.
Clinical Pharmacist
Arnett Health Plan
01.2004 - 11.2006
- Defined strategic goals for the pharmacy benefit in partnership with the P&T Committee Chairman, aligning policy with organizational priorities.
- Maintained and optimized the Preferred Drug List to ensure accuracy and clinical relevance.
- Partnered with the Pharmacy Benefit Manager to safeguard benefit integrity and compliance.
- Analyzed pharmacy utilization data to identify cost-saving opportunities and improve patient outcomes.
- Delivered academic detailing to practitioners, driving evidence-based prescribing through utilization trend and peer comparison insights.
- Provided sole pharmacist expertise, guiding clinical decision-making across all pharmacy initiatives.
- Implemented full formulary setup with Epocrates and ensured ongoing accuracy of the Arnett formulary.
Pharmacy Director
Arnett Clinic
03.2000 - 01.2004
- Hired, supervised, and evaluated performance of 18 personnel at two outpatient pharmacy locations.
- Negotiated contracts with third party payers and drug manufacturers.
- Monitored drug inventory, pricing, and supply including vaccine selection (clinic formulary) and managing product shortages. Devised and implemented drug pricing formulas.
- Worked closely with software vendor to resolve operational issues, which involved local programming and set-up.
- Served on inter-disciplinary committees within the clinic to address such issues as pharmaceutical marketing and drug sampling.
- Responsible for auditing processes of drug distribution and administration in provider offices.
- Authored and argued proposal for change in physical layout and workflow of pharmacy.
Staff Pharmacist
Arnett Clinic
05.1994 - 03.2000
- Directed hiring, supervision, and performance evaluation of 18 staff across two outpatient pharmacy locations, ensuring operational excellence.
- Negotiated contracts with third-party payers and drug manufacturers to optimize reimbursement and cost savings.
- Oversaw drug inventory, pricing, and supply chain management, including vaccine selection and shortage mitigation; developed and implemented drug pricing formulas to improve financial performance.
- Collaborated with software vendors to resolve operational issues, leading local programming and system setup to enhance workflow efficiency.
- Served on interdisciplinary health system committees to influence policies on pharmaceutical marketing and drug sampling.
- Audited drug distribution and administration processes in provider offices to ensure compliance and patient safety.
- Authored and successfully advocated for redesign of pharmacy layout and workflow, improving efficiency and service delivery.
Education
Doctor of Pharmacy -
Purdue University; College of Pharmacy
West Lafayette, IN08.2013
Bachelor of Science - undefined
Purdue University; College of Pharmacy
West Lafayette, IN05.1994
Skills
- Formulary optimization
- Utilization management
- Quality assurance
- Performance improvement
- Patient education and safety
- Staff development and mentoring
Certification
- Indiana Pharmacist License #26018372A
- Michigan Pharmacist License #5302418300
PRESENTATIONS / SPEAKING ENGAGEMENTS
- Jul 2021 Achieving Successful Market Access in Medicaid Managed Care: A Dialog with MMC Executives. Panelist at Crossroads, An Artia Solutions Conference; Nashville, TN
- Sep 2018 Pharmacy Practice in the Managed Care Setting. Presented at the Annual Modern Clinician Event; AMCP Chapter Meeting; Purdue University; West Lafayette, IN
- Mar 2018 Indiana Medicaid’s Approach to the Opioid Crisis. Presented at the MedImpact Annual Conference; San Diego, CA
- Feb 2018 Non-Traditional Career Pathways in Pharmacy. Presented at the AMCP Chapter Meeting; Purdue University; College of Pharmacy; West Lafayette, IN
LEADERSHIP EDUCATION / TRAINING
- Dec 2023 McLaren Leadership Academy; McLaren Health Care; Grand Blanc, MI
- Feb 2014 Emerging Leader Program; The Wharton School / UnitedHealth Group
PROFESSIONAL SERVICE
- Jan, 2019-2021, 2025 Judge; AMCP Pharmacy & Therapeutics Competition Purdue University; College of Pharmacy; West Lafayette, IN
- 2019 to present Governor’s Appointee, IN Medicaid Mental Health Quality Advisory Committee
- 2019 to present Pharmacy Women for Purdue Steering Committee; West Lafayette, IN
- 2004 to present Member, Academy of Managed Care Professionals (AMCP)
- Schools of Pharmacy Relations Committee (2006)
- Delegate, Midwest AMCP Affiliate (2022 to present)
TEACHING EXPERIENCE / UNIVERSITY AFFILIATIONS
- 2017 to present Affiliate Faculty; Department of Pharmacy Practice Purdue University; College of Pharmacy; West Lafayette, IN
- Sep, 2017-2025 Guest Lecturer; PHRM 84800 – Principles of Drug Info & Literature Evaluation Medication Use Management: Role of the P&T Committee in Managed Care Purdue University; College of Pharmacy; West Lafayette, IN
- Nov, 2018-2025 Guest Lecturer; PHRM 450 – Dossier Analysis & Formulary Management Managed Care Principles Purdue University; College of Pharmacy; West Lafayette, IN
Timeline
Director of Pharmacy
MDwise, Inc., a McLaren Company
09.2014 - Current
Specialty Programs & Implementations Manager
OptumRx
09.2009 - 09.2014
Clinical Programs Manager
UnitedHealth Pharmaceutical Solutions
11.2006 - 09.2009
Clinical Pharmacist
Arnett Health Plan
01.2004 - 11.2006
Pharmacy Director
Arnett Clinic
03.2000 - 01.2004
Staff Pharmacist
Arnett Clinic
05.1994 - 03.2000
Bachelor of Science - undefined
Purdue University; College of Pharmacy
Doctor of Pharmacy -
Purdue University; College of Pharmacy