Prior Authorization Clinical Data
Resume:
Amal Attal
Fresh Meadows, NY *1365
ad0dei@r.postjobfree.com
Self-motivated professional with 7 years of experience in hospital, and retail pharmacy pursuing a pharmacist position. Offering excellent educational background and strong knowledge of standard pharmacy clinical, operations, sales, and leadership skills. A proven track record of using my excellent personal, communication, and organizational skills to lead, recruit excellent personnel, and improve department efficiencies. Team player with excellent communication skills, high quality of work, driven, and highly self-motivated.
Experience
NOVEMBER 2022 – CURRENT
SPECIALTY ONCOLOGY PHARMACIST
NYC HEALTH+HOSPITALS/ BRONX, NY
Collaborate with the oncology department to assist in obtaining prior authorizations.
Create prior authorization workflow and policies and procedures for the department of pharmacy.
Perform clinical reviews of PA, Step Therapy, Quantity Limit, and all other pharmacy utilization requests in accordance with quality, timeliness, and efficiency standards.
Perform coverage determinations and appeals requests according to criteria guidelines and in compliance with all state and federal regulations, including Medicare and Medicaid.
Consult with the physicians to obtain clearance that the treatment regimen is appropriate.
Process referrals and submit clinical supporting documentation to insurance carriers to expedite prior authorization processes.
Manage correspondence with insurance companies, physicians, and patients as required.
Look through denials and submit appeals if requested by physicians to get them approved by insurance companies.
Document all prior authorization information including approval dates, and prior authorization number in the patient profile.
Develops and implement clinical utilization criteria for new market entries and market updates utilizing evidence-based medicine principles.
Secure patients’ demographics and medical information by using great discretion and ensuring that all procedures are in sync with HIPAA compliance and regulation.
Assist the Director of Pharmacy with compiling statistical data, reporting, and analyses to demonstrate PA clinical, financial, and operational effectiveness and quality.
APRIL 2021 – NOVEMBER 2022
STAFF PHARMACIST
NYC HEALTH+HOSPITALS/ BRONX, NY
Proficient in filling prescriptions and patient orders, resolving discrepancies in patient therapying in both outpatient and inpatient systems.
Utilize clinical data in evaluating physician orders to ensure appropriate therapy adhering to federal, state, and local laws.
Fill and manage unit dose cassettes and medications carts.
Provide and document drug information and patient counseling to outpatient discharge patients.
Document interventions, adverse drug reactions (ADRs), and medication errors.
Direct and utilizes personnel including technicians, aides, and clerical staff.
Assist in the monthly inspection of the patient care units and the Pharmacy.
Maintain adequate medication supply in the individual work areas.
Able to package and label pharmaceuticals into units of use or unit dose blisters.
Perform all pharmacy-related functions such as managing and troubleshooting the Automatic Dispensing Cabinet (PYXIS).
Participate in Pharmacy staff in-services and meetings relating to Systemwide and/or health care setting programs.
OCTOBER 2013 – AUGUST 2020
PHARMACY GRADUATE INTERN
Walgreens/ Brooklyn, NY
Participate in all aspects of the dispensing process including prescriptions intake, processing, dispensing, and compounding.
Facilitate MTM and Targeted intervention programs for eligible patients.
Assist pharmacists in taking prescriptions over the phone and maintaining an inventory of medications or supplies.
Counsel patients on the proper use and storage of medications and related devices.
Help display extraordinary customer care behaviors to establish the business in the development of sales and volume of scripts.
Counsel patients on prescriptions, over-the-counter medications, and dietary supplements with the supervision of a pharmacist.
Responsible for resolving third-party rejections with insurance.
Skills
Pharmacy Operations •Drug Utilization Review • Prior Authorization Specialist • Patient Counseling• Pharmaceutical Research• Team player • Clinical Review Competency
Education
MAY 2019
ARNOLD SCHWARTZ & MARIE COLLEGE OF PHARMACY
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