Professional Summary
Clinical pharmacist with 5+ years in managed care and health plan partnerships, with a demonstrated record of driving policy change at the PBM level through payer collaboration and advocacy. Proven record of building relationships across 7 major health plans, designing outcomes-based formulary programs, and translating clinical complexity into client-facing solutions. Deep GLP-1 utilization management expertise with a track record of driving change at the policy and practice level.
Core Competencies
Utilization Management | Formulary Education | GLP-1 Strategy | Prior Authorization Approvals | Relationship Building | Advocacy | Health Outcomes Analysis | Clinical Outcomes | Member Retention | Total Cost of Care | Evidence-Based Recommendations | Patient Education | Health Plans | Clinical Decision Support | Medication Management | Clinical Protocols | Insurance Authorizations | Formulary Management | Editorial Writing
Professional Experience
Guidewell | Sanitas Medical Centers — Remote + Field, FL
- Developed GLP-1 patient education materials approved by both the payer and practice marketing teams, deployed across 60+ clinics. Incorporated direct-to-consumer cost navigation resources for patients facing access barriers. Strategy was adopted as CMO-signed standard policy across a 500,000+ member population.
- Negotiated and exceeded payer contractual prescription reduction targets from 15% to 5%, delivering $2M in drug spend savings with improvement in A1C performance metrics.
- Identified patients on non-therapeutic GLP-1 doses prescribed for extended periods of time; advocating for members to advance to therapeutically effective doses, a change that was accepted and adopted into coverage policy.
- Developed proactive polypharmacy intervention program validating $236,152 in combined savings (Oct 2023 to Mar 2024) across 40 provider interventions, representing 56% of the total opportunity; identified that the remaining 44% required a structural solution and advocated upstream to embed the fix at the prior authorization level, creating prevention before prescriptions are filled.
- Initiated correspondence with the ADA to address polypharmacy involving DPP-4 inhibitors and GLP-1 receptor agonists; following two outreach attempts, the 2026 Standards of Care included clear guidance on this therapeutic duplication, celebrated by physician leaders as the guideline-based recommendation they had asked for.
- Built and maintained effective working relationships with pharmacy teams across 7 major health plans; led formulary education, PA workflow redesign, and payer strategy discussions incorporating downstream medical cost offsets.
- Independently conceived, designed, and built ChoiceRx, a proprietary web application developed to support members and improve formulary transparency at the point of prescribing; supports 4 formularies across 2 health plan partners with real-time drug lookup, tier classification, and prior authorization data.
Reliance Healthcare | USF Health Taneja College of Pharmacy — Hillsborough & Polk Counties, FL
- Architected and launched a comprehensive pharmacy program across 4 clinics as part of a $1M partnership; developed collaborative practice agreements with CMO and Co-CEO enabling pharmacist-driven medication management including prescribing, initiating, and modifying treatment plans.
- Built and maintained payer relationships with Humana, Devoted Health, CarePlus, Freedom Health, Optimum Health, and Simply Healthcare; conducted monthly touchpoints on practice performance, formulary adherence, and HEDIS/Stars quality metrics.
- Independently negotiated and contracted OutcomesMTM, bringing USF faculty and students to deliver MTM services to Reliance patients, creating a new clinical service line and revenue stream.
- Delivered formulary and benefit design education to providers and clinical staff; performed patient assessments, lifestyle counseling, and drug therapy modifications under collaborative practice authority.
Education
Doctor of Pharmacy (PharmD), Summa Cum Laude | University of South Florida
Concentration: Pharmacy and Health Education
May 2019
Bachelor of Science, Biology | University of Florida
May 2015
Licensure & Certifications
Registered Pharmacist, FL (#59317) | Consultant Pharmacist, FL (#9030) | Pharmacy Revenue Cycle Certificate, ASHP (2024) | Collaborative Practice Certification, UF (2021)
Selected Publications
Multiple editorial articles in Pharmacy Times, 2016 to 2019.
Ad Hoc Peer Reviewer, Hospital Pharmacy.
Cited as clinical reference in doctoral dissertation on medication reconciliation, Dr. Sharon L. Konrad, DNP.