EDWINA L. JONES

**** ****** ***** *****

Lawrenceville, GA 30043

770-***-****

ac6biq@r.postjobfree.com

EDUCATION: MERCER UNIVERSITY SOUTHERN SCHOOL OF PHARMACY

Doctor of Pharmacy

Degree Conferred: May 1998

CLARK ATLANTA UNIVERSITY

Master of Business Administration

Degree Conferred: May 1991

Concentrations: Marketing and Finance

ALABAMA A & M UNIVERSITY

Bachelor of Science

Degree Conferred: July 1986

Major: Zoology

Minor: Chemistry

SKILLS:

Management of staff consisting of Pharmacist, Pharmacy Technicians, Medical Assistants, and Nurses.

Written and oral communication skills from experience as an instructor, medical educator, clinical liaison with Medicaid, Medicare and commercial clients, and Regional Associate Vice-President of Pharmacy.

Strong time management and organizational skills from managerial positions, managed care and retail pharmacist positions, and laboratory technician positions.

Strong organizational skills from implementing state pharmacy programs.

Strong analytical skills from years of scientific research experiences.

Strong drug information skills from retail and managed care positions as a clinical pharmacist.

EXPERIENCE:

October 2015- US Script/Centene Corporation Atlanta, Georgia

Present Pharmacy Director

Develop and implement clinical drug policies and guidelines that assure appropriate utilization and cost control.

Complete therapeutic class reviews, drug monographs, and formulary

recommendations to the Pharmacy and Therapeutics Committee.

Submit formulary change requests and approve testing of changes submitted for all Medicaid plans prior to changes being implemented.

Collaborate with Compliance teams to ensure pharmacy guidelines and policies and procedures are operating according to state and federal regulations.

March 2015- Healthcare Scouts, Inc. Winter Park, Florida

October 2015 Contract Clinical Pharmacist, US Script

Reviewed clinical prior authorization requests for health plans.

Conducted peer-to-peer consultations with physicians.

August 2012- Amerigroup, Inc Atlanta, Georgia

February 2015 Associate Vice-President, Pharmacy, South Region

Reported financial, operational and quality metrics and trends to the health plan related to the Pharmacy program.

Assisted in the development and implementation of health plan pharmacy medical earnings initiatives (MEIs) to ensure health plan goals are met.

Active participant and Amerigroup representative on the state Drug Utilization Review Board, state Pharmacy & Therapeutics (P&T) committee, and/or other state meetings as necessary.

Active participant in health plan Medical Advisory Committee (MAC) and/or Quality Management Committee (QMC) meetings.

Collaborated in the development and implementation of point of sale interventions, retrospective drug utilization reviews, polypharmacy, pharmacist case management, medication therapy management, disease management, lock-in, and other clinical programs.

Subject matter expert for new business implemented within my region.

Collaborated with Compliance teams to ensure pharmacy programs operated according to state and CMS requirements.

Ensured the provision of pharmacy clinical support for the health plans.

Optimized clinical drug policies and related clinical protocols to assure appropriate utilization and cost control.

Maximized quality assurance activities to ensure regulatory and clinical policy compliance.

Co-chair of the Behavioral Health Subcommittee which reviewed and made

recommendations on psychotherapeutic drugs for the company’s health plans.

Member of the Georgia Drug Utilization Review Board which made decisions on drug utilization for state Medicaid recipients.

June 2011 - Amerigroup, Inc Atlanta, Georgia

August 2012 Clinical Pharmacy Director, South Region

November 2006- Amerigroup, Inc Atlanta, Georgia

June 2011 Clinical Pharmacy Manager

March 2005- Pharmacare Specialty Pharmacy Atlanta, Georgia

October 2006 Staff Pharmacist

June 2004- Express Scripts, Inc Roswell, Georgia

February 2005 Clinical Program Manager

October 2002- ACS, Inc Atlanta, Georgia

June 2004 Clinical Services Manager (Clinical Liaison)

August 2000- ACS, Inc Atlanta, Georgia

October 2002 DUR Clinical Manager

March 2000- ACS, Inc Atlanta, Georgia

October 2002 DUR Supervisor

October 1998- CVS (FORMERLY REVCO/BIG B DRUGS) Atlanta, Georgia

June 2003 Staff Pharmacist

April 1993- ETOWAH QUALITY OF LIFE Gadsden, Alabama

August 1994 Sickle Cell Coordinator (Medical Educator)

February 1994- ETOWAH QUALITY OF LIFE Gadsden, Alabama

August 1994 Marketing Director

March 1992- GADSDEN STATE COMMUNITY COLLEGE Gadsden, Alabama

January 1993 Biology Instructor

September 1988- MOREHOUSE SCHOOL OF MEDICINE Atlanta, Georgia

August 1989 Laboratory Technician III

June 1987- LAWRENCE LIVERMORE NATIONAL LAB Livermore, California

August 1987 Biomedical Scientist - Summer Internship

September 1986- ATLANTA UNIVERSITY Atlanta, Georgia

August 1988 Graduate Research Assistant

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