Breadcrumb
Diplomat Spotlight
August 2022 Spotlight
Brenden O’Hara RPh, BCACP – Diplomat at Campbell University School of Pharmacy
How did you become involved in AMCP?
In one of my previous jobs, we had a new CEO who hosted a meet and greet. She asked about our interests, and I talked about my work within the profession (state and national), and she mentioned AMCP. I honestly knew nothing about it at the time, so I went back to my desk and googled it. It seemed to match nicely with my professional focus, so I joined and have been an active member ever since.
What interested you the most about managed care and ultimately led you to pursue a career in managed care pharmacy?
In one of my previous positions, we began working with managed Medicaid in other states. I knew what role pharmacists could play in improving outcomes, but this was my first exposure to contracts that reimbursed pharmacists for improving member outcomes! After that, I was hooked and have transitioned my career focus/ trajectory ever since then.
What was your first job or position in managed care?
Director of Provider Engagement at Physicians Pharmacy Alliance in Cary, NC. I have always had a knack for dealing with challenging customers. I worked with the CMO to address concerns from providers regarding the process we had for onboarding new patients. It could be challenging to a provider/ practice, so it was a lot of “fire extinguishing” in that position.
What does a typical day or week look like in your current role?
Currently, I work with our Value Based programs at Blue Cross NC (Blue Premier.) I work with our partners and other pharmacists within those systems to help them identify opportunities to improve quality and cost of care. A typical week is attending/ running meetings to facilitate conversations with Blue Premier partners or preparing information/ data to share in these meetings.
What interactions have you had with your AMCP student chapter or school of pharmacy?
Campbell does not have a student chapter. This makes for a great opportunity to educate faculty, staff, and students on the role of pharmacists in non-traditional practices like managed care. We have presented to the faculty on managed care and developed a managed care elective at the school.
Words of advice?
Really in many aspects of my professional life, I follow a few maxims.One of the biggest is “Meet people where they are.”
Being a diplomat for Campbell, they did not have a focus on managed care, and the faculty was going through a syllabus change. It was not the time to push to have a student AMCP chapter. BUT we were able to get them to agree to an elective, presentations to the faculty, and expanded student precepting. This is the start of a grassroots effort where we show future pharmacists the opportunities in managed care, and then they push to gain even more knowledge and potentially request a chapter.
October 2021 Spotlight
Rowe B. Brookfield, PharmD, CPE - Diplomat at Union University
How did you become involved in AMCP?
As a resident in 1995. I was searching for the most fitting publications to report work I was doing in both member satisfaction with pediatric nocturnal enuresis and the integration of case management and pharmacy in managed care environments. In my search, I came upon a relatively new and small organization called AMCP. I discussed it with my very forward-thinking residency director and some other career-guiding people in my life. I was encouraged to join. I did and was a member for several years.
My career and life path later diverged from a managed care focus, taking me back into a clinical role and then into medical affairs role within the pharmaceutical industry. In the early 2000’s, managed care was just becoming noticed within industry. My previous training and experience with managed care led to me being utilized in multiple projects and initiatives involving the flow of the healthcare dollar. This resulted in ever-increasing and evolving health outcomes and managed care-focused medical affairs roles. As a result, for at least the last 10+ years, I have been increasingly involved with AMCP.
What interested you the most about managed care and ultimately led you to pursue a career in managed care pharmacy?
Upon graduation from the University of Tennessee, I was contemplating my career path. I was really torn between pursing a pediatric clinical residency and going to medical school. In good fortune, I was made aware of a new type of residency surrounding ‘managed care and pharmacoeconomics.’ This really intrigued me as an option I had not yet considered. Ultimately, I chose this non-traditional pharmacy path because it involved various aspects of clinical pharmacy, patient-centered activities, and efficient use of resources; this seemed to present the potential for me to make positive impact on a larger scale than either of my previously considered options.
What was your first job or position in managed care?
As eluded to in my previous responses, my first managed care job was as a managed care and pharmacoeconomics resident. The residency was with a small, innovative private consulting company. The company had various clients that spanned from large medical systems to pharmaceutical industry. Within the company, I was afforded many opportunities that neither I, nor my pharmacy school classmates and faculty, could fully believe. It exposed me to the then infantile science of pharmacoeconomics and the growing field of managed health care. (At that time, managed care was most entrenched on the west coast and vehemently fought by healthcare professionals elsewhere.) The residency aligned me a staff-model HMO on the west coast to give me insight into the internal workings and business model of the HMO, allowing me to observe the ‘gears’ that kept the HMO running.
The residency led to a position within the consulting company and my responsibilities increased with expansion into phase III & IV research that incorporated health outcomes to help industry further justify their place in the market. Some of these activities included the creation of ‘formulary kits,’ the precursor of today’s AMCP Dossier, assisting with some clients’ formulary management, and holding leading advisory boards.
My roles over the last 10+ years in industry have generally involved being managed care and health outcomes leads at various companies. I have often been charged to help partner industry with managed care organizations to ensure the most appropriate and efficient utilization of marketed products.
What does a typical day or week look like in your current role?
With the volatile environment of healthcare, especially the pharmaceutical industry, today, there is no such thing as a ‘typical’ day or week; there may not even be a typical month, quarter, or year. However, my current role involves and divides my time between three branches: 1. HEOR lead: I am responsible for developing the HEOR strategic research plans for both our marketed and pipeline products, and then managing the projects; 2. Managed Care lead: I am in charge of developing product presentations that are to be delivered to MCOs upon request; and, 3. I have some field responsibilities to meet with key medical experts to discuss research activities and respond to medical information requests.
What type of interactions have you had with your AMCP student chapter or school of pharmacy?
I am the diplomat for a fairly young pharmacy school at Union University in west Tennessee. With it being relatively new, interactions have been rather limited. I have liaised with some faculty members and given AMCP student chapter information presentations; but to date, there has not been enough interest (committed students or faculty) to form a new chapter.
Words of advice?
Stay engaged…in all aspects of our profession. We are in a time where knowledge is increasing at a faster rate than ever before in human history. We are also facing increased scrutiny with the way healthcare services are delivered, recorded, and allocated. This leads to a rapidly-changing, unpredictable environment where what we know today, may be totally different (and outdated) for what we need to know for tomorrow. To quote the FAA Flight Instructor manual (no, I am not a pilot, but read it in preparing for my CPE certification): No individual’s understanding of anything is ever “complete.”…Learning occurs continuously throughout a person’s lifetime.
We must remember this and constantly strive to as stay as informed as possible. We may not always be able to be the first to adopt new ideas, but we certainly cannot afford to be the last...lest we become archived in the history of our profession.
June 2021 Spotlight
Angelica Asadi, PharmD - Diplomat at University of Houston
How did you become involved in AMCP?
I was fortunate to be introduced to AMCP early in my pharmacy career as a first-year pharmacy student. Through local involvement, regional and national events, I created a remarkable network of mentors who helped shape my professional growth for a career in managed care.
What interested you the most about managed care and ultimately led you to pursue a career in managed care pharmacy?
What first sparked my interest was the versatility and unique utilization of a pharmacist's skillsets in various settings. The more I learned about managed care and its impact on every individual seeking health care, the more I realized it was the correct path for me.
What was your first job or position in managed care?
My first official work experience in managed care was post my graduation from the PGY-1 Managed Care Pharmacy Residency at Kelsey-Seybold Clinic, where I stayed on working with the organization's 5-Star Medicare Advantage health plan KelseyCare Advantage. I currently work as a health plan pharmacist, where my role consists of Medicare Part D compliance and operations oversight and administration and PBM oversight. I also serve as a Kelsey-Seybold Clinic PGY-1 Managed Care Residency Program Coordinator (RPC).
What does a typical day or week look like in your current role?
What drew me to a career in managed care and health plan operations was the fact that no two days are the same, which certainly rings true. Working for a Medicare Advantage health plan, a typical week consists of reviewing new Centers for Medicare & Medicaid Services (CMS) guidance and interpreting its impact on operational workflow; reviewing quality performance measures, and ensuring all processes are in place to excel in performance and services provided; and staying updated with new rules and legislation. Additionally, I work closely with our delegated Pharmacy Benefit Manager (PBM) to ensure compliance with CMS regulations and our organization's expectations. What I love about this role is that all daily functions are done to guarantee member satisfaction and confidence in their health plan.
What type of interactions have you had with your AMCP student chapter or school of pharmacy?
I'm fortunate to be able to serve as the diplomat for my alma mater, the University of Houston, where I am still connected with many faculty members and the AMCP organization advisors. My interactions with the college include providing mentorship for the local P&T competition, serving as a P&T competition judge, assisting with local and regional educational events, and assisting chapter leaders with finding appropriate resources and contacts for various events. I also aim to help integrate managed care in the pharmacy school experience by assisting with lectures and educational experiences at the college.
Words of advice?
Always be curious and ask questions! Learning what you are or aren't passionate about in life and your career will help you become an excellent practitioner, so don't be afraid of meeting new people in the field and asking them what they love about their job.
March 2021 Spotlight
Babette Edgar, PharmD, MBA - Diplomat at University of Maryland
How did you become involved in AMCP?
Wow, it has been almost 26 years! I joined AMCP when I started working for a PBM named Advance Paradigm because I did not know anything about managed care and needed/wanted to learn everything I could to excel at my job. Becoming involved in leadership was a natural evolution as I like to make a difference and immerse myself in what I do. I have always been involved in leadership positions since high school. I think once you start, natural curiosity and drive to make a difference follows you throughout life.
What interested you the most about managed care and ultimately led you to pursue a career in managed care pharmacy?
I was working in academia and running a Pharmacy and Therapeutic Committee (P&T) for an affiliated hospital. I was recruited by a colleague to run the P&T committee for the PBM. I honestly did not know what managed care was at the time, as it was just starting to gain momentum in the industry. Someone suggested I join AMCP to network and learn about managed care. So, I kind of fell into it and ultimately ended up helping to shape it through various volunteer and leadership positions in AMCP and in my daily jobs. And here I am!
What was your first job or position in managed care?
Clinical Director for a PBM
What does a typical day or week look like in your current role?
I am one of two Founders of a Government Programs Consulting Company, BluePeak Advisors. In my current role, I advise health plans, pharmacy benefit management companies and pharmaceutical companies on Medicare and managed care strategies, operational and compliance issues. In addition, I spend a good portion of my time on sales and marketing activities for my company; writing proposals, giving presentations, relationship building and management and helping plans grow and become successful.
What type of interactions have you had with your AMCP student chapter or school of pharmacy?
The University of Maryland School of Pharmacy is a very large, very active chapter. This is the institution where I was employed for four years as an Assistant Professor, then Preceptor for many years I have been involved with the University of Maryland School of Pharmacy for years since I was a full time Assistant Professor in 1995. I have been involved on several different levels before I became the Diplomat. With the AMCP Chapter, I have given lectures on Managed Care at their symposiums for many years. For the past five years, I have participated in their “Speed dating” like roundtables for their career fairs. Since becoming the formal Diplomat, I have had an active role, along with their new Managed Care Chapter Advisor (Catherine Cook who I have known for many years) of helping the Chapter better understand Managed Care and how the pharmaceutical industry is only a small part of the careers out there in managed care. I have introduced guest speakers into their speaker series who are Managed Care residents at health plans and PBMs to show students the opportunities out there. I have helped Catherine plan a curriculum for their new “P&T Elective” that is designed to help students understand the P&T process better so they can be competitive in the AMCP P&T competition. It also is worth two credits as an elective. We are working to help Managed Care principals and activities get into other parts of the academic curriculum as well. The AMCP Student Chapter puts out a weekly newsletter to their members and I monitor the newsletter and make suggestions, when appropriate, to help incorporate AMCP direction and principals and correct misconceptions.
Words of advice?
You need a strong relationship with both the Chapter president and the faculty advisor in order to make things happen. Without a strong faculty advocate, it is very difficult to get programs implemented and get students motivated.
January 2021 Spotlight
Elizabeth Sampsel, PharmD, MBA, BCPS - Diplomat at Xavier University of Louisiana
How did you become involved in AMCP?
In 2005, when I was hired at MedImpact, I learned about and joined AMCP. Over the years, I have been involved with the AMCP Format Executive Committee, LRAC, the AMCP Foundation P&T Competition and as a Diplomat. In addition, several years ago, I was an employee of AMCP on the Pharmacy Affairs team. I have also had the privilege of lobbying with AMCP for our profession on PIE, MTM and other important managed care pharmacy topics.
What interested you the most about managed care and ultimately led you to pursue a career in managed care pharmacy?
I enjoy combining the clinical and business aspects of pharmacy. Managed care connects the dots of every facet of pharmacy and overall health care. I am passionate about leading efforts in managed care pharmacy to develop and successfully implement innovative models to enhance U.S. and global health care systems.
What was your first job or position in managed care?
My first job that involved managed care was when I worked at the VA Medical Center San Diego. It was there that I was introduced to the importance of a formulary. However, it wasn’t until I worked at MedImpact and joined AMCP years later did I fully appreciate the complexity of the broader scope of managed care and really find my calling there.
What does a typical day or week look like in your current role?
In my role at MedImpact, I work directly with health plans to provide proactive clinical consultative services to include aggressive trend management, formulary management, clinical quality gap analysis, and the up sell of clinical products and services. At Xcenda, my role is to engage with payers to use the FormularyDecisions platform and to work on key projects with strategic partners.
What type of interactions have you had with your AMCP student chapter or school of pharmacy?
Xavier University started their AMCP Chapter last year. My role was to assist them as a liaison to AMCP. I have continued to be a liaison for their chapter. In addition, I attend their meetings and assist with recruiting speakers as needed. I am excited that this year they will have their first team competing in the AMCP Foundation P&T Competition!
Words of advice?
Pay it forward! There are so many people that have invested in each of us over the years; it is so important to give back by mentoring others on a similar path. Also, I encourage students to set up informational interviews to connect with those in our profession to gain a broader perspective of pharmacy and to journal their interviews to be able to refer to the wisdom they gain from them in the future.
December 2020 Spotlight
Erika Kaplan, PharmD, BCACP - Diplomat at Wilkes University
How did you become involved in AMCP?
I became involved with AMCP as a P1 student at Wilkes University. At the time, the chapter was led by a student who was very passionate about managed care and AMCP. The student’s passion sparked my interest in managed care and motivated me to join AMCP and later become chapter president.
What interested you the most about managed care and ultimately led you to pursue a career in managed care pharmacy?
The idea of utilizing both clinical and business knowledge got me interested in managed care. As I learned more through my involvement in AMCP and experienced managed care at a health plan on APPE rotations, I knew managed care was a match for me. I enjoyed using studies, guidelines, and economics to help make sure patients were getting the most clinically appropriate and cost-effective medications.
What was your first job or position in managed care?
My first position in managed care was a PGY1 resident at PerformRx, a PBM in Philadelphia, Pennsylvania. During my residency, I worked in many aspects of managed care including formulary management, prior authorization, operations, specialty pharmacy, and medication therapy management.
What does a typical day or week look like in your current role?
I am currently a pharmacist in the Clinical Outcomes and Therapeutic Optimization department at PerformRx. In my role, I complete telephonic comprehensive medication reviews with both Medicare and Medicaid members and work on programs designed to improve quality measures for our health plan clients. I also serve as a coordinator for our residency program and a preceptor for our bleeding disorder rotation. Therefore, a typical week includes meetings with our residents, preceptors, and other program leadership.
What type of interactions have you had with your AMCP student chapter or school of pharmacy?
I am currently a diplomat for Wilkes University. My interactions with their AMCP student chapter include speaking at meetings, serving as a judge for chapter competitions, and hosting students for job shadowing days. I also meet with the chapter advisor and/or student leadership to discuss chapter recruiting strategies, events, and fundraisers.
Words of advice?
Take advantage of opportunities to work on different projects and do things that take you outside of your comfort zone. You never know what doors will open as a result.
September 2020 Spotlight
Joe Honcz, MBA, RPh - Diplomat at University of Connecticut
How did you become involved in AMCP?
I had a great mentor when I started at my first managed care company and he directed me to consider joining AMCP. Once I looked into the organization, their mission and the fact that they provided several forums to collaborate and learn more about managed care pharmacy it was a no brainer to join.
What interested you the most about managed care and ultimately led you to pursue a career in managed care pharmacy?
To be completely candid, I stumbled upon managed care. I would often pass our States blue cross and blue shield plan during my travels and one day I dawned on me that I should look to see if there were any job opportunities.
What was your first job or position in managed care?
I was the Pharmacy Director for the Public and Labor Segment for Anthem BCBS in Connecticut.
What does a typical day or week look like in your current role?
After spending more than 20 years in managed care I recently left to start my own consulting company focused on market access. As a consultant, no two days are alike, which is perfect for me! There are some common themes that center around problem solving, research and developing tactics/strategies to help my clients maximize the potential of their innovations when it comes to patient access and revenue.
What type of interactions have you had with your AMCP student chapter or school of pharmacy?
I have had the pleasure of being the co-diplomate with Glen Smyth for the University of Connecticut for the past 10 years. Glen and I have working with the faculty leader and students increase their knowledge of managed care with a focus on what opportunities exist and how they can best prepare to enter the industry.
Words of advice?
First, I thinks it's important that students figure out what’s important to them when it comes to career, for instance I often suggest students take a couple personality tests to see what excites or doesn’t excite them when it comes to job functions/types. Once a student has a sense of what they want to get out of role, I suggest that they network as much as possible to find others in that field to learn from them about their journeys.
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.
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!