John Smith
(123) 321-5678
123 S. Main Street, New York, NY 80231
A highly successful healthcare manager with more than 18 years of progressively increasing responsibility directing large medical centers and pharmaceutical operations for a leading healthcare system.
PROFESSIONAL EXPERIENCE
Blue Cross and Blue Shield of NY, New York, CO 2003-Present
Director of Pharmacy
Responsible to a three state regional Blue Cross and Blue Shield organization for administration of all pharmacy programs. Oversee and coordinate pharmacy benefit management company (PBM) activities, RFP responses for new business (including the provision of sales presentations regarding the proposed drug benefit), drug utilization management, formulary and manufacturers' rebate programs, and staff and network education. Serve as the primary resource for pharmacy-related issues for the corporation.
- Direct the research, design and systems implementation of cost-effective prescription plans for new and existing product lines.
- Serve as the Chair of Pharmacy and Therapeutics Committee and coordinator of related activities including formulary development, prior benefit authorization criteria, and drug use evaluation.
- Provide Drug Information services to case management nurses and medical directors.
- Created the drug prior authorization process including the development of appropriate use criteria.
- Coordinated mail order pharmacy requests for proposal, including composition and distribution, response analysis, and contract awards, which resulted in significant cost savings.
- Negotiated contract with Pharmacy Benefit Management Company (PBM).
- Coordinated the home infusion therapy re-contracting process, including RFP design, response analysis, and contract negotiations.
- Design and present appropriate use period prevalence studies of drugs and the treatment of disease states for NCQA accreditation.
- Serve as a member: Benefit Interpretation/Provider Information/Member Complaint, Member Appeals, Information Systems Steering, Governance and Prioritization, QA Council, Disease Management, NCQA Preparation, and Data Warehouse User Group Committees
St. Joseph Medical Center, New York, NY 1976-2003
Administrator - Medical Staff Support Services (2001-2003)
Responsible to the CEO for nine departments including medical records, admissions, quality and case management, medical staff office and communications for a 386-bed acute care medical center.
- Spearheaded the development of an integrated case management system that coordinated the efforts of utilization review, social services, discharge planning, infection control and pre-admission.
- Proposed and participated in the conversion of 30 acute care hospital beds to a distinct-part skilled nursing facility that achieved an 80% census within three months. Served as Administrator.
- Participated in the contract review and selection for medical transcription services that saved $30,000 annually and increased physician satisfaction.
- Initiated and led a task force of 60 nursing home administrators that improved communications and relations with the hospital.
- Created and implemented a formal quality improvement training program that included instruction for all levels of staff.
- Involved in the development of critical pathways for orthopedic patients that reduced length of stay by an average of three days.
- Directed hospital-wide preparation for a JCAHO survey and achieved maximum accreditation.
- Reviewed, evaluated and disseminated quarterly morbidity, mortality and utilization reports produced by the national data base, Medisgroups.
- Initiated a quarterly medical continuing education program that presented economic case studies, resulting in a 50% decrease in physician orders for lab tests.
- Served on a multi-hospital task force to research and develop criteria for the selection of prosthetic devices for orthopedic implant surgeries.
- Instructed and facilitated courses for an ongoing management development training program.
- Represented administration at 11 monthly medical staff department meetings and on five hospital committees.
Manager - Pharmacy Department (1987-2001)
Directed 16 professionals with a budget of $1.6 million per year to service an average daily census of 150 patients.
- Developed a pharmaceutical care approach that improved quality of drug utilization and service by 100% and saved $100,000 annually.
- Created and implemented an intravenous medication delivery system that saved $30,000 annually.
- Designed and implemented an employee prescription service that saved $20,000 per year in insurance costs.
- Revised the pharmaceutical inventory system, resulting in an improved turnover ratio from six to ten.
- Negotiated a wholesaler agreement that saved $200,000 over five years while improving the quality of drug procurement.
- Developed a surgery and anesthesia charge procedure that reduced lost charges and brought in an additional $120,000 per year.
- Selected by the Sisters of Charity to represent 20 medical centers to a group purchasing organization for manufacturer contract evaluation.
Critical Care Clinical Pharmacist (1980-1987)
Staff Pharmacist (1976-1979)
LICENSES
Registered Pharmacist at Nevada, New Mexico and New York
EDUCATION
University of NY, New York, NY
Master of Science - Health Administration, Honors: Graduating Student Award from HFMA
New York University, New York, New York
Bachelor of Science in Pharmacy, Honors: Magna Cum Laude
University of Nevada School of Pharmacy, Reno, Nevada
Certificate in Pharmaceutical Economics, expected completion May, 2008
PROFESSIONAL AFFILIATIONS
NY Society of Health-System Pharmacists - Past President 2003, Pharmacist of the Year 2005, Chair Legal and Public Affairs Council, 2006-2008
American Society of Health-System Pharmacists
Academy of Managed Care Pharmacy - Director, Board of Directors, 2007-2009, Legislative Committee 2005-2007
Rho Chi Pharmacy Honor Society
Pharmacy Technician Certification Board State Advisory Panel, 2005-2007
NY Medicaid DUR Committee, 2004-2006
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