1. Jennifer Jackson
150 W 9th
Ave, Unit 2112
Denver, Colorado 80204
Mobile: 440-292-7108
Email: jenniferejackson1988@gmail.com
Work
Experience:
AccessManagement Services
10065 East Harvard Avenue
Suite 600
Denver, Colorado 80231
Clinical Pharmacist, Pharmacy Services
Responsibilities:
- Lead pharmacist in pharmacy coverage determination and
appeals audits; trained in data validation of pharmacy
universes, Medicare technical specifications, and reporting
requirements
- Processed prior authorization and exception requests in
accordance to CMS and DOI regulations for Medicare,
Medicaid, and commercial lines of business
- Worked on interdisplinary team to construct, execute,and
monitor medication use improvement strategies specific to
medication adherence,inappropriate drug utilization, and
quality performance measures
- Regularly ran reports to monitor PBM performance and
delegation against contractual terms
- Created physician and member mailings related to
medication changes and optimization of cost-effective
pharmacotherapy
- Reviewed formulary reference files to decide placement of
medications on formulary, including tier and utilization
management restrictions; presented decisions on basis of
cost analysis and place in therapy relative to other available
formulary options to management and Pharmacy and
Therapeutics Committee
- Regularly monitored high-cost, high-touch medication
utilization reports for appropriate use; identified gaps in
therapy and worked to close gaps by coordination with
clinical case manager,medical director, and prescribing
physicians
- Presented and collaborated with medical directors on
challenging clinical cases on monthly basis at clinical care
meetings
- Instrumental in implementing medication adherence and
therapeutic intervention programs related to increase
STARs and HEDIS measures
- Proficient in Medicare submission requirements, including
8/2014-Present

2. PDE files, DIR reporting, and pricing data
- Developed monitoring tools for tracking timeliness and
accuracy of coverage determinations and appeals; assisted
with compliance monitoring and corrective action
procedures
- Fluent with Microsoft Word, Excel, and Outlook software
CVS Caremark
29100 Aurora Rd
Solon, OH 44139 United States
08/2012 – 8/2014
Clinical Pharmacist, Medicare Part D Operations
Responsibilities:
- Worked in Medicare Part D Operations to review prior authorization and formulary
exception criteria to make coverage determinations
Ensured timely communication to client, member, and Medicare regulatory agencies
regarding decisions
Educated members on the prior authorization process and drug utilization rationale
through inbound phone calls
Prepared and uploaded reports into Sharepoint regarding daily progress and work
functions
- Worked closely with account managers to implement the plan-specific policies and
procedures in case reviews
Counseled members on safe and effective utilization of medication based on prior
authorization criteria
Researched drug and disease states using appropriate compendia to ensure safe and
proper medication decisions were applied to authorization reviews
- Served as drug information resource for other departments within company
- Developed efficient work flow processes and reporting tools to manage daily requests
and outreach for daily operations
- Provided clinical input and feedback to committees responsible for formulary
development, prior authorization criteria, and exception requirements
Education: University ofToledo
Toledo, OH United States
Doctorate of Pharmacy: May 6, 2012
GPA: 4.0
Major: Doctor of Pharmacy
Bachelor of Science, PharmaceuticalSciences
Minor: Chemistry
Honors: Summa Cum Laude

3. Additional Training and Certifications:
American Heart Association, HeartSaver AED and CPR
Ohio State Board of Pharmacy,Immunization Certification
PCCA Introductory Pharmacy Compounding Certification
Outcomes Medication Therapy Management Billing Certification
HIPAA Training and Certification
Part D Coverage Determinations, Appeals, and Grievances Medicare Certification
Part C Appeals: Organization Determinations, Appeals, and Grievances Medicare Certification
Medicare Part C and Part D Reporting Requirements and Validation Certification
Medicare DME Certification
Associations and Organizations:
Phi Kappa Phi Academic Honors Fraternity,2009-present
Lambda Sigma Academic Honors Fraternity,2010-present
Rho Chi Pharmacy Honors Fraternity, 2011-present
American Pharmacists’ Association, Member 2012-present
National Comprehensive Cancer Network, Member 2012- present
Licensure:
Colorado State Board ofPharmacy, Registered Pharmacist,May 2014-present
Ohio State Board ofPharmacy, Registered Pharmacist,June 2012- present
References:
Available upon request