Remote Prior Authorization Pharmacist (Payer-Side)

RESUME

BAHAREH FARHADMEHR, PharmD, RPh

Calabasas, CA (Remote Eligible) 310-***-**** ️ *********@*****.*** License #88738 (CA)

PROFESSIONAL SUMMARY

Licensed Pharmacist with dedicated payer-side experience in prior authorization, utilization review, and formulary-based decision-making. Proven ability to independently manage high-volume case reviews, apply evidence-based clinical guidelines, and communicate effectively with providers in fully remote environments. Combines strong clinical judgment with a background in pharmacy operations, compliance, and exceptional patient care.

CORE SKILLS & KEYWORDS

PA & Utilization Management: Prior Authorization (PA) & Coverage Determination Utilization Management (UM) Medical Necessity Review Step Therapy & Quantity Limits

Clinical Guidelines: Evidence-Based Guidelines (FDA, NCCN, USP, CDC) Formulary & Policy Interpretation

Operations & Compliance: Provider Outreach & Appeals Support Clinical Documentation & Audit Readiness Remote Productivity & Quality Metrics HIPAA & Regulatory Compliance

Clinical Services: MTM / CMR (Outcomes) Immunizations Patient Counseling & Drug Information

PROFESSIONAL EXPERIENCE

Prior Authorization Pharmacist (Remote)

UMP Examworks September 2025 – February 2026

Conducted independent medical necessity reviews for prior authorization and coverage determination requests.

Applied formulary policies, step therapy, and clinical guidelines to coverage decisions.

Reviewed supporting clinical documentation, diagnostic notes, and laboratory data to evaluate appropriateness of therapy.

Communicated via phone and written correspondence with prescribers to resolve incomplete or non-compliant requests.

Ensured defensible clinical documentation meeting rigorous audit, HIPAA, and compliance standards.

Consistently met productivity, quality benchmarks, and turnaround time (TAT) metrics in a fully remote environment.

PIC / Manager

Independent Pharmacy March 2026 – Present

Directed daily pharmacy operations while ensuring state and federal regulatory compliance.

Delivered MTM services, immunizations, and patient counseling.

Managed staffing, workflow optimization, and quality assurance to enhance patient safety and operational output.

Collaborated with providers to improve medication therapy outcomes.

Pharmacist in Charge / Pharmacy Manager

Rite Aid 2024 – July 2025

Managed high-volume retail pharmacy operations, inventory control, and staff performance metrics.

Maintained compliance with state pharmacy boards and federal regulations while driving stellar customer satisfaction.

Pharmacist in Charge

Independent Pharmacy 2023 – 2024

Led pharmacy operations emphasizing clinical accuracy, rigorous documentation, and patient safety.

Implemented workflow enhancements to increase prescription throughput and minimize dispensing errors.

Intern Pharmacist & Pharmacy Technician

CVS Health 2017 – 2023

Performed MTM and Comprehensive Medication Reviews (CMR) using the Outcomes platform.

Administered immunizations, assisted with prescription verification, and resolved complex patient inquiries.

CLINICAL TRAINING (APPE)

Hospital Practice – Los Angeles Downtown Medical Center: Medication reconciliation, anticoagulation monitoring, interdisciplinary rounds.

Acute Care (Infectious Disease) – Kindred Hospital: Antimicrobial therapy monitoring, dose adjustments, literature evaluation via NIH databases and Micromedex.

EDUCATION & LICENSURE

Doctor of Pharmacy (PharmD) – West Coast University

B.S., Molecular, Cellular & Developmental Biology – UCLA

A.A., Biology – Moorpark College

Licensure: Registered Pharmacist (RPh), California – License #88738

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