Clinical Prior Authorization Pharmacist
Resume:
Summary
Dedicated Pharm.D. with a background in clinical pharmacy, offering a unique combination of experience and expertise from pharmaceutical industry and managed care pharmacy benefit management (PBM).
Principal pharmacist at a major PBM, responsible for the development and implementation of clinical intervention programs for optimizing patient care among Medicare and Commercial health plan patients.
Drug Safety Specialist for a pharmaceutical manufacturer, responsible for submitting adverse event reports to the Food and Drug Administration.
Seasoned professional seeking to pivot extensive clinical and administrative experience into a prior authorization role in a managed care setting.
Licensure and Credentials
Actively Licensed & Registered Pharmacist in California, RPh License # 50546
Doctor of Pharmacy, University of California School of Pharmacy, San Francisco.
Bachelor of Science in Biological Sciences, University of California in Irvine.
ASHP-Accredited Pharmacy Practice Residency. Kaiser Permanente, Fontana, CA.
Experience
Volunteer Community Service & Parenting
12/2012- present
June 2026: Volunteer camp coach and counselor for So Cal Youth Mountain Biking League, Big Bear, CA. Served as one of 25 coaches at a 6-day, 5-night camp with over 50 teen-aged campers.
November 2025 - present: Volunteer Assistant Coach for the Foothill Team, So Cal Youth Mountain Bike Racing League.
April 2025 - present: Volunteer Project Leader for the Orange County Chapter of 4H, one of America’s largest youth development organizations promoting community service and leadership.
June 2023 & 2024: Volunteer camp counselor for the Boy Scouts of America. Served as a camp counselor for youth Scouts for a 5-day camp at O’Neil Park, Rancho Santa Margarita, CA
April 2023 - December 2024: Active Parent Volunteer for the Boy Scouts of America
Sept 2023 - June 2024: Active Parent Volunteer for the Girl Scouts of America
2021-2022 - Volunteer Sunday School Classroom Aide and Camp Counselor for Vacation Bible School at Presbyterian Church of the Master, Mission Viejo, CA
2019- present: Active volunteer for The Parent Teacher Association
Optum Rx United Health, Irvine, CA
Title: Clinical Program Development Pharmacist
7/2011-12/2012
Developed, implemented and evaluated clinical intervention programs for optimizing patient care for Medicare and Commercial health insurance plans.
Evaluated patient outcomes data, drug therapy problem resolution rates and cost-savings analysis.
Served as the primary clinician responsible for the development and analysis of clinical intervention programs targeting physicians and patients in addressing various drug-related problems, such as drug-disease interactions and gaps in therapy.
Collaborated with a multidisciplinary team of pharmacists, biostatisticians, project managers, and business analysts in the implementation and data analysis of the clinical programs.
Utilized pharmacy and medical claims data for identification and resolution analysis of drug-related problems.
Developed educational materials for physicians and patients for a variety of disease states and medication therapies.
Working knowledge of Healthcare Effectiveness Data and Information Set (HEDIS) measures, and guidelines set forth by the National Committee for Quality Assurance (NCQA), and Center for Medicare & Medicaid Services (CMS).
Proficient in Microsoft Office Applications (Excel, Word, Power Point, Outlook).
Proficient in drug information research: Pubmed, Micromedex, Drug Fact and Comparisons, Lexicomp, Identidex, AHFS.
Watson Pharmaceuticals (aka: Actavis, Allergan, AbbVie), Corona, CA
Title: Drug Safety Specialist
2/2004 – 7/2011
Performed all steps in the day-to-day case processing of adverse event reports originating from spontaneous post-market sources, clinical trials, and scientific literature for regulatory submission to the FDA, Health Canada, and EMA via Medwatch & CIOMS forms.
Collected individual adverse event case reports via live phone interviews from consumers and health professionals.
Authored case narratives, conducted medical coding of adverse event terms and drugs in MedDRA and WHO-Drug, and performed data entry into Argus Safety database.
Closely followed Work Instructions, Coding Conventions, and Safety Data Exchange Agreements (SDEA) with corporate partners and global database holders, to ensure compliance with Standard Operating Procedures (SOP’s), FDA and ICH Guidelines, and Good pharmacovigilance Practices (GVP).
Performed QA/MR (Quality Assurance & Medical Review) of cases and Participated in DSRC (Drug Safety Review Committee).
Collaborated with the Corporate Quality Department and conducted various quality oversight activities.
Fountain Valley Regional Hospital, CA
Title: Inpatient Clinical Pharmacist
7/2002 - 3/2004
Performed clinical services and drug distribution at a 400-bed community hospital, including customized dosing and monitoring per pharmacy protocol for intravenous nutrition, antibiotics with a narrow therapeutic index (aminoglycosides, vancomycin), intravenous and oral anticoagulation therapy (heparin, warfarin), and dose adjustments for renal impairment.
Served as a preceptor for 4th year pharmacy students and interns.
Hoag Hospital Presbyterian. Newport Beach, CA
Title: Inpatient Clinical Pharmacist
8/2000-6/2002
Performed clinical and drug distribution service at a 400-bed community hospital.
St Joseph Home Infusion Pharmacy, Orange CA
Title: Home Infusion Clinical Pharmacist
6/1999-8/2000
Performed distributive services for intravenous, parenteral and enteral products and miscellaneous injectables for administration in patient homes.
Kaiser Permanente. Fontana, CA
Title: Pharmacy Practice Resident
7/1998-6/1999
Completed a one-year ASHP-accredited residency program encompassing a variety of pharmacy practice settings including inpatient pharmacy, outpatient pharmacy, ambulatory care clinics, home infusion, a formal drug information service, and pharmacy administration.
References
Available upon request
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