Pharmacist

Kimberly Smith-Edmondson

PO Box ***, Kendalia, TX 78027 512-***-****

**********@*****.*** LinkedIn profile

SUMMARY

Texas Licensed pharmacist with experience and knowledge in pharmacology, med- ication therapy, Medicare & Medicaid Coverage Determinations & Appeals in the PBM and retail settings, Clinical and business acumen to build pharmacy revenue. Highly proficient in mastering new technology and software programs. Known as a problem solver with an excellent track record in maintaining positive relationships with patients and peers.

EXPERIENCE

UTILIZATION MANAGEMENT PHARMACIST & CLINICAL PHARMACY REVIEW HUMANA NOVEMBER 2018 TO PRESENT

Process Prior Authorization type requests for Medicare members following process flow and clin- ical judgement

Review patient records to determine the appropriateness of medication therapy Perform collaborative drug therapy management to offer excellent patient care MANAGER QUALITY ASSURANCE MEDICARE CD&A AND MEDICAID CVS HEALTH JUNE 2016 THRU JUNE 2018

Lead staff responsible for quality assurance reviews for Coverage Determination & Appeals case reviews

Data analysis and root cause analysis of the case review results providing a means to identify error trends, areas of risk to the company, areas for process and operational improvements Responsible for presenting error findings to the operations group on a regular basis thru verbal and written presentations

MANAGER CLINICAL OPERATIONS MED D CVS HEALTH JULY 2015 TO JUNE 2016 Reduced the number of cases reported to CMS as Auto-Forward for the client from 2014 to 2015 by approximately 75%

Managed the operational staff of 70-90 technicians completing case reviews for Aetna Med-D Coverage Determinations

Oversaw a staff of 12 who were responsible for validating that approved cases would properly adjudicate and correct or escalate any that failed the adjudication checkpoints Staff met or exceeded productivity expectations while maintaining quality standards set forth by the operational direction

Participated in the daily IRW (Immediate Recovery Workgroup) calls with Aetna for claims identi- fied that were failing to pay correctly.

STAFF PHARMACIST CVS HEALTH TEXAS MAY 2015 TO JULY 2015 Assigned to a specific store to work as a staff pharmacist and mentor the new Pharmacist-In- Charge (PIC) assigned to the store.

Improved staff efficiency in proper workflow and overall customer service scores while mentoring the PIC

REGIONAL SUPPORT PHARMACIST CVS HEALTH TEXAS MAY 2014 TO MAY 2015 Assigned to specific stores by the District Staff to lead the teams to improve challenged opera- tional standards

Improvements in driving script volume, patient care, process and workflow I was able to successfully turn around overall performance in the 4 stores during this time DISTRICT PHARMACY SUPERVISOR CVS HEALTH & ECKERD DRUG FEBRUARY 2002 TO MAY 2014

Responsible for multiple districts during this time period from 15 to 60 stores. This includes the overall professional support to the pharmacists as well as recruiting, hiring and staffing the stores based on manpower needs. Actively sought out and succeeded in multiple file buys and ensured that the pharmacists and pharmacies were in compliance with federal, state and local laws as well as the marketing and managed care programs for the company. Represented the company before the Board of Pharmacy multiple times during hearing for stores across the state as well as the regular quarterly board meetings Improved relations for CVS with the University of Texas College of Pharmacy, repairing deterio- rated relations due to disgruntled Eckerd pharmacist who had left the company around 2000-2001

Led the efforts to support the Hurricane Katrina victims in the Austin Convention Centre for 10 days were we filled over 15,000 scripts during that time as well as providing OTC assistance and comfort to the population housed in the site.

During the CVS acquisition of Eckerd Drugs, I was responsible for 2 districts who successfully converted and worked with 2 very different District Managers in the process. Consistently produced double digit script count percentage increases 9 out of 10 years Rx sales to budget in district always exceeded the expectations set forth by the company. Responsible for a district producing pharmacy sales over $100 million and a total store EBIT over $16 million.

STAFF & PIC PHARMACIST ECKERD DRUG TEXAS JUNE 2001 TO FEBRUARY 2002 Responsible for single store staffing, maintaining professional and regulatory requirements, in- ventory management, financial profitability, and workflow management Routinely assigned to stores that were lacking in overall management with the assignment to turn them around

PHARMACIST AND CUSTOMER SERVICE SPECIALIST RX.COM JUNE 2000 TO JUNE 2001 rx.com was a startup and soon moved into the newly identified need for a Pharmacy Customer Service Specialist. responsible for satisfying the needs of the pharmacy customers once the customer service reps had exceeded their ability to assist. Displayed patience, understanding, and education resulting in satisfied customers with less than 1% of those calling in needed to have assistance beyond my role. STAFF & PIC PHARMACIST ECKERD DRUG TEXAS SEPTEMBER 1999 TO JUNE 2000 Worked as a staff pharmacist in a store that had recently acquired a Drug Emporium file buy. My responsibility was to retain the existing customer base, satisfy the new patients coming into the store, improve workflow and inventory challenges while influencing the existing staff to success- fully maintain the achievements once I was gone.

Leveraged to another store that was having a downward trend in scripts due to customer service challenges. I was able to turn the service expectations around resulting in a 25% growth in script volume in 4 months time.

DISTRICT PHARMACY SUPERVISOR ECKERD DRUG FLORIDA & TEXAS FEBRUARY 1997 TO SEPTEMBER 1999

Responsible for overall operations of 30-35 pharmacies in the central Florida area, including the opening and/or relocation of 3 stores.

Responsible for the overall operations of 20-28 pharmacies in San Antonio with significant staffing challenges. I took over the district with 20 pharmacists openings and left with just 5 in less than a years time

PHARMACIST ECKERD DRUG TEXAS, GEORGIA, & FLORIDA JUNE 1990 TO FEBRUARY 1997 Pharmacist in the Austin, Tx, Atlanta, GA, and Palm Beach, FL areas. Developed a pilot roll-out of automated Medicaid billing in both Austin and Atlanta and part of the initial rollout of the automation of the City of Austin Medical Assistance Program (MAP) PHARMACIST, INTERN, & TECHNICIAN REVCO DRUG TEXAS JUNE 1984 TO JUNE 1990 I started my pharmacy career in Austin while in pharmacy school with Revco. I was a clerk, stock-person, bookkeeper, technician, intern and pharmacist. My most memorable accomplishment during this time was assisting in the conversion from man- ually filling prescriptions using a typewriter to computer based filling of scripts. EDUCATION

BACHELOR OF PHARMACY DECEMBER 1988 THE UNIVERSITY OF TEXAS AT AUSTIN PROFESSIONAL ACCOMPLISHMENTS

CVS Pharmacy Supervisor of the Year 2004

CVS Billion Dollar Region Award in 2007 with my district contributing right at $100 million in overall store sales

Received the Area 4 College Ambassador Award for 2008 and 2009 Received the Distinguished Service Award from the City of Austin November 11, 2005 Preceptor Achievement Award for mentoring and training pharmacy interns for CVS/Caremark in 2011

Preceptor with the Texas Board of Pharmacy and the University of Texas at Austin Certified Immunizer

Sterile Compounding and Aseptic Technique (IV Certification) Pending receipt of certificate

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