Diplomat Spotlight

July 2020 Spotlight

Mary Kemhus, PharmD - Diplomat at University of Washington

How did you become involved in AMCP? 
I was aware of AMCP throughout pharmacy school and interned in a managed care setting, but really became involved with AMCP as a resident at Regence BCBS (Portland, OR). My residency director and many of my mentors within the program were actively engaged in AMCP. Through them, I learned about the myriad of resources offered to managed care professionals through AMCP and presented my residency project at the annual meeting in 2007.

What interested you the most about managed care and ultimately led you to pursue a career in managed care pharmacy?
As a native to the Pacific NW, I often joke that I was “raised” in managed care. Working first at Group Health Cooperative (Kaiser), then at Regence BCBS, managed care is all I have ever known. While individual patient care is clearly important, I am drawn to the idea of coming up with ways to care for large populations, while acknowledging that resources are often limited.

What was your first job or position in managed care?
My first role in managed care was as a pharmacy technician, then intern at Group Health Cooperative in Seattle (now Kaiser). I worked on medication utilization management initiatives to ensure that patient therapy was optimized. My areas of focus included asthma and diabetes. Though perhaps what was most exciting to me at the time was the work I did surrounding HIV patients to ensure they were receiving the best possible therapy and optimizing therapies when appropriate.

What does a typical day or week look like in your current role?
I am currently a member of the Medical Account Management and Strategic Alliances team at Sandoz, Inc. My primary focus is working with managed care stakeholders, including health plans and pharmacy benefit managers, to provide medical information related to Sandoz products. Since Sandoz is a pioneer in biosimilar development, I often provide education on biosimilar development and manufacturing. What this means is that a typical week involves preparing presentations, staying up to date on managed care topics and traveling to meet with health care professionals. Another part of my role involves partnering with Strategic Alliances in areas like endocrinology to identify collaboration opportunities.  

What type of interactions have you had with your AMCP student chapter or school of pharmacy?
I annually participate in career roundtable discussions with my AMCP student chapter. These have taken different formats over the years. This year I was a panelist with other pharmacists in industry. Last year, I partnered with a pharmacy fellow at the University of Washington and we provided insight on managed care career paths (residency versus fellowship). Many of these engagements have led to follow up conversations and eventual mentorship with students interested in pursuing fellowships and careers with industry.

Words of advice?
While serving as a diplomat for a student AMCP chapter provides a formal opportunity to engage students, there are many ways to become involved. Years before I was a diplomat, I volunteered my time to work with students. For me that meant letting the Dean of the school know I was available, but there are other avenues too.

May 2020 Spotlight

Danielle Massie, PharmD - Diplomat at Oregon State University College of Pharmacy

How did you become involved in AMCP?   
I was first introduced to AMCP as a student pharmacist during my time at the University of Washington. We had strong representation of the various professional organizations which exposed us early in our careers to the numerous and different options to become affiliated. 

What interested you the most about managed care and ultimately led you to pursue a career in managed care pharmacy? 
During my final year in pharmacy school I had a rotation at Group Health Cooperative in Seattle where I learned how clinic based pharmacists managed patients with chronic disease, such as diabetes. This role within a large managed care organization combined a lot of areas of interest for me, such as, population health, evidence based approach to medicine, and working to the full extent of a pharmacist license. 

What was your first job or position in managed care? 
Due to an expanding focus on the Medical Home Model of care, my first role was as a decentralized ambulatory care pharmacist supporting a team of physicians at Group Health Cooperative. Work that I did in this role included drug information, chronic disease management, MTM, performing medication reconciliation in patients at high risk for hospital readmission, and supporting large therapeutic interchanges in our population. All of this work was fundamental to any future work in managed care as it taught me a lot about the patient experience and provider perspective.

What does a typical day or week look like in your current role? 
I am currently a Pharmacy Manager of Business Development at Moda, a regional health plan based in Portland, Oregon. Some activities that are pretty typical include regularly meeting with pharmaceutical and biotech partners to discuss drug pipeline, clinical development of recently FDA-approved medications, and understanding areas where we can collaborate. I also evaluate and negotiate financial opportunities among our formulary once clinical efficacy and safety has been determined.  Another activity includes reviewing new programs with innovative approaches that allow us to work with different vendors and technologies, which ultimately assist us and our members.  

What type of interactions have you had with your AMCP student chapter or school of pharmacy?
The most recent interactions have included preparing my student chapter for the AMCP P&T competition. I created a mini evening lecture series tackling topics to include managed care principles, navigating dossiers, critiquing clinical trials, and pharmacoeconomics. In my position at Moda I work with many industry partners which allows me the opportunity to identify strong teachers. I also have some pretty amazing health plan colleagues who also volunteered. All have graciously provided their time to support the students, who are lucky as these individuals are truly experts in their field.

Words of advice? 
Be curious. Don’t be afraid to take on new projects or assignments which are new to you to develop your expertise and skills – you will find we are all learning every day.

November 2019 Spotlight

Manjula Jayabalan, PharmD - Diplomat at Ferris State University

How did you become involved in AMCP?   
I became involved in AMCP during my third year of pharmacy school. I was fortunate to have a few managed care APPEs lined up for my upcoming fourth year rotations, so I joined AMCP to learn more about managed care concepts as I was preparing for the year ahead. During my fourth year of pharmacy school, I attended AMCP Nexus and found the residency showcase to be incredibly valuable in identifying programs that best suited my interests and long term career goals. 

 What interested you the most about managed care and ultimately led you to pursue a career in managed care pharmacy? 
Managed care allows me to combine my expertise in pharmacy, business and policy in order to make decisions impacting population health outcomes and the use of health care resources. There are numerous opportunities to do something unique and interesting within this field and I find that really exciting. 

What was your first job or position in managed care? 
My residency at BlueCross BlueShield of Tennessee was instrumental to helping me land my first job as a Clinical Pharmacist – Marketing Liaison at Blue Cross Blue Shield of Michigan. I loved being in a client facing role while also working on pricing, contracting and juggling various other projects. 

What does a typical day or week look like in your current role? 
For so many jobs in managed care, there is no “typical day” or “typical week” which is very rewarding because variety keeps things interesting for me. In my current role, I travel all over the country to speak with my clients about their pharmacy spend and cost savings recommendations. When I’m not traveling, I’m usually preparing for my next presentation or working on projects to meet the needs of our clients.  

What type of interactions have you had with your AMCP student chapter or school of pharmacy?
I have delivered presentations on residency/career opportunities within managed care pharmacy, student opportunities within AMCP and various other topics within managed care.  I have also been meeting with faculty members to explore the idea of starting a student AMCP chapter at their school. 

Words of advice? 
As you move through your career, think about your professional goals as well as your personal goals and then find opportunities that are conducive to both sets of goals. 

September 2019 Spotlight

Sunny Hirpara, PharmD - Co-Diplomat at University of Illinois at Chicago

How did you become involved in AMCP?   
I always knew that when I entered pharmacy school that I wanted to do something different within the profession. I was not exactly sure what I was going to do for a career when I was a P1, but I wanted to keep my options open and be willing to try new things. Shortly after I entered my P1 year, it was time to determine what organizations I wanted to be a part of, and luckily, I knew a few older classmates that suggested that I check out our local AMCP student chapter. I never really heard of managed care until this moment and thought to myself that this might open up a few opportunities for me. Low and behold, I ended up participating in the student P&T competition that year and that set me on a course of exploration into managed care thereafter. I ended up on the executive board for the following 2 years and became a huge advocate for AMCP, which I believe still holds true today.

 What interested you the most about managed care and ultimately led you to pursue a career in managed care pharmacy? 
I always knew I wanted to have an impact on peoples' lives, but I wasn't sure how I was going to create that impact. As I got more involved with managed care and AMCP, I soon realized that I could have a dramatic effect on peoples' lives by getting involved in population health. As a student, that meant attempting to get more involved within managed care such as IPPEs, shadowing opportunities, and looking for a managed care internship, if possible. Fortunately, I was selected for a 10 week long internship at CVS/Caremark in Phoenix, AZ. I took a leap and accept the position and during those 10 weeks, I was able to get a better understanding on how PBMs operate and how I saw myself potentially fitting into managed care, from prior authorization to client management. After those 10 weeks, my mind was set on becoming a managed care pharmacist.

What was your first job or position in managed care? 
My first position within managed care was as the first PGY-1 managed care resident at Navitus Health solutions, a PBM located in Madison, WI. It was a yearlong residency where I was able to perform in multitude of roles throughout the year, including presenting at the national P&T on several occasions.
 
My first job was also at Navitus, as a clinical programs pharmacist where I led the maintenance and development of clinical programs for the company. This job entailed taking the input into a PBM, such as claims data, and looking to do two things: 1. Improve outcomes, and 2. Increase cost savings/generate revenue.

What does a typical day or week look like in your current role? 
Currently, I am a clinical advisor for CVS/Caremark. My role is unique in that every day is a bit different. My job is to be the clinical liaison between the company and our client, which currently happens to be one of the largest health plans in the country. I'm expected to know a little bit about everything related to PBM functionalities, essentially behaving like a jack-of-all-trades, but not an expert in one specific area. A lot of my work today deals with problem solving and knowing who to turn to for which problem, resulting in delegation of work and translating requirements into actionable tasks. I also work from home full time, which I know may sound attractive to a lot of students, and while it comes with its own downsides, I do appreciate the flexibility. I am also expected to travel up to 50% of my time, but rarely am I actually traveling that much.

What type of interactions have you had with your AMCP student chapter or school of pharmacy? 
I am currently the co-diplomat for the University of Illinois at Chicago, College of pharmacy's student AMCP Chapter. I participate in the student/alumni mentoring program where I mentor two students a year on average. I also participate as a judge in the yearly P&T competition. Finally, on occasion, I come to speak at the general body meeting for the local chapter depending on the topic. I do my best to be available for students, knowing that I also had support from alumni when I was a student and relied heavily on their support.

Words of advice? 
The best piece of advice I can give to students, and frankly any professional, is network, network, network! I cannot stress this enough. Every job I have had since graduating pharmacy school come into fruition due to someone who was willing to stick their neck out and refer me for role within their company, including the job I have today. Pharmacy is a small world so never burn a bridge if you can help it. In the same light, don't be afraid to ask for help or advice from your network. You would be surprised how willing most people are to help if you were to simply ask for it. Lastly, don't forget to pass it forward once you've achieved your goals and support others that are asking for help.

July 2019 Spotlight

Jane Guo, PharmD, MBA - Co-Diplomat at Long Island University

How did you become involved in AMCP?   

I joined AMCP because of my current role.  As a Managed Market Liaison, it's important to stay well informed on the rapid changes of the managed care field.  AMCP has been a great resource and network to be involved in and I try to volunteer my time whenever the opportunity arises.

 What interested you the most about managed care and ultimately led you to pursue a career in managed care pharmacy? 
I didn't know much about managed care prior to joining Express Scripts.  I started out in front end operations but ultimately transitioned to the PBM side.  It was a big learning curve for me, but one of the best decisions I made professionally.  The knowledge I gained at Express Scripts really helped me understand the complexity of our healthcare system.  It also opened my eyes to the vast array of opportunities that exist for pharmacists.

What was your first job or position in managed care? 
My first managed care related role was Sr. Clinical Consultant on the Medicare Market Strategy team at Express Scripts.  The role required me to develop and implement strategic solutions to support the Medicare team, clients and beneficiaries.  

What does a typical day or week look like in your current role? 
Like many other pharmacists in the managed care space, I don't think a "typical" day or week exists, and that is both a reward and challenge of the field.  As a Managed Market Liaison, I am responsible for the entire portfolio of Otsuka Pharmaceuticals.  I provide both clinical and economic information to managed care leaders, so I am constantly learning and preparing.  My role is also field based, and I am on the road at least 60% of the time.  Therefore, another important part of my job is moonlighting as a travel agent for myself and trying to stay organized between emails, trainings and conference calls.

What type of interactions have you had with your AMCP student chapter or school of pharmacy? 
As a recent co-diplomat at Long Island University, I attended their mock P&T competition.  The amount of time and dedication these students put forth was very impressive.  I'm also working with my co-diplomat and the executive board to create a managed care panel and professional shadowing opportunities, along with a more structured program in the coming years.

Words of advice? 
Be curious and ask questions.  The more you educate yourself about the many facets of pharmacy, the easier it'll be for you to find your passion.  Also, don't burn bridges.  Pharmacy is a small world, so always put your best foot forward!

May 2019 Spotlight

Ryan Haynes, MBA, RPh - Diplomat at University of Wyoming

How did you become involved in AMCP?   
I became involved in AMCP after I started my career at a PBM upon the urging of my manager as an avenue to learn more about the industry and better understand the opportunities associated with Managed Care Pharmacy. I became involved in the AMCP Diplomat program as a way to give back to my pharmacy school by sharing experiences and providing insight into an important and growing component of the pharmacy industry. 

What interested you the most about managed care and ultimately led you to pursue a career in managed care pharmacy?  
After completing pharmacy school, I had a very solid grasp on the way medications worked clinically in the patient.  How were these medications ultimately being provided to the patient? What were the costs to the member? Who was responsible for the overall costs associated with treatment?  What is being done to manage the costs and access to the medications?  The business side of pharmacy fascinated me and initially caused my interest in managed care pharmacy. Being able to leverage both clinical information and business considerations in my day to day activities is what has kept me in managed care pharmacy.      

What was your first job or position in managed care?   
My first job in managed care was as a Clinical Pharmacist in the Prior Authorization department at PCS HealthSystems.  This was a great way to get my foot in the door and begin to learn more about the business and in an industry that I really did not know much about when finishing pharmacy school.     

What does a typical day or week look like in your current role?   
I joke about it, however it is true that it is difficult to explain exactly what I do. There is never a dull moment which makes my role enjoyable and the days fly by.  I may be assisting a client to better understand certain elements within a PBM request for proposal (RFP), while an hour later can be having contracting discussions with a PBM followed by internal discussions around therapeutic categories and trends. There are days when I will address multiple clinical questions and discussions as well as days where the topics are focused on financials.       

What type of interactions have you had with your AMCP student chapter or school of pharmacy?   
The University of Wyoming School of Pharmacy does not have an AMCP student chapter.  My interactions with the school of pharmacy generally include participation in the career week for the P4s in addition to volunteering to speak on managed care topics. I join other pharmacy colleagues who have taken career paths which may be outside the norm of traditional pharmacists. 

Words of advice?   
Keep an open mind about opportunities. You don't know what you don't know. Pharmacy students have many opportunities available to them in this ever-changing segment of pharmacy. It is fine to be uncomfortable and embrace the unknown.

January 2019 Spotlight

Tasmina Hydery, PharmD, MBA, BCGP - Diplomat at Massachusetts College of Pharmacy and Health Sciences

Tasmina Hydery is the AMCP Diplomat for Massachusetts College of Pharmacy and Health Sciences. She is a Clinical Consultant Pharmacist for Clinical Pharmacy Services at University of Massachusetts Medical School. In addition, she is an Assistant Professor at University of Massachusetts Medical School and Adjunct Professor at Massachusetts College of Pharmacy and Health Sciences. Tasmina serves as a lead in implementing formulary initiatives for specialty pharmaceutical medications for the Massachusetts Medicaid program (MassHealth). Her other roles include development of comprehensive internal guidelines, analysis of drug utilization, and review of complex clinical cases. Tasmina received her Doctor of Pharmacy from Albany College of Pharmacy and Health Sciences and Masters in Business Administration from Boston College Carroll School of Management.   

How did you become involved in AMCP?   
I have always had an interest in being involved with national pharmacy organizations. Once I started working in the managed care area, I took it upon myself to learn about what AMCP does as organization and how membership could benefit me as pharmacist. Since that time, I have attended Nexus and Annual meetings, served as a member of the School of Pharmacy Relations Committee, judged the Annual P&T Competition, and volunteered as a conference buddy. I have enjoyed the learning and networking opportunities through AMCP.  

What interested you the most about managed care and ultimately led you to pursue a career in managed care pharmacy?  
Prior to transition into managed care pharmacy, I worked in community pharmacy and academia. I was interested in career in managed care because of the far-reaching impact I could have on individuals of the Commonwealth of Massachusetts. Every day is a new learning opportunity when it comes to clinical outcomes research, therapies that have entered the market, and legislative changes which may affect our internal decisions.      

What was your first job or position in managed care?   
My first position from five years ago is still my current position. I now wear many other hats as a preceptor for pharmacy students and residents, and educator for medical students and staff. The first year was a learning curve and I developed many of the communication and technical skills I continue to use today.      

What does a typical day or week look like in your current role?   
I generally work Monday through Friday during normal business hours. Throughout the week, I progress through client projects, including new drug reviews, quality assurance analyses, clinical updates, and internal guidelines. On Tuesdays, our clinical team meets to discuss the various projects we are working on and opportunities for improvement. On Thursdays, we meet with our client to provide clinical recommendations for management of new drugs and therapeutic classes. There is a healthy balance of independence and interdependence in my weekly workflow.       

What type of interactions have you had with your AMCP student chapter or school of pharmacy?   
Clinical Pharmacy Services offers an APPE managed care elective rotation and PGY1 residency program. I have trained and precepted numerous students from Massachusetts College of Pharmacy and Health Sciences. I have also provided talks on formulary management and the role of a managed care pharmacist during career panels and within coursework.  

Words of advice?   
I won't be the first or last person to recommend this – network! Pharmacy is a small world, and the managed care pharmacy world is even smaller. Ask and be open to new opportunities. Create and maintain positive relationships with others, you never know if your former college roommate will be your future supervisor. Stay organized and create a set of professional goals so you can better understand and articulate what you are looking for.

December 2018 Spotlight

Allison Handler, PharmD, RPh - Diplomat at Rutgers University

How did you become involved in AMCP?   
My engagement with AMCP first started when I was completing my non-traditional PharmD degree out of Nova Southeastern University.  As part of program requirements, I had a research project to complete and it was accepted as a poster presentation at the AMCP annual meeting in Orlando FL in 2000.  This was my first time attending an AMCP meeting and learning all about what the organization had to offer.

What interested you the most about managed care and ultimately led you to pursue a career in managed care pharmacy?  
Managed care touches every aspect of pharmacy and healthcare.  As a pharmacist, I enjoy the ability to have a broad focus and managed care also provides the ability to reach broader populations than a traditional retail pharmacist role that I had started out in.

What was your first job or position in managed care?   
My first 'official' job in managed care was as a concurrent case pharmacist at Caremark Prescriptions Services in Westin FL.  I initially took the job because the hours were great  and it provided full benefits which allowed me to go to school at night to complete my PharmD.  Little did I realize that this job would actually change the trajectory of my career in pharmacy.  In my role within the Concurrent Case Management department I was responsible for reviewing patient claims for drug interactions, adherence and duplicate therapies for high cost therapies and transplant medications.  These assessments required telephonic interaction with physicians and patients to address gaps in care, etc.  This experience was very eye opening to me and I really enjoyed what I was doing and wanted to learn more.  However, I would be remiss if I didn't acknowledge that I do feel that indirectly, I was first exposed to managed care as a retail pharmacist where dealing with managed care was a big part of the day to day when filling prescriptions.

What does a typical day or week look like in your current role?   
There is no such thing as a typical day or week in my current role as a Market Access Executive for Celgene!  I am a field based (work from home) colleague covering a territory that includes NJ, NY Metro (the 5 boroughs) and CT.  My primary responsibilities include protecting, maintaining or improving access for our entire product portfolio with regional health plans in this geography and ensuring appropriate pull through and understanding of overall access across all national payers as well.  This includes providing or facilitating business reviews, clinical updates and presentations, daily monitoring of payer policies and alignment with field sales to address questions related to managed care denials and coverage.  I spend a lot of my time in my company car and on the phone on conference calls and webex's.  Occasionally I head to our corporate offices for internal meetings or travel for national meetings and conferences.     

What type of interactions have you had with your AMCP student chapter or school of pharmacy? Words of advice?
I feel very fortunate to have a wonderful long standing relationship with the Rutgers University Ernest Mario School of Pharmacy. The preceptor from my managed care residency was instrumental in starting the AMCP chapter and elective at Rutgers. As a result of our close relationship, her role as faculty advisor and my desire to give back to my alma mater, I signed up as the diplomat for the University and I have not looked back.   Over the years, I have had the opportunity to meet with the chapter in various ways.  This has included participation in managed care panels, serving as a guest lecturer, providing guidance to the chapter leadership regarding event planning for the year, serving as a judge for the local P&T competition, attending chapter meetings and events and coordinating student dinner and networking events at national AMCP meetings.  I have been very fortunate to both stay involved and be a constant for the chapter.  In my opinion, having an engaged and active faculty advisor(s) is a critical success factor in elevating awareness of managed care and AMCP at a school of pharmacy.  As the diplomat, persistence in supporting the chapter and faculty advisor as well as leveraging all contacts and resources available to me in whatever role I may be in are all important pieces to the puzzle.  For any new diplomats starting out, bring your passion for managed care and desire to improve awareness about AMCP to your role and you will achieve success.  Everyone's experience is going to be different, but you are in control of your own so give it your best. 

September 2018 Spotlight

Shuk Wai Chan, PharmD -  Diplomat at Touro University - New York

How did you become involved in AMCP? 
I definitely joined in a very unconventional way – I was at a CE dinner and someone was recruiting for a Diplomat for a fairly new pharmacy school in the area, I was very interested in the opportunity to mentor next generation pharmacists who are interested in Managed Care so I volunteered! Of course, one of the requirements to be a Diplomat is to be an AMCP member – so here I am!      

What interested you the most about managed care and ultimately led you to pursue a career in managed care pharmacy? 
Honestly, I knew nothing about managed care before my first job at Fidelis Care (a managed care company). When I first moved to NYC 3 years ago, I was hired on as a temp staff pharmacists with focus on reviewing prior authorizations. I was promoted a year later to be the supervisor of a newly created behavioral health-focus pharmacy team. Through this experience, I witness first-hand the impact the pharmacy team can make on a large scale. Now, I just can't get enough of it! We are constantly working on creating, implementing and maintaining clinical initiatives that will better help our most vulnerable members – those with serious mental illness and substance use disorders.      

What was your first job or position in managed care? 
I moved to NYC 3 years ago and started as a temp employee at Fidelis Care, today I am the manager for the pharmacy behavioral health team     What does a typical day or week look like in your current role? A lot of meetings since I manage about six to seven projects with an interdisciplinary team (IDT) of pharmacists, nurses, social workers, and medical directors – there are a lot of back and forth communications prior, during and after implementation of any projects. My typical day would include a variety of the following: preparing presentation on cost justification of a new project, coding for new reports to obtain key metrics, checking-in with players who are involved with a particular project, keeping up-to-date with any legislative guidance, preparing training material for any new process, training the IDT on new process, etc.      

What type of interactions have you had with your AMCP student chapter or school of pharmacy? 
Since I am fairly new, I have attended their P&T mock competition and was so happy to see students who are really dedicated to the preparation and presentation. I have since been in touch with the chapter president here and there when she has general questions about managed care, we agreed that we will likely start to create more structured programs starting fall with the new incoming chapter president       

Words of advice? 
Create opportunities for yourself and find what drives you and just keep doing that. It helps to find a strong support system that will call you out when you are doing stupid things and celebrate with you on your accomplishments (big or small). Drink a lot of water and make sure you use sunblock – it really helps with your skin. Treat yourself often (yes, I mean with materialistic things) – you deserve it!