add photo
John
johnmajor11@hotmail.com
303-915-0952
Belleair Bch, FL 33785
Clinical MTM Pharmacist
21 years experience W2
0
Recommendations
Average rating
117
Profile views
Summary

  • Perform clinical review of Medicaid and Affordable Care Act prior authorization requests and validate that they are error-free prior to being promoted to production.
  • Review authorizations for specialty medications and advise and consult physicians, nurses and patients on specialty drug therapy.
  • Managed a staff of pharmacy technicians in processing prior authorizations for Medicare Parts C and D, directed a cost effectiveness and quality enhancement project, reconciled and reviewed paid and rejected claims to provide excellent customer care for members provided management of all aspects of a Medicare Advantage (MAPDP) plan.
  • Have experience of Medicare Part D, MTM services.

Experience
Education
Doctoral in Dental Medicine
Washington University Medical Center
Doctoral in Pharmacy
University of Colorado School of Pharmacy
Certifications
Registered Pharmacist
Licensed Pharmacist
Certified Immunizer Pharmacist
BLS for Healthcare Providers
RN
Skills
Drug Therapy
2021
4
Medicare
2020
4
Pharmacology
2020
4
Medication Review
2023
3
Medication Therapy Management
2023
3
Microsoft Excel
2020
3
Pharmacy Technician
2020
3
Project Management
2020
3
Clinical Pharmacist
2017
2
Clinical Review
2023
1
Medicaid
2023
1
Nursing
2021
1