K
Kaitlyn Molina
About
Detail
Oregon, United States
Contact Kaitlyn regarding:
Flexible work
Starting at
USD60/hour
Résumé
Jobs
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- SManaged Care PharmacistSamaritan Health PlanAug 2021 - Mar 2026 (4 years 8 months)Supported pharmacy strategy across Medicare, Medicaid, and Commercial lines of business, aligning clinical recommendations with regulatory, quality, and benefit design requirements. Partnered with PBMs and vendors to optimize pharmacy operations, resolve access barriers, and improve utilization management workflows, reducing issue resolution time by 57%. Served as a clinical liaison across pharmacy leadership, medical directors, analytics teams, and external partners to support pharmacy benefit performance and strategic initiatives. Translated clinical, utilization, and financial data into actionable insights to inform coverage decisions, formulary strategy, and program performance. Led provider education and adherence initiatives tied to M
- ODrug Use Research Management InternOregon State University and Oregon Health AuthorityMar 2021 - May 2021 (3 months)As a Drug Use Research Management Intern, I designed a retro-drug utilization research program focused on the analysis and intervention of polypharmacy. I advised the Oregon Health Plan and Oregon Health Authority on formulary placement for new drug indications, employing evidence-based medicine techniques to ensure informed decision-making. My responsibilities included analyzing three journal articles to present to the team, critiquing and appraising the methodologies of the studies to enhance our understanding of clinical effectiveness. I evaluated formulary and coverage considerations across Medicaid populations and state-specific requirements, providing well-founded recommendations for new drug and indication formulary placements based
- PManaged Care Pharmacy InternPacific Source Health PlansApr 2020 - Dec 2020 (9 months)Saved $500,000 and improved member experience and STAR ratings by remodeling scripting for a medication therapy management call vendor. Conducted in-depth review of the 2021 Medicare STARS ratings, including: analysis of changes to PacificSource's ratings, clarification of implementations designed to increase the 2020 STAR ratings, and delineation of plans made for increasing 2022 STAR ratings. Centralized intern resources (Intern OneNote), and collaborated with a pharmacist and fellow intern to catalogue and combine notes and resources for future interns to utilize as they complete rotations. Collaborated in case management as part of an Interdisciplinary Care team for a high-risk mental health patients to assess barriers to optimal care a
Commercial Team Lead Prior Authorization CoordinatorModa HealthMar 2015 - Sep 2017 (2 years 7 months)Transitioned the Commercial team from a paper to online platform, including beta testing the platform and creating templates for the team to use. Crafted and delivered training, policy, and procedure documents used to train 12 new team members on processing prior authorizations, office etiquette, Microsoft Office, and basic insurance concepts. Audited over 35,000 prior authorizations alongside 8-12 team members on a monthly basis. Conducted monthly meetings with team regarding process improvements and corrections based on audit findings and requests from alternate departments for documentation and implementation.
Education
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- ODoctor of PharmacyOregon State & Oregon Health and Sciences UniversityJun 2021Licensed Pharmacist, Aug 2021-current
- Bachelor of Science, BiochemistryUniversity of PortlandMay 2014May 2014 License Number: RPH-0018497 NPI: 1360052