Dr. Debbie Meyer I was born and raised in the great state of Indiana. During high school I became interested in healthcare and saw the profession of pharmacy as a way to become involved in improving the health of people. I received my Bachelor of Science from Purdue University College of Pharmacy. After graduation I worked in a large hospital. Our team initiated a pharmacokinetic dosing program and I saw the true impact pharmacists could make on patient care. After several years of practice I made the leap from hospital practice to managed care practice.
I transitioned to my first role with Humana working in a primary care clinic. I was the pharmacist in charge. I knew little about managed care but dug in to learn more and was introduced to AMCP. I joined AMCP and became involved on the local, regional and national level. I have served on several national committees with AMCP. I have been involved on AMCP panels, participated with the webinar AMCP hosts each fall on “What is Managed Care Pharmacy”, served as a Diplomat with pharmacy schools, and have been a conference buddy at national AMCP meetings. In 2017 I was named Preceptor of the Year by the University of Kentucky and received AMCP’s national recognition as Preceptor of the Year. 1. What is your current role as a managed care pharmacist? My role is Pharmacy Clinical Advisor Lead & Residency Program Director. In this role I am the Residency Program Director for Humana’s Managed Care Pharmacy Residency, precept 15 pharmacy students annually, host Humana internships related to the practice of pharmacy, mentor pharmacy students and colleagues, support partnerships with pharmacy schools to influence and encourage managed care as part of the academic curriculum and have oversight of the scholarships provided to pharmacy students at the University of Kentucky and Sullivan College of Pharmacy. I am the pharmacy lead supporting the Humana and University of Houston partnership. My role provides leadership providing managed care experiences for pharmacy students. Humana generously offers many opportunities for pharmacists pursuing non-traditional pharmacy practice.
2. How long have you practiced in managed care pharmacy, and what interested you in the practice area? I have been working in managed care practice for approximately 21 years. All of my managed care career practice has been spent working for Humana in various pharmacy roles. I enjoy the involvement with business and clinical decisions that make a positive impact to a broad population of patients. I enjoy the flexibility with the work style that managed care practice provides, especially after the structure and schedule of hospital pharmacy practice. My role as a hospital pharmacist provided me with a lot of great experience that synergized my contributions today as a pharmacist in managed care. The career opportunities have been endless for me here at Humana. It has been an amazing organization and has supported my career journey. I learn every day and enjoy Paying It Forward to the next generation of pharmacists. I especially enjoyed my role with specialty pharmacy prior to becoming the Residency Program Director. Grow your knowledge relative to specialty pharmacy it is here and it is the future.
3. What do you like the most or find the most unique about your role? I have the opportunity to impact and influence pharmacy students in managed care practice through program leadership that contributes to the future of pharmacy. Pharmacy experiences, internships, residency, fellowship and mentorships are important as we continue to raise the bar of pharmacy practice. It is important to support the growth of pharmacists leaders. The opportunities for pharmacists to practice at the top of license continue to evolve and in my current role I provide the support young pharmacists growth in their professional competence. It is exciting and humbling to mentor bright, dedicated, and hardworking pharmacy students.
4. What advice do you have for current pharmacy students?
Greet everyone with a smile.
Develop professional and personal goals.
If you identify a problem, suggest a solution.
Listen to and respect the views of others.
Learn new things.
Serve your community and be a role model for all
Dr. Thomas Nguyen I graduated from Oregon State University/Oregon Health and Sciences Univesity with a PharmD and MBA. I completed a PGY-1 Managed Care Residency in Salt Lake City at Select Health/Intermountain Healthcare. After Completing my reisdency, I moved to Austin, TX to work for Navitus Health Solutions as a Clinical Account Executive. As a CAE, I worked with clients across all LOBs ( Commerical, self-funded, TX Medicaid, Marketplace, and Medicare Part D). I am now the Pharmacy Director for Medicaid and Marketplace LOBs at Superior HealthPlan. I am currently an active member of AMCP and serve as diplomant to Texas Southern University and serve as the current President of the Southwest AMCP Affiliate.
1. What is your current role as a managed care pharmacist? Pharmacy Director for Medicaid and Marketplace at Superior Health Plan
2. How long have you practiced in managed care pharmacy, and what interested you in the practice area? 4 Years; I enjoyed a mixture of clinical and financial aspects of managed care and making population health decisions.
3. What do you like the most or find the most unique about your role? No two days are the same in managed care or healthcare in general. There is always constant learning and growth as a healthcare professional. Relearning drugs under the medical benefit and understanding how medical benefit billing works has been rewarding.
4. What advice do you have for current pharmacy students? Keep an open mind when it comes to rotations and pharmacy experiences. Your interests may change over time and find a niche in pharmacy that you are passionate about.
Dr. Dominic Vu Dr. Dominic Vu has over 8 years of pharmacy managed care experience in his professional career. It started from his early experience at Kelsey Seybold Managed Care pharmacy, where he was formerly a resident where he was involved in clinical initiatives for medication adherence, MTM, and hospital readmission prevention protocols, which lead to his days as a pharmacy director implementing and operationalizing government and commercial health plans or insurance plans for Memorial Hermann, the largest non-profit health system in southeast Texas. His work focuses on leveraging data for clinical programs, and improving medical and pharmacy benefits as drivers for cost containment strategy, while running the day to day pharmacy operations and PBM oversight. In his current role, he serves as Senior Vice President of Pharmaceutical Strategies for USI Insurance Service, negotiating PBM contracts for employer groups throughout the US.
1) What is your current role as a managed care pharmacist?
USI Insurance Services is one of the largest consulting & brokerage firms serving employer groups of middle-market America. We help serve self-insured employer groups by finding turn-key solutions to help reduce medical/drug spend while ensuring member access and satisfaction. My role is a “non-traditional” managed care role where I help clients understand their drug spend and negotiate better terms with their pharmacy benefit managers. In some cases, we help clients carve out certain services based on their individual needs. The work environment has proven to be very challenging and fast-paced, but has also been a fulfilling experience.
2) How long have you practiced in managed care pharmacy, and what interested you in the practice area?
I have been practicing in the managed care field for over 8 years now, but my first career was actually in computer science. The job market for computer science was challenging, so going into pharmacy I knew I wanted to pursue a role that presented new and unique opportunities to grow. During my fourth year of pharmacy school, I came across a managed care residency and found that managed care aligned with my personal interests and presented many opportunities for growth as a pharmacist.
3) What do you like the most or find the most unique about your role?
Good relationships and trust are key to my role. My goal is to help provide access to the medications that members need at a price they can afford. It’s a team effort that I couldn’t do alone. As a pharmacist consultant, I ensure transparent lines of communication between all parties - HR Executives, CFOs, PBMs, or health plans. It's important to get along with everyone you work with, and I like to make sure there's not a dull moment when conversing with my colleagues.
4) What advice do you have for current pharmacy students?
Trust will be a key component regardless of what career you enter. We can’t find all the solutions on our own, so building positive relationships with everyone you meet will take you a long way.
Dr. Alina Belousova Alina Belousova is a licensed pharmacist and Senior Consultant for Mercer’s Managed Pharmacy Practice. With experience in the specialty and retail pharmacy industries, she provides guidance and expertise in optimizing the client’s benefit strategy, while keeping in mind clinical outcomes and employee satisfaction. Prior to joining Mercer, Alina managed a specialty pharmacy, that encompassed a wide range of responsibilities and projects, including: -Completing prior authorizations and appeals for specialty and non-specialty medications -Providing in-depth clinical management of specialty patients, with a focus on Rheumatology, Hepatitis C, Gastroenterology, and Neurology -Acting as a business liaison between a national infusion company and the pharmacy -Assisting with implementation of a pharmaceutical manufacturer adherence program -Working in a cross-functional team, that included nurses, administrators, executives, and IT personnel, to construct and implement an electronic portal/EMR In addition to this role, Alina managed several medium to high volume retail pharmacies, gaining extensive experience in customer service, operational efficiency, financial reviews, and management of non-specialty disease states such as hypertension and diabetes. The broad range of projects and responsibilities throughout her career have provided Alina with signification exposure to managed care, the pharmaceutical industry, specialty, mail order, and retail pharmacy.
What is your current role as a managed care pharmacist? Senior Pharmacy Consultant
How long have you practiced in managed care pharmacy and what interested you in the practice area? I have 2 years of experiences in the managed care field and I started becoming interested in this area of practice due to its unique opportunities that utilizes both my business and specialty pharmacy background to influence high level decisions for a variety of companies.
What do you like the most or find the most unique about your role? I enjoy the fact that every day is different and there are always new challenges and opportunities for me to learn.
What advice do you have for current pharmacy students? Don't box yourself in and think that there is only one role for you in pharmacy or only one path to get there. This profession is very diverse and unique opportunities exist - with hard work and networking, you can find the right opportunities.
Dr. Tara Esse Dr. Tara Wright Esse is a 2009 graduate of the University of Houston College of Pharmacy. She began her career as a retail pharmacist, but pursued a residency after 2 years of retail practice. She completed her residency experience with Cigna-HealthSpring in 2012, and was retained by the company as a Clinical Pharmacist. She has since become the Residency Coordinator and actively works to ensure each pharmacy resident has a quality experience that prepares them for any position within the broad field of pharmacy.
1. What is your current role as a managed care pharmacist? I manage a diverse team - Social Workers, nurses and a registered dietician. What I love about my role is that our team focuses on addressing the Social Determinants of Health, which can impact upwards of 80% of overall health outcomes. Essentially, we address the social and behavioral aspects of medicine to invoke positive health outcomes. My team is able to make meaningful interventions for patients. 2. How long have you practiced in managed care pharmacy, and what interested you in the practice area?I became interested in residency while working as a retail pharmacist – population health drew my attention, as did ambulatory care pharmacy. Dr. Nancy Ordonez and Dr. Jeff Sherer encouraged me to pursue a residency position with HealthSpring. I applied to residency after 2 years of retail work, and was able to secure a position with HealthSpring. I completed my residency in 2011, and have been working there since then. 3. What do you like the most or find the most unique about your role?Keep an open mind, as pharmacy is very diverse. The options are endless - it always amazes me how often people in-general only see "retail" or "hospital/clinical." And you know what's the best part? You have the opportunity to change your mind later down the road! I worked in the retail space for 2 years before I moved to managed care/clinical. It's important to seek out as many opportunities you can to learn and grow - expose yourself to different areas of pharmacy that might, on the surface, "scare" you a little! Who knows - you may end up LOVING it and want to pursue it for your future career. 4. What advice do you have for current pharmacy students?Because I do not practice pharmacy, I can speak in generalities about topics like the residency program (I am still the CareAllies PGY1 Residency Program Coordinator), give tips on strengthening applications, etc., and obviously my passion, SDoH!