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