Prior Authorization Clinical Pharmacist
Resume:
Sandy Yeh
San Diego, CA *****
206-***-**** - aduobo@r.postjobfree.com
Professional Summary
Seasoned Clinical Pharmacist with experience in hospital, community, and clinic pharmacy environments. Collaborative and customer-focused with proven ability to partner with multi-disciplinary teams to discuss medication therapies and therapeutic drug management. Exemplary assessment skills in medication dispensation, therapeutic monitoring and effectiveness, and drug safety management. Accomplishments include more than 15 years as a clinician working to improve processes, protocols, and treatments as part of operational support and system improvement. Decisive leader focused on open communication, positive team culture with excellent planning and problem-solving abilities, as well as specialized and unique experience in Emergency Department, Prior Authorization and Insurance, Software and Product Development and 340B Program.
Skills
Medication dispensing and immunizing
Quality Review Processes
Medication Management
Team Leadership
Drug Safety
Documentation skills
Pharmacy Process Improvement
Pharmacy Software
Monitoring therapeutic effectiveness
Drug utilization review
Operations Support
Clinical Efficacy
Strong assessment and communication skills
Staff Training and Education
Customer service, education, and counseling
Work History
04/2020 to Current
Customer Solutions Director, Product Management
Verity Solutions – Kirkland, WA
Identify and determine problem statements to develop user stories and requirements in Product Management for product expansion, innovation and strategic initiatives for software enhancements and system development.
Maintain and update project plans by tracking requirements and dependencies and issue project Agile updates.
Evaluate data to find actionable insights and make product recommendations.
Conduct customer research, education and outreach to understand consumer opinions and workflow needs.
Serve as primary point person and Subject Matter Expert for customer solutions and provide Sales support with customer demos for technical understanding and education related to maximizing Verity Solutions V340B product platform.
04/2013 to 04/2021
Staff II Pharmacist, Per Diem
UCSD Medical Center – La Jolla, CA
Interpreted, evaluated, and verified medication orders entered by CPOE (computer physician order entry) from healthcare providers for appropriateness and completeness to properly dispense medications and health products.
Directly supervise fulfillment of medications and intravenous drugs (IVs) by Pharmacy Technicians, interns, and support staff while on duty.
Evaluate and check compounded and repackaged medications, including unit-doses, topical medications, and sterile products.
Adjust, monitor and follow-up on antibiotics, TPN, and chemotherapy regimens per P&T pharmacy protocols.
Properly instructed pharmacy students and residents on introductory and advanced pharmacy practice rotations.
Complete profile review and pharmacokinetics (PK) monitoring, as needed.
Actively participate in all codes (Neuro, Code Blue, NSTEMI, Rapid Response) by expediting drug therapy such as preparing, dosing, and administering medications.
07/2018 to 04/2020
Strategic Accounts Director
Verity Solutions – Kirkland, WA
Supported continuous improvement of group strategies, program development and organizational effectiveness to drive revenue.
Determined direction for strategic accounts by researching competitive landscape, market insights and communication across stakeholders.
Identify and communicate software requests from customers and Sales for product expansion and strategic planning for software enhancements.
Serve as primary point person and Subject Matter Expert for Sales support, technical understanding and education related to maximizing Verity Solutions V340B product platform.
Collaborate with Development to create, update and maintain Demo Platform.
04/2016 to 07/2018
Principal Requirements Engineer
Becton Dickinson – San Diego, CA
Identify and determine problem statements to develop requirements and specifications for customer requests for software enhancements and system builds.
Serve as primary point of contact and Subject Matter Expert for several pharmaceutical operations, platforms, workflow, and efficiency.
Recommended changes, improvements, or enhancements in products to cross-functional teams based on customer feedback.
Quickly learned new skills and applied them to daily tasks, improving efficiency and productivity.
Customer validation and solution development for pharmacy platform software products such as Pyxis® Logistics inventory management program and BD Pyxis® ES MedStation and Server.
Oversee reverse engineering project on automated dispensing cabinets for controlled substances. Lead voice-of-customer feedback sessions on new software platform development.
Design and continuously improve BD Pyxis® medication-dispensing products in collaboration with marketing, development, and quality teams.
04/2014 to 05/2016
Clinical Specialist Pharmacist, Prior Authorization and Utilization Management
MedImpact – San Diego, CA
Clinically review, analyze, recommend, and evaluate prior authorization requests for Medicare Part D, Medicaid, and commercial plans to support decisions as indicated by insurance carrier.
Manage accessibility, quality, and cost-effectiveness of drug and medical therapy for members and providers.
Reviewed data collection across settings to determine progress and participated in professional clinical review of insurance programs.
Tracked submission during facilitation of prior authorization issuance.
Supervised and collaborated with Prior Authorization Coordinators (PACs) staff to support quality and integrity by conducting clinical assessments of prior authorization cases.
04/2015 to 03/2016
Safe Medication Practice Pharmacist Specialist
Sharp Mesa Vista Hospital – San Diego, CA
Coached staff on daily performance and conducted evaluations to constructively address concerns.
Educated staff on organizational mission and goals to help employees achieve success.
Facilitate safe medication working group with frontline nursing staff to review and communicate medication-related events and develop strategies for improvement.
Inputted, reviewed, collected, and arranged information into i-Report medication-related event reporting system.
Spear-head Pharmacy Improvement Project to decrease duplicate prn pain orders without sequencing.
Develop general Behavioral Health Pain Orderset with sequencing to assist with physician-ordering and compliance with CMS and Joint Commission standards.
Identify opportunities for education and quality improvement initiatives from surveillance activities and review of pharmacists' interventions.
05/2013 to 02/2014
Clinical Pharmacist
Promise Hospital – San Diego, CA
Developed and implemented policies, procedures and protocols for antibiotic, warfarin and other therapeutic monitoring at Pharmacy and Therapeutics Committee.
Update and standardize medication order sheets for improved patient care, quality, compliance, and safety (ie. High alert medications- vasopressors, insulin; line flush).
Interpreted, evaluated, and entered medication orders from healthcare providers for appropriateness and completeness to properly dispense medications and health products.
Directly supervise fulfillment of medications and intravenous drugs (IVs) by Pharmacy Technicians, interns, and support staff while on duty.
Evaluate and check compounded and repackaged medications, including unit-doses, topical medications, and sterile products.
Educated nursing staff on possible drug interactions, potential side effects and optimal methods of administration.
12/2012 to 10/2013
Pharmacist/Consultant, Per Diem
Sharp Grossmont Hospital – La Mesa, CA
Consult and assist in development and progression of Emergency Department (ED) Pharmaceutical Services provided in Emergency Department.
Review and evaluate current Emergency Department Pharmacy practice provided in ED setting and provide recommendations for Pharmacy support.
10/2012 to 04/2013
Staff II Pharmacist, Full-Time
UCSD Medical Center – La Jolla, CA
Interpreted, evaluated, and verified medication orders entered by CPOE (computer physician order entry) from healthcare providers for appropriateness and completeness to properly dispense medications and health products.
Directly supervise fulfillment of medications and intravenous drugs (IVs) by Pharmacy Technicians, interns, and support staff while on duty.
Evaluate and check compounded and repackaged medications, including unit-doses, topical medications, and sterile products.
Monitor, regulate, and perform follow-ups on antibiotics, chemotherapy regimens, and total parenteral nutrition (TPN) in compliance with Pharmacy and Therapeutics (P&T) protocols. Perform daily pharmacokinetic (PK) therapeutic drug monitoring and profile review.
Properly instructed pharmacy students and residents on introductory and advanced pharmacy practice rotations.
Actively participate in all codes (Neuro, Code Blue, NSTEMI, Rapid Response) by expediting drug therapy such as preparing, dosing and administering medications.
09/2008 to 08/2012
Emergency Department Clinical Pharmacist
Good Samaritan Hospital – Puyallup, WA
Interpreted, evaluated, and verified medication orders entered by CPOE (computer physician order entry) from healthcare providers for appropriateness and completeness to properly dispense medications and health products.
Directly supervise fulfillment of medications and intravenous drugs (IVs) by Pharmacy Technicians, interns, and support staff while on duty.
Evaluate and check compounded and repackaged medications, including unit-doses, topical medications, and sterile products.
Initiate, adjust, monitor and follow-up on antibiotics, warfarin, TPN and tube feedings, pain management, insulin therapy, renal adjustments, and chemotherapy regimens per P&T pharmacy protocols.
Dose and administer medications such as Propofol or Brevital for procedural sedations.
Properly instructed pharmacy students and residents on introductory and advanced pharmacy practice rotations.
Complete profile review and pharmacokinetic (PK) monitoring, as needed.
Actively participate in all codes (Neuro, Code Blue, NSTEMI, Rapid Response) by expediting drug therapy such as preparing, dosing, and administering medications.
Review and verify formal medication reconciliations conducted by Pharmacy Technicians for admitted patients in Emergency Department.
Served as EPIC Go-Live Zone Leader during technology implementation.
Trained pharmacy residents and interns on clinical care and medication dispensing.
07/2006 to 03/2008
Emergency Department Clinical Staff Pharmacist
St Joseph Medical Center – Tacoma, WA
Interpreted, evaluated, and verified medication orders entered by CPOE (computer physician order entry) from healthcare providers for appropriateness and completeness to properly dispense medications and health products.
Directly supervise fulfillment of medications and intravenous drugs (IVs) by Pharmacy Technicians, interns, and support staff while on duty.
Initiate, adjust, monitor and follow-up on antibiotics, warfarin, TPN and tube feedings, pain management, insulin therapy, renal adjustments and chemotherapy regimens per P&T pharmacy protocols.
Dose and administer medications such as Propofol or Brevital for procedural sedations.
Properly instructed pharmacy students and residents on introductory and advanced pharmacy practice rotations.
Actively participate in all codes (Neuro, Code Blue, NSTEMI, Rapid Response) by expediting drug therapy such as preparing, dosing, and administering medications
Trained pharmacy residents and interns on clinical care and medication dispensing.
Education
General Pharmacy Practice Residency (PGY1)
Franciscan Health System - Tacoma, WA
Doctor of Pharmacy, Summa Cum Laude
Washington State University - Pullman/Spokane, WA
Bachelor of Science, General Biological Sciences
Washington State University - Pullman, WA
Licensures and Certifications
Washington State Pharmacist License, PH 00065626
California State Pharmacist License, 63526
Nevada State Pharmacist License, 17667
ACLS Certified, American Heart Association, Active 3/2023
CPR and AED Certified, American Heart Association, Active 3/2023
Immunization Certification in Adults and Adolescents, Washington State Pharmacy Association
Basic Tobacco Cessation Interventions, Washington State Department of Health
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