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Prior Authorization Clinical Pharmacist

Location:
Tampa, FL
Posted:
January 31, 2024

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Resume:

Michael H. Nguyen, PharmD

813-***-**** ad287y@r.postjobfree.com

Tampa, FL 33618 https://www.linkedin.com/in/michaelnguyenpharmd/

CLINICAL PHARMACIST

Healthcare management professional with extensive experience building clinical programs, managing teams, and working cross-functionally to bring effective client solutions. Broad expertise in pharmacy benefits management, specializing in client support, prior authorization, and prescriber interventions and outreach. Adept at developing and overseeing innovative programs to ensure optimal clinical and fiscal outcomes. Known for leveraging strong analytical and communication skills to drive measurable positive change, enhance patient care, and achieve high client engagement and retention rates. Areas of Expertise:

Clinical Program Development and Management Team Management and Morale

Quality Improvement and Assurance Client Relationship Management

Strategic Planning and Decision-Making Analytical and Technical Skills

Training and Development Effective Communication and Presentation

URAC accreditation and QIP development Compounding (Sterile & Non-Sterile)

Pain management treatment protocols and guidelines Technical Writing & Communications

Tableau and Medispan PriceRx Formulary Development & Management

EXPERIENCE

MYMATRIXX – An Express Scripts Co., Tampa, FL

Director of Clinical Pharmacy, February 2012 – November 2023

Led dynamic growth of a drug utilization review program, demonstrating increased demand and efficacy.

Successfully integrated all clinical products with Express Scripts following Express Script's acquisition of myMatrixx; owned all clinical products going forward.

Continued expansion and modification of the drug regimen review program to accomplish a 1500% increase in referral volume.

Led and managed a high-performing team of 30 pharmacists, resulting in the timely fulfillment of all clinical program deliverables and meeting 100% of productivity goals.

Led development of a Prior Authorization Program for the Department of Labor Office of Workers' Compensation Programs, Black Lung and Energy Program; Set strategies and designed interventional campaigns to address immediate deficiencies in drug utilization trends.

Led the development of a Prior Authorization Program mandated by the New York State Workers' Compensation Board; completing 1500-2500 monthly requests for two clients.

Created and executed an automated prescriber outreach program to reduce the utilization of potentially addictive or habit-forming drugs, including skeletal muscle relaxants, sedative-hypnotics, benzodiazepines, and opioids.

Developed data analysis strategy and techniques to fulfill client stewardship obligations and enhance existing clinical products, including a method for measuring outcomes from clinical programs.

Provided subject matter expertise to the RFP team and directly authored responses to pharmacy-related questions.

Served as quality program manager and represented myMatrixx to the enterprise Quality Management Committee.

Authored blogs, whitepapers, and market materials to promote myMatrixx's clinical expertise, capabilities, and programs.

Authored and managed clinical policies and procedures necessary for URAC accreditation.

Led implementation of a Quality Improvement Project (QIP) mandated by URAC, focusing on enhancing patient safety, and provided direction and strategies for non-clinical QIPs.

Clinical and Pharmacy Department Manager, May 2010 – February 2012

Elevated mail-service pharmacy performance by implementing strategic oversight, resulting in a remarkable achievement of zero dispensing errors in over 18 months, a substantial improvement from the previous average of an error every 20 days. Formulated and finalized policies and procedures for mail service, emphasizing continuous quality improvement.

Implemented changes to increase 90-day fills to over 60%, reducing shipping costs by 30% and enhancing efficiency and output.

Strategically focused on mail service conversion, which doubled revenue over five years.

Established clinical rotations for UF, USF, FAMU, NOVA Southeastern, PCOM, and Mercer University fourth-year pharmacy students at myMatrixx, consistently hosting 10-30 students per year as the sole preceptor.

Continuously focusing on developing or enhancing student communication skills, professional proficiency, and personal confidence.

Clinical Pharmacist, May 2009 – May 2010

Provided ongoing drug information support to clients and internal departments, contributing to client services and sales.Undertook the management and further development of the drug regimen review program, which quickly led to increased organic demand and recognition; the product remains the company's flagship clinical product.

Led business development for a non-sterile compounding lab, taking volume from 1 prescription per month to 60.

Spearheaded the establishment and operation of a new compounding lab, securing a sterile compounding permit. Wrote and implemented a comprehensive set of policies and procedures mandated by the Board of Pharmacy, encompassing stringent requirements for environmental testing of the facility and personnel training and certification. This rigorous process ensured full compliance and regulatory approval.

EDUCATION

Doctor of Pharmacy (PharmD), Mercer University, Atlanta, GA

Bachelor of Arts (BA), Chemistry, Mercer University, Macon, GA

LICENSES AND CERTIFICATIONS

Pharmacist Licensure, Florida (License No: PS45038)

Training, Primary Compounding, PCCA®- Professional Compounding Centers of America

Specialty Training Program, Pharmacy Ownership and Management, Mercer University

Certificate, Geriatric Pharmaceutical Care, Mercer University



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