Patient Care Clinical Pharmacist

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YULIA DADASHYAN

Linkedin-Profile 818-***-**** ***********@*****.*** Los Angeles, CA

PROFESSIONAL SUMMARY

With over 12 years of clinical pharmacy experience, I have demonstrated proficiency in integrating clinical and distributive services. My expertise extends to comprehensive direct patient care, specializing in oncology and autoimmune disease management, therapeutic drug monitoring, pharmacy protocols, sterile compounding, and drug information provision. SKILLS

WORK HISTORY

UNITEDHEALTH GROUP, E&I Appeals and Grievances, Remote 01-2023 to 05-2024 Clinical Pharmacist

• Focused on optimizing patient care when rendering determinations on appeals of pharmacy benefits coverage.

• Evaluated complex clinical information, approved compendia, medical literature, coverage policy, and criteria information while adhering to regulatory guidelines.

• Provided consultative support to members and physicians, offering insights on medication use, potential drug interactions, and clinical status.

• Evaluated prescriptions and patient histories with meticulous attention to detail, ensuring accuracy and adherence to pharmaceutical standards.

• Developed and continuously updated supportive platforms including Job Aids, State Mandate guidelines, FDA updates, and clinical insights for team members. CVS HEALTH, Coverage Determination and Appeals, Medicare, Remote 06-2021 to 07-2022 Clinical Pharmacist

• Provided clinical decisions for prior authorization and appeal requests by applying evidence-based clinical guidelines and utilizing formularies, ensuring the delivery of optimal patient care.

• Maintained a high rate of productivity, achieving a remarkable 99% quota accuracy, reflecting precision and efficiency in decision-making processes.

• Conducted thorough reviews of members' profiles, drug interactions, sensitivities, and the drug usage database, contributing to a comprehensive patient-centered approach.

• Ensured compliance with CMS regulations and consistently upheld the company's standards of care, contributing to the achievement and maintenance of the CMS Five-Star rating.

• Comprehensive Patient-centered approach

• Pharmacy Operations and Monitoring

• Medicare, Medicaid, Private PBM

• Clinical Collaboration & Guideline Development

• Clinical Subject Matter Expert

• Intravenous Admixture

• ACPE IV Certified

• Comprehensive Medication Review,

• Medication Therapy Management

• Disease Specific Medication Review

2

CHOICE SPECIALTY PHARMACY, Sugar Land, Texas 06-2018 to 2-2021 Senior Clinical Pharmacist

• Ensured optimum drug therapy by processing chemotherapy and specialty medication orders with a focus on accuracy and appropriateness.

• Improved patient care and adherence by conducting personalized and comprehensive Medication Therapy Management (MTM), Comprehensive Medication Review (CMR), and Disease Specific Medication Review (DSMR).

• Led the Pharmacy Reimbursement team, actively assisting medical providers with Prior Authorization and Appeals, demonstrating leadership and expertise in navigating reimbursement challenges.

• Increased revenue by successfully resolving pharmacy claims issues, ensuring efficient claims process.

• Served as the primary contact for internal (Market Specialists, Medical Directors) and external

(Pharmacists, Physicians, Patients, PBM) customers, addressing inquiries related to patient therapy, drug information, eligibility, health plan navigation, and operational issues, fostering positive relationships.

• Developed and supported comprehensive specialty pharmacy operational procedures, enhancing service efficiency for patients and providers while maintaining optimal standards. SOUTHSIDE SPECIALTY PHARMACY, Houston, TX 07-2016 to 05-2018 Pharmacist in Charge, Central Processing Pharmacy

• Processed infusion and specialty medication orders with a meticulous approach, providing accurate and appropriate therapy for patients.

• Improved clinical outcome by conducting Medication Therapy Management (MTM) using Outcomes and P3Link platforms for personalized one-on-one patient care.

• Supervised the activities of the Central Processing Specialty Pharmacy, Reimbursement Department, and Customer Service Department, showcasing effective leadership and management skills.

• Optimized patient care by providing clinical direction and support to members of multidisciplinary teams concerning medication utilization. evidence-based pharmaceutical care. UNITEDHEALTH GROUP CLINICAL SERVICES, Sugar Land, TX 10-2015 to 06-2016 Appeals and Grievances Pharmacist, Medicare

Gathered complex clinical information, considered approved compendia, medical literature, coverage policy and criteria working within regulatory guidelines to render decisions.

Worked independently, solving complex and urgent issues.

Consistently rated among the top during monthly performance reviews for productivity, accuracy, and efficiency.

Consulted and collaborated with medical directors, benefit operators, management, and peers to provide optimal decision and care for patients, comply with CMS regulations, and maintain company’s standards of care and the CMS Five-Star rating. 3

WALGREENS PHARMACY, Houston, TX & Los Angeles, CA 01-2008 to 10-2015

Staff Pharmacist

• Improved wait time and overall efficiency by customizing the workflow, enhancing the overall patient experience.

• Conducted thorough evaluations of physician prescriptions, assessing appropriateness in terms of drug, dosage, potential interactions, and route of administration. Provided suitable recommendations for therapy changes, ensuring optimal patient care.

• Organized and conducted vaccination clinics and health testing both off and on-site, contributing to community health and well-being.

• Performed Drug Utilization Review (DUR) on all prescriptions and Medication Therapy Management (MTM) specifically for Medicare patients, ensuring the highest standards of pharmaceutical care.

• Ensured continual compliance with all State and Federal rules and regulations, demonstrating commitment to maintaining the highest standards of pharmacy practice.

• Maintained adequate control and documentation of all controlled substance records and inventory, ensuring compliance with regulatory requirements, and promoting patient safety. EDUCATION

Doctor of Pharmacy, Roseman University of Health Science College of Pharmacy, Henderson, NV Bachelor of Science in Biochemistry, California State University, Northridge, CA REFERENCES

• Danielle Moore: ********.*****@***.***

Manager Pharm PA/Appeals

Clinical Leadership & Accountability

UHC Clinical Services

• Muslima Lawabni: *******.*******@***.***

Pharmacist PA/Appeals

Clinical Leadership & Accountability

UHC Clinical Services

Sejal Upadhyaya: ******@*****.***

Senior MSL Hepatology and GI

Novo Nordisk

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