Dailin Martinez Medel

**** ** ***** *** *****, FL 33185

Cell: 305-***-**** - adydkq@r.postjobfree.com

Professional Summary

Newly licensed pharmacist with more than 10 years of experience in pharmacy services, broad medical knowledge, and management experience in healthcare institutional settings. Strong background in clinical pharmacology, high experience in patient Medication Therapy Management and wide expertise on CMS HEDIS Measures. Positive relationships with patients, medical professionals, pharmaceutical representatives, healthcare organizations, insurance providers and PBMs. Skill Highlights

• Extensive medical terminology knowledge and a strong skilled clinical background.

• Broad understanding and interpretation of prescriptions terminology, and in-depth knowledge of generics and brand medications.

• Experience in retail pharmacy, physician dispensing, Part D Department and MSOs operations.

• Advance knowledge of CMS HEDIS measures.

• Demonstrable experience in managerial skills.

• Exceptional communication skills.

• Fully read, write, and speak bilingual (English and Spanish). Professional Experience

Pharmacy Quality Analyst/Pharmacist Intern

Anthem/HealthSun Health Plans

August 2019 to July 2022

• Oversee the Healthsun OTC Benefit including:

o Updating the OTC Benefit Formulary.

o Review and edit OTC Forms and Flyers, monitor printing process, coordinate OTC forms deliveries to all Healthsun OTC distribution centers and MSOs, and maintain OTC forms inventory. o Responsible for carefully review, investigate, and respond all OTC grievances sent by Grievances and Appeals Department.

o Pull monthly OTC metrics.

o Assist on updating OTC Ordering App including Creating New Items, Enabling/Disabling Items, Updating Items Inventory, and Updating Items Quantity Limitations. o Provide ongoing training and education to all Healthsun providers regarding the OTC Benefit best practices, and how to place OTC Orders using OTC Ordering App.

• Function as a liaison between Healthsun providers and Part D Department, assisting with all types of inquiries such as formulary, copays, pharmacies claims, LIS, and CVS Caremark Credentialing process.

• Provide ongoing training and education regarding all Part D processes such as: Coverage Determination Request, Vacation/Lost/Damaged/Stolen Medication Supply, Medication Sync and Direct Member Reimbursement Request.

• Assist prescribers with PMPM metrics, establishing workflows and training.

• Work with all Healthsun providers and internal departments to organize and maintain a plan of action to improve Part D HEDIS measures.

• Oversee the Flu and Pneumonia Vaccines process including, create Flu and Pneumonia Campaign Flyers, placing vaccine orders, coordinate vaccines deliveries to all Healthsun MSOs, maintaining log inventories, providing data to finance department, and assuring HEDIS measures compliance.

• Oversee REMEDIA Portal App process including updating all the Healthsun providers’ information, provide/remove access to users, and provide ongoing Remedia trainings to all users.

• Assist with the MTM Program, acting as a liaison between the PBM Ingenio Rx, Healthsun and all MSOs, and ensuring compliance by conducting training and plans of action. Pharmacy Coordinator Supervisor Pasteur and Wellmax Centers-North Region Pharmacist Intern

Delivery Network LLC/Healthsun Health Plans

April 2015 to August 2019

• Responsible for all pharmacy services provided by Pharmacy Coordinators.

• Assess daily workload and provide necessary support to Pharmacy Coordinators.

• Responsible for the EnvisionRx Options credentialing process for new dispensaries.

• Function as a liaison between network pharmacies, physicians, specialists, medical centers and Healthsun to ensure patients receive prompt delivery of all medications.

• Ensure Part D Exception Requests such as coverage determinations, vacation/lost medications, and medication synchronization submitted by pharmacy coordinators meet criteria.

• Use Cost and PDR reports as a guide to manage the plan formulary and decrease PMPM Part D Metrics.

• Maintain accurate inventory of medications and supplies on hand by verifying against invoices and inventory logs.

• Ensure HEDIS measures compliance.

• Oversee MTM Program, acting as a liaison between members and PBM.

• Review and approve payroll on a biweekly basis, coordinate vacations, schedules, and job responsibilities. Pharmacy Coordinator/Pharmacist Intern

Wellmax Medical Center - Pembroke Pines, FL

November 2012-April 2015

• Function as a liaison between network pharmacies, physicians, Wellmax Centers and HealthSun to assure patients receive prompt delivery of all medications.

• Refill medications per patient's requests.

• Receive the weekly PCP "no refill remaining report" and determine if patient qualifies for refills.

• Process all Part D Exception Requests such as Coverage Determinations, Vacation/Lost medications, and Medication Synchronization.

• Assist patients in completing OTC forms and placing members OTC orders using OTC Ordering App.

• Oversee the daily medication reconciliation process using Remedia Portal and Nextgen.

• Input prescription data into Pharmacy Rx system for adjudication, dispense medications from the Physician Dispensing Cabinet and educate patients how to safely use medications.

• Ensure HEDIS measures compliance.

Registered Pharmacy Technician

Walmart Pharmacy - Pembroke Pines, FL

January 2010 to November 2012

• Create new patient profiles and enter prescriptions into medication input software system using Conexus Software.

• Communicate directly with doctors' offices via telephone, fax and email.

• Provide friendly customer service at prescription drop-off and pick-up counters.

• Answer phone calls and provide responses in an efficient manner.

• Process refill requests.

• Keep all pharmacy records required including daily reports and controlled substances reports.

• Maintain drug inventory levels by ordering necessary medications and supplies and verify deliveries against order invoices.

• Verify patient data and billing information.

• Appropriately resolved customer’s issues and complaints. Licenses

Licensed Pharmacist PS65748

Education

Bachelor’s degree on Pharmaceutical Sciences

University of Havana - Havana, Cuba 2008

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