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A Day in the Life of a Managed Care Pharmacist

A Day in the Life of a Managed Care Pharmacist - Headshot

We’re excited to introduce you to Ramya Devineni, PharmD, RPh!

Dr. Devineni is a pharmacist with a very unique and interesting pharmacy career. She works as a Medicare Part D manager at Visiting Nurse Service of New York.

She was kind enough to allow us to ask her a few questions about her job. Here’s a look at what a day in Dr. Devineni’s life as a pharmacist looks like!

What type of pharmacist are you?

I’m a managed care pharmacist—specifically, I work as a Medicare Part D manager. My role is to oversee the pharmacy benefits offered under my organization’s health plans.

My job involves keeping the organization compliant with the federal Part D regulations set forth by the Centers for Medicare and Medicaid Services (CMS), serving as a subject matter expert in clinical matters associated with the Part D benefit under our organization’s plans, and more.

What makes your career path unique?

My career path is unique within managed care pharmacy because it has been mainly focused on the regulatory aspects of managed care pharmacy. But, at the same time, my career still allows me to apply the clinical background I obtained during my time in pharmacy school.

What does a typical workday look like for you?

My responsibilities as a Medicare Part D manager follow a revolving cycle every year. This cycle begins on January 1 each year, when a new plan year begins and runs through until December 31 each year, when a plan year ends.

Each day, I simultaneously work on the upcoming year’s plan benefits, while also overseeing and ensuring CMS compliance for the current year’s plan benefits. That said, there really isn’t a typical work day in my role. Here are just a few of the things I might do in a typical week:

  • Meet and communicate with our organization’s Pharmacy Benefits Manager (PBM)
  • Connect with various internal departments about topics related to the administrative functions of a health plan
  • Facilitate communications directly with CMS
  • Work on deliverables for audits

Describe the most rewarding day of your career.

Health insurance companies are often viewed unfavorably because of coverage limitations related to medications or services. Our members view some of these coverage limitations as an unnecessary hindrance to their health care.

The truth is, my job as a managed care pharmacist is to ensure that individuals are able to obtain the medications that are necessary to their health (under the guidelines provided by CMS), while also ensuring that these resources are utilized in a financially responsible way.

While my team’s intentions are always good, sometimes errors can occur. When an individual is wrongfully denied a medication that is necessary to their health, it can become a serious issue—especially because my team works closely with elderly and vulnerable individuals. 

My most rewarding days as a managed care pharmacist are the days when my team doesn’t receive any of these types of complaints!

Describe the most challenging day of your career.

Every day as a managed care pharmacist is challenging because my role is heavily focused on regulatory compliance. Staying up-to-date on CMS regulations is a necessary but challenging and time consuming part of my job. Whenever federal regulations are involved, minor errors can result in my organization becoming non-compliant to a federal law.

What most attracted you to pharmacy over other healthcare professions?

I was always drawn to science-related subjects when I was in school. So, when it came time to choose a career path, I chose pharmacy. This was mainly because it allowed me to combine two topics I was very interested in—chemistry and biology. It also helped to have my dad, a pharmacist and pharmaceutical company executive, as a mentor.

What advice would you give a student entering pharmacy school?

My advice to students entering pharmacy school is to form relationships with your professors and mentors. I was fortunate to have had very good professors in both high school and early college. They helped me to learn and strengthen the skills necessary to enter and succeed in pharmacy school.

Additionally, once you’re in pharmacy school, it’s important to always keep an open mind and be eager to learn. During pharmacy school, there are many people ready to help you learn, grow, and gain new perspectives. Don’t shut yourself off from these opportunities.

When I was in school, I made sure to take advantage of many opportunities that came my way. For example, when a class required me to spend time at a practice experience site, I would take advantage of the experience to the best of my ability—not just to obtain the minimum requirement for my course. Spending extra time at these experience sites gave me great insight into what my career could look like after graduation.

Learn more

Thanks again to Dr. Devineni for allowing us to ask her a few questions about a day in her life as a managed care pharmacist and Medicare Part D manager. 

If you’re interested in learning more about the large array of career options available in the pharmacy industry, visit our Career Paths page.

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