Michele Mosier
Washington PA 15301 [email protected]
www.linkedin.com/in/michelemosier
CLINICAL PHARMACIST / PHARMACY MANAGER
CAREER PROFILE
ACCOMPLISHED CLINICAL PHARMACIST with over 14 years experience
in retail and PBM settings. Proven ability to achieve sales goals,
maintain uncompromising operational standards, maintain excellent
customer
service standards, train and develop teams, drive quality
assurance, and meet regulatory compliance. Passion for
drug therapy optimization, while addressing all health and
wellness needs. Seeking a team-oriented opportunity
where quality of care and health of patients is the first
priority.
Quality Assurance Medicare Part D Regulatory Compliance Process
Improvement Dept. Development Staff Mentoring Staff Training
Patient Safety Medication Therapy Management Health Wellness
Fitness Retail Skills Customer Service Skills Sales Skills
CAREER EXPERIENCE
SENIOR PHARMACIST
HIGHMARK, 2014 - 2015
Served as liaison between Operations and Government Compliance
Department, including but not limited to the following tasks: CMS
audit remediation efforts, new or revised guidance interpretation
and
implementation, CMS Call Letter initiatives, and CMS audit
readiness.
Supported quality improvement and compliance efforts within the
Clinical Operations Department by performing monthly audits.
Provided the necessary support to train staff on various
compliance related topics.
Assisted in the development of Highmarks Drug Formularies by
writing drug monographs for Pharmacy & Therapeutics Committee
review.
Assisted in the development and implementation of utilization
management programs, including but not limited to: prior
authorization, dose and duration edits, quantity limits, and
medical policy review and
development.
Provided clinical review and decisions, including but not
limited to: physician and member appeals.
Identified and assisted in managing department process
improvements to maximize overall efficiencies.
Participated in Medicare Stars performance measures to drive
contribution to excellence.
Mentored residents through various compliance initiatives.
CLINICAL PHARMACIST / QUALITY ASSURANCE ANALYST
CVS / CAREMARK, 2010 - 2014
Reviewed clinical appeals, maintaining compliance with ERISA,
Medicare and client specific requirements. Completed data analysis,
and reviewed medication exception requests.
Assisted in the development of various audits for the Quality
and Audit team.
Supported quality improvement efforts within the Clinical
Operations Prior Authorization and Appeals department to ensure
compliance and improve quality.
Selected, pulled, and reviewed cases to ensure compliance with
department policies and procedures and clinical appropriateness
criteria are met.
Collaborated with management to recommend process improvements
based on audit findings.
Assisted in the development and implementation of Medhok, a new
operating system.
Trained clinical pharmacists in Raleigh, NC and Salt Lake City,
UT on various Medicare Part D topics and Medhok.
Michele Mosier
Washington PA 15301 [email protected]
www.linkedin.com/in/michelemosier
EXECUTIVE TEAM LEADER - PHARMACY
TARGET, 2004 - 2010
Managed the pharmacy team that included a pharmacist,
technician, and a student intern. Analyzed and reacted to sales
performance, customer service scores and other metrics. Recruited
and hired for all open
positions. Controlled expenses through payroll hours.
Answered all statewide legal questions relating to pharmacy laws
in Pennsylvania as the Legal Resource Captain at Target. Researched
answers via multiple resources including the Pennsylvania Board
of
Pharmacy.
Accepted challenge to become Donation and Volunteer Captain.
Partnered with the community to gather all charitable requests.
Distributed all approved requests and managed within the
predetermined budget.
Identified volunteer event opportunities through networking with
the community; recruited team members
to participate in scheduled events; and ensured that each was
recognized for their commitment.
EDUCATION
Duquesne University
Doctorate in Pharmacy 2001
CERTIFICATIONS & LICENSURES
Anticoagulation Therapy Management Certificate Program
February 2011
Delivering Medication Therapy Management Services National
Certification
March 2014
Active Pharmacist License in the following states: Pennsylvania,
Ohio, and Maryland.
VOLUNTEER
Deliver Medication Therapy Management Services for an
independent consultant.
April 2015 - Present
