1. PATRICIA SHORT
7231 Forestedge Court, Trinity, FL 34655
Phone (727) 742-0116 Email:Trish5275@Outlook.com
SUMMARY OF QAULIFICATIONS
 Over20 yearsmanagementexperience focusedinManagedCare Markets
 Strongwrittenandverbal communicationskills
 Detail orientedprojectmanagementskills
 Stronginterpersonal skills;proactive inproblemresolution,abilitytomulti-task
 Provenability tomeetproductionandqualitystandards
PROFESIONAL EXPERIENCE
Health Choice Florida
dba/ IasisIntegrated Care Solutions,Tampa, FL 4/2014-Present
Florida Senior ManagementTeam - Clinical Pharmacist
 Engaged team member focused on integration of Health Choice Arizona, Health Choice Florida and
Humana delivery systems and solutions for Managed Medicaid plans
 Oversightof pharmacydepartmentadherence andprocessimprovementsfor regulatory, compliance
and contractual obligations to CMS and AHCA
 Clinical pharmacy liaison for pharmacy benefit operation and medical management operations
 Extendedindividual andgroupphysician consultationand educationoncost-effectiveprescribingas
well as providingBestPractice programsbasedon prescriptionand medical claimdata
 Strategic analysis of potential business and/or operational opportunities by conducting and guiding
work on complex projects and programs
 Development,administration,andcontinuousevaluationof FloridaspecificUtilizationManagement
as well asQuality Improvement for medical services delivered by contracted healthcare providers
 Innovate methods for cross-functionality of teams for comprehensive assessment of care
managementandavailable alternative services fortransitionof care (TOC),acute case management,
dual-eligible beneficiaries and complex needs populations
Wellcare HealthPlans,Tampa, FL 1/2008- 10/2013
SeniorClinical Managerof Pharmacy Operations/SpecialProjects
 Executed clinical review of managed care services for Specialty medications and Oncology utilizing
NCQA and URAC standards
 Strategic analysis of potential business and/or operational opportunities by conducting and guiding
work on complex projects and programs across all lines of business
 Developed J-code medical benefit management program with $5.7 million savings to plan
 Integrated the development, administration, and continuous evaluation of Utilization Management
as well as Quality Improvement for medical services delivered by contracted healthcare providers;
Curtailed fraud, waste and abuse (FWA) by monitoring and reviewing Prior Authorization requests
against Medically Likely Edits

2.  Innovated methods for cross-functionality of teams for comprehensive assessment of care
managementandavailable alternative services fortransitionof care (TOC),acute case management,
dual-eligible beneficiaries and complex needs populations
 IncorporatedFormularybuilding,PharmacyandTherapeutics presentations,developmentof Clinical
Decision Tools into workflow
 Subjectmatterexpert(SME) onMedical ManagementAutomatedsystem(EMMA).Providedongoing
education to staff of technicians and clinical pharmacists regarding use of clinical, CMS and NCCN
guidelines.
JSA Healthcare/Healthcare Partners, St. Petersburg, FL 3/2002- 11/2007
Corporate Clinical Pharmacist
 AnalyzedMedicare fundingriskbuckets;activelymanagedMedicare PartB andPart D medication
expensesfor>50% of Humana’sHMO; average Part D expensesmaintainedat$14 PMPMbelow
marketplace
 Customizedmanagedcare ‘formulary withinthe formulary’forriskgroupsandMSOs
 Innovative strategicplanningandpresentationstophysician groupspromoting‘BestPractices’ to
enhance cost-effective quality medical/pharmaceutical care
 Initiated providercontractpurchasingprogramsforbiotechnologicals
 Implementedconcurrentandretrospectivedrugutilizationreviewsandmedical outcomes
 Active participationon P&TCommittee andQualityMedicalOutcome Committee
 Consultantindevelopmentof NCQA DiseaseManagementProgram,MRA codinginitiative and
increasingscoresforHEDIS measures
Humana Health Plans,Tampa, FL 7/2001- 3/2002
Pharmacy Manager,Pharmacist in Charge
 Managed staff model pharmacyprovidingoral medications, injectable andDME products;yearly
gross salesexceeding$1.2 million
 Implementedprogramstoprovide consistentuse of appropriate medicationsfromHumana
preferreddruglistforMedicare ANDcommercial planmembers
 Maintainedmedical benefitcostsforCommercial insurancemembersincludingHillsboroughCounty
School Board andCity of Tampa employees
 Extendedindividual andgroupPhysician consultationand educationoncost-effective prescribingas
well as providingBestPractice programs
 Strategicplanningfordevelopmentof pharmacystaff includingperformance evaluationsandgoal
setting
EDUCATION AND AWARDS
University of Florida
ConsultantPharmacist
St. John’s University
Bachelors of Science Pharmacy
JSA Healthcare
Pharmacist of the Year
Sears Holding Corporation
Chairman’s Award for Pharmacy