EXPERIENCE

Communications Pharmacist OptumRx; Irvine, CA 3/2014 - present

• Pioneer of Appeals Communications; formulate/write, manage and edit over 180+ work instruction job aids for Commercial, Medicare, and Medicaid markets for staff to maintain efficiency for work process.

• Incorporate new clients to work instructions while maintaining compliance with governing bodies; dissemination of information to staff pharmacists in an easy-to-digest format.

• Align processes between prior authorization and the appeals department. Assist in resolving discrepancies between guideline and formularies, and Internal Audits of pharmacists in the appeals department.

• Editor of member-facing denial and approval verbiage among various markets for all medications that require review; ensure that guidelines are accurately reflected from September 2020-present. Clinical Appeals and Prior Authorization Pharmacist OptumRx; Costa Mesa, CA 3/2014 - present

• Review denied Medicare Part D prior authorization drug claims and apply formulary and utilization management guidelines to determine if the drug shall be a covered benefit for the beneficiary based on medical history.

• Quality Assurance audits to ensure compliance with governing bodies. Clinical Appeals Pharmacist United Health Group; Cypress, CA 3/2014 - 3/2017

• Review denied Medicare Part D appeals; apply Medicare Part D Plan formulary and utilization management guidelines to determine if the drug shall be a covered benefit for the beneficiary based on medical history.

• Communicate and consult determinations with Medical Directors.

• Answer questions from support personnel regarding prescription drugs. Community Staff Pharmacist Vons Pharmacy; Desert Hot Springs, CA 9/2014- 2/2015

• Single staff pharmacist serving patients of the Palm Springs community. Medication Therapy Management (MTM) Pharmacist Cardinal Health - 9/2014 - 2/2015

• Comprehensive remote medication reviews for elderly Korean patients at community pharmacies. Certified Pharmacy Technician Walgreens; Irvine CA - 4/2009 - 6/2010 EDUCATION

Pharm.D, Doctor of Pharmacy California Northstate University, College of Pharmacy May 2014 B.S., Biological Sciences University of California, Irvine June 2010 SKILLS

Healthcare content marketing, medical communications, social media, website design. Languages: Korean, Spanish. Experience in: Pharmacy Systems PAS, RxCLAIM, Microsoft Word, Excel, Powerpoint, Outlook. Hobbies: music (guitar, keyboard), calligraphy, design, innovative skincare, cosmeceuticals. REFERENCES

Upon request

2 Fair Oaks, Irvine CA - 949-***-**** - adkdjq@r.postjobfree.com Eunice Lee, Pharm.D