PGY-1 UPMC Health Plan


The integration of resources from University of Pittsburgh Medical Center (UPMC) Health Plan, the UPMC Health System, Community Care Behavioral Health (CCBH), and the University of Pittsburgh School of Pharmacy, creates a challenging environment for UPMC Health Plan's Managed Care Residency. Highly motivated pharmacy residents are provided the opportunity to apply safe and effective, evidenced-based medicine practices to individual patients and in populations throughout the Health Plan. UPMC Health Plan has access to the complete health management information for plan members (i.e. inpatient admissions, out-patient laboratory values, diagnosis, pharmacy claims, etc.).

The managed care resident will have the opportunity to create criteria for drug utilization reviews and evaluations, develop clinical intervention activities in conjunction with medication therapy management programs, participate in Health Plan Pharmacy and Therapeutics Committee activities, and assist in formulary management and policy development. The Health Plan develops and implements evidence-based formularies in order to provide high quality, cost-effective medicine to its members. Residents will also gain exposure to specialty pharmacy management through design and analysis of a specialty drug use evaluation.

The operational side of the department implements pharmacy benefits via the pharmacy benefit manager and responds to provider and physician requests through the pharmacy call center. Residents also have the opportunity to do an off-site rotation with a pharmacy benefit manager.

The residency is affiliated with the University of Pittsburgh. Residents will present seminars and complete a research project, as well as have opportunities for teaching and precepting of pharmacy students.

Residency Objectives:

  1. Participate in formulary and utilization management including developing drug monographs and new policies, tracking drugs in the pipeline, and reviewing prior authorization cases.

  2. Develop and participate in clinical programs, including Medication Therapy Management (MTM), Drug Utilization Reviews (DURs), hospital discharge follow-up calls, and other clinical outreach opportunities to improve quality.

  3. Gain exposure to specialty pharmacy management through design and analysis of a specialty drug use evaluation, as well as evaluation of the need for a utilization management strategy for a new specialty drug or group of drugs.

  4. Apply clinical and outcomes research concepts through completion of a research project for presentation at the AMCP Annual Meeting, as well as preparation of a manuscript for publication in a peer-reviewed journal.

  5. Provide effective lectures and facilitate small group sessions at the University of Pittsburgh School of Pharmacy, as well as serve as a preceptor for pharmacy students on a managed care rotation. The resident will also have the option to participate in the Mastery of Teaching Program.

  6. Demonstrate professionalism and effective communications skills in all components of managed care pharmacy through effective presentations, in-service presentations to professionals, appropriate documentation, and daily interactions with other managed care professionals.

Applicants must have completed a Doctor of Pharmacy program and be eligible for Pennsylvania licensure. Resident is required to obtain Pennsylvania licensure no later than September 30th of the residency year.

Pennsylvania requires 1500 registered intern hours in order to be eligible for licensure. Of the 1500 hours, only 500 hours can be obtained through an academic program. That is, 1000 intern hours must be obtained outside of school. These 1500 intern hours must be registered with a state board of pharmacy to count toward licensure in Pennsylvania. If you have not yet started registering hours with your state board of pharmacy, we encourage you to do so as soon as possible in order to be eligible for Pennsylvania licensure. We also encourage you to review your own state's rules regarding the registration, reporting and transfer of intern hours. Please do not hesitate to discuss any questions you have regarding licensure with individual program directors.

An on-site interview is required. Candidates are required to submit application materials through the Pharmacy Online Residency Centralized Application Service (PhORCAS). A completed application includes:

  • Letter of intent

  • Curriculum vitae

  • College transcript

  • List of three references with contact information

  • Three references (at least one letter from a clinical rotation experience) are required to complete the Standardized Reference Form in PhORCAS.

Completed application must be received no later than January 5 for consideration.

Contact Information:

Residency Program Coordinators

Erin Lopata, PharmD
Manager, Clinical Pharmacy
Phone: 412-454-8716
Email: lopatae@upmc.edu

Sara Burnheimer, PharmD
Coordinator Pharmacy Quality, Clinical Pharmacy
Phone: 412-454-4944
Email: burnheimersa@upmc.edu

This residency site agrees that no person at this site will solicit, accept, or use any ranking related information from any residency candidate.

PGY1 pharmacy residency programs build on Doctor of Pharmacy (Pharm.D.) education and outcomes to contribute to the development of clinical pharmacists responsible for medication-related care of patients with a wide range of conditions, eligible for board certification, and eligible for postgraduate year two (PGY2) pharmacy resident training.

To prepare pharmacists for positions in a managed care organization, health plan, or pharmacy benefit manager. Residency graduates will be qualified for a position in prior authorizations, clinical programs, MTM, disease state management, formulary utilization management, quality, account management, pharmacy benefit management, consulting, or a similar type of position within managed care.

Our residents will design and implement clinical programs to enhance the efficacy of patient care, understand how to manage the drug distribution process for an organization's members, ensure the safety and quality of medication-use systems, provide medication and practice-related education, and collaborate with plan sponsors to design effective benefit structures to service a specific population's needs. Additionally, our residents will exercise leadership and practice management skills, as well as project management skills.

Duration: 12 months
Number Positions: 1
Starting Date: July 1
Estimated Stipend: $44,000
Benefits: Health, dental, eye care, life and disability available; vacation time allotted, professional travel and stipend available, no staffing requirements in a pharmacy
Training Site Type: Managed Care
Accredited: Yes
Owner/Affiliates: UPMC Health Plan
Model (type): Health Plan
Professional Staff: 35 Pharmacists

Required Learning Experiences

  • Prior Authorizations
  • Commercial, Medicaid, Medicare, CHIP
  • Clinical Operations
  • Managed Care Marketing, Communications, and Account Management
  • Quality
  • Specialty Clinical Management
  • Rebates
  • Pharmacy Benefits Manager

Required Longitudinal Learning Experiences

  • Medication Therapy Management/Outreach
  • Formulary and Utilization Management
  • Ambulatory Care Clinic
  • Teaching/Preceptorship

Select Elective Learning Experiences

  • Industry
  • Consulting

Other elective rotations are available based on resident interest and faculty availability.

Preceptors

Nicole Ansani, PharmD
Erin Brown, PharmD
Sara Burnheimer, PharmD
Vanessa Campbell, PharmD, CGP
Nicole Cerussi, PharmD, MPH
Tami Coppler, PharmD, BCPS
Jessica Daw, PharmD, MBA
Michelle Gardiner, PharmD, MHA
Krista King, PharmD, MPH, BCOP
Jessica Kubilius, RPh
Erin Lopata, PharmD
Daniel Mancini, PharmD
Paris Maurer, PahrmD
Melinda Morgan, PharmD
Erin McConnell, PharmD
Maggie Ryan, PharmD
Alan Sekula, PharmD

Site

UPMC Health Plan, the second-largest health insurer in western Pennsylvania, is owned by UPMC, an integrated global health enterprise. The integrated partner companies of the UPMC Insurance Services Division - which includes UPMC Health Plan, UPMC WorkPartners, LifeSolutions (EAP), UPMC for You (Medical Assistance), and Community Care Behavioral Health - offer a full range of group health insurance, Medicare, Special Needs, CHIP, Medical Assistance, behavioral health,employee assistance, and workers' compensation products and services to over 3.1 million members. Our local provider network includes UPMC as well as community providers, totaling more than 125 hospitals and more than 11,500 physicians throughout Pennsylvania and parts of Ohio, West Virginia, and Maryland.

This integration of resources from UPMC Health Plan, UPMC, Community Care Behavioral Health, and the University of Pittsburgh School of Pharmacy helps to create a challenging Managed Care Residency Program. Highly motivated pharmacy residents have the opportunity to apply safe and effective evidence-based medicine practices to individual patients as well as to larger populations. The Health Plan has access to complete health management information for members, including data on hospital admissions, laboratory values, diagnoses, and pharmacy claims.

Residents train in the UPMC Health Plan Pharmacy Services Department, located in the city of Pittsburgh. The department has two main areas - clinical and operations. The clinical side supports the development of pharmacy benefits for lines of business, including: Health Insurance Exchange, Children's Health Insurance Program, Commercial, Medicaid, and Medicare. The operational side implements pharmacy benefits via the pharmacy benefit manager and responds to provider requests through the pharmacy call center.

Diehl JL, Daw JR, Coley KC, Rayburg R. Medical Utilization Associated with Palivizumab Compliance in a Commercial and Managed Medicaid Health Plan. JMCP. 2010;16 (1): 23-31

Program Director

Erin Lopata, PharmD
Manager, Clinical Pharmacy
Phone: (412) 454-8716
lopatae@upmc.edu

UPMC Presbyterian