Edward
US Registered Nurse (RN) | Registered Pharmacist (RPh) | Doctor of Pharmacy (Pha
Verified
Overview
Looking for full-time work (8 hours/day)
at $14.15/hour ($2,720.00/month)
Post-graduate degree (Masters, Doctorate, etc.)
Last Active
June 25th, 2026 (2 days ago)
Member Since
May 3rd, 2026
Profile Description
US Registered Nurse (NY) and Registered Pharmacist with a Doctor of Pharmacy degree and over 5 years of experience in Utilization Management, Clinical Appeals, and Pharmacy Benefit Management within U.S. healthcare systems. Skilled in medical necessity determination, prior authorization review, formulary and step therapy management, and Medicare appeals. Experienced in reviewing high-volume complex cases using MCG guidelines and payer policies while maintaining compliance with CMS standards. Strong background in pharmacovigilance, drug utilization review, and interdisciplinary clinical decision support across payer and PBM environments.
Top Skills
Customer Support » Healthcare
Experience: 5 - 10 years
Customer Support » Healthcare » Electronic Health Record
Experience: 5 - 10 years
Coaching » Health And Wellness » Health Education
Experience: 5 - 10 years
Other Skills
Basic Information
- Age
- 29
- Gender
- Male
- Website
- Sign Up with Pro Account to View
- Address
- Las Pinas City
- Tests Taken
- None
- Government ID
- Sign Up with Pro Account to View
“I have found someone who is smart, has a great work ethic and is easy to work with.”
Sara Brumfield
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