Summary
Overview
Work History
Education
Skills
Websites
Certification
Software
Timeline
Generic

Wendy Dean, RPh

Registered Pharmacist
Bristol,CT

Summary

Productive pharmacist with proven track record of excellent customer service and consistent results. Possesses excellent communication skills, professional attitude and keen attention to detail. Dedicated to using latest technologies and processes to deliver highest level of efficiency. Extensive knowledge of clinical pharmacy, evidence-based medicine as well as Medicare benefits and operations. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.

Overview

22
22
years of professional experience
1
1
Certification

Work History

Senior Pharmacist, Government Programs

EmblemHealth/ConnectiCare
Farmington, CT
08.2020 - Current
  • Project Manager for Medicare Pharmacy Annual Enrollment Period (AEP) since 2020; Minimal to no 1/1 member disruptions for four consecutive years.
  • Leads benefit implementation for Medicare Pharmacy.
  • Manages on-going maintenance of programs, which includes but is not limited to building, configuring, and testing of yearly Medicare Pharmacy benefits in conjunction with PBM.
  • Leads Pharmacy Medicare website updates, yearly Open Enrollment changes, monthly formulary changes, and monthly ongoing maintenance.
  • Manages annual comparison of pharmacy benefits and formulary to competitors and develops recommendations to ensure alignment with competitors plans.
  • Acts as Pharmacy representative in Medicare Bid process.
  • Partners with Formulary Team on Part D & B formulary content, monthly/yearly changes, printed formularies, EOBs, UM impact, and general monthly/yearly QA.
  • Manages yearly formulary disruption letter campaign to members.
  • Creates, authors, and maintains yearly renewed pharmacy products such as Formulary Guidebooks, Pharmacy Directories, and EOCs.
  • Manages PDE reconciliation process in coordination with PBM and Medicare Eligibility; Maintained yearly 99.9% acceptance rate.
  • Reports non-compliance issues to compliance/regulatory and works for resolution (e.g., CAP, BIA).
  • Reviews all Medicare Letter templates to ensure compliance in conjunction with Government Programs team.
  • Aides in selecting changes to Pharmacy Networks to drive increased financial performance.
  • Participates in all Medicare audits as needed.
  • Coordinates with Government Programs team to implement new or updated CMS guidance for Medicare Product as it relates to Pharmacy
  • Creates, reviews, and implements provider letters and calls for notifications or opportunities for interventions and coaching.
  • Performs retro quality assurance reviews on PBM decided UM cases verifying accuracy and timeliness.
  • Acts as pharmacy clinical representative on programs related to Medicare projects.
  • Contributes to pharmacy program quality improvements by collaborating with product leaders and identifying opportunities for improvement.
  • Partners with other clinical leaders to identify and uphold best practices.
  • Acts as liaison with Customer Service, Sales, and other departments regarding member complaints and questions related to billing, benefit interpretation, clinical UM, formulary, and pharmacy coverage.
  • Partners with finance to pursue monies owed to health plan via Plan 2 Plan CMS process or direct pay.
  • Liaisons between PBM and Quality team to improve STARs measures.
  • Develops policies and procedures for effective Medicare pharmacy management and conducts annual reviews of existing policies to update information.

Clinical Operations Pharmacist

ConnectiCare
Farmington, CT
11.2017 - 08.2020
  • Evaluated medication therapy utilizing evidence-based research to review prior-authorization requests and executed member overrides according to established policies.
  • Communicated with providers for Peer-to-Peer discussions, coaching and prescribing recommendations, or other consultations as needed.
  • Performed proper thorough documentation of encounters.
  • Collaborated with ConnectiCare Disease Management staff to improve and maintain members' health.
  • Updated and created PA criteria including clinical and financial data along with formulary recommendations to present to P&T.
  • Assisted in benefit plan implementation for both Commercial and Exchange lines of business along with ongoing maintenance of programs.
  • Provided liaison assistance with internal and external pharmacy partners, regulatory agencies, and other entities.
  • Worked closely with Pharmacy Directors in administration of clinical programs and collaborated with internal departments (Eligibility, IT, Claims and UM) to accomplish smooth administration of programs.
  • Evaluated drug therapy to drive appropriate medicine use.
  • Complied with pharmacy regulations to increase quality of health care and inhibit criminal abuse of drugs.
  • Reviewed and evaluated exception requests for non-formulary to identify generic alternatives.
  • Discussed medical histories with patients in effort to provide most effective medical advice.
  • Established and maintained effective communication with staff, physicians and community organizations to promote high quality patient care.

Pharmacy Operations Manager

Arrow Pharmacy
Hartford, CT
07.2002 - 11.2017
  • Directly supervised approximately 20 employees, including staff pharmacists, techs, clerks, and delivery drivers as well as Medicine-On-Time and Med Box departments
  • Coordinated schedules for 45 employees for 5 stores
  • Responsible for initial Medicare accreditation and 2 additional re-accreditations of company through HQAA
  • Supervised one full 340B pharmacy and 2 half retail and half 340B pharmacies
  • Created monthly report packages that are sent to Federally Qualified Health Centers and details pharmacy activity including total cost of drugs, total revenue, and gross margin due facility as well as pharmacy fee for service
  • Monitored reconciliation claim, regularly checked for losses reducing gross margin
  • Prepared and reviewed any documents needed for audits; more then 75% of audits reduced to $0
  • Revamped DME department, increasing efficiency and necessary documentation while still providing customers products needed
  • Acquired contracts from two private third parties to provide equipment to patients.
  • Improved patient health by bringing prescription and rental breast pumps to area and worked with St Francis Hospital lactation nurses to allow program to service all mothers, making Arrow Pharmacy only available place to get them covered by third party insurance in northern Connecticut.
  • Prepared medications in blister packs to provide safe and convenient way to take prescribed medication.
  • Trained pharmacy interns and newly hired pharmacy technicians.
  • Monitored and managed pharmacy staff performance to maximize productivity and customer satisfaction.
  • Implemented and provided Medication Therapy Management (MTM) programs using Outcomes and Mirixa
  • Spearheaded new medication synchronizing system to ensure timely filling of prescriptions and promote compliance among patients
  • Evaluated patient histories to assess medication compliance and spot issues such as doctor shopping or excessive usage.
  • Discussed medical histories with patients in effort to provide most effective medical advice.
  • Vaccinated patients to provide immunity against influenza, pneumonia, and other diseases.
  • Educated patients about possible drug interactions and gave special administration instructions.
  • Communicated regularly with physicians, nurses, insurance companies and managed care organizations.
  • Regularly stocked shelves, rotated stock and checked for expired medications.
  • Complied with all federal laws, company policies and procedures and state regulations regarding intern, technician and assistant training and licensure.
  • Checked prescriptions for appropriate dosage, drug interactions, allergies and contra-indications before dispensing medications.
  • Prepared medications such as emulsions, liquids, powders and ointments.

Education

Bachelor of Science - Pharmacy

University of Connecticut
Storrs, CT

Skills

    Pharmacy Operations Management

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Certification

Licensed Pharmacist Lic. # 8956

Software

QS1

ScriptPro

PA Hub

NCCN

Excel

Word

PowerPoint

ICD codes

HCPCS codes

Timeline

Senior Pharmacist, Government Programs

EmblemHealth/ConnectiCare
08.2020 - Current

Clinical Operations Pharmacist

ConnectiCare
11.2017 - 08.2020

Pharmacy Operations Manager

Arrow Pharmacy
07.2002 - 11.2017

Bachelor of Science - Pharmacy

University of Connecticut

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Wendy Dean, RPhRegistered Pharmacist