Summer Intern Alumna Spotlight: Carly Rodriguez
Over the past 27 years, nearly 200 student pharmacists have taken part in our summer internships. We're pleased to highlight our intern alumni in this reoccurring feature.
Name: Carly Rodriguez, PharmD, FAMCP
Current Role: Pharmacy Director, Clinical Innovation, Moda Health
Internship: AMCP Foundation/Pfizer Summer Internship
Internship Site: Regence BlueCross BlueShield
Carly Rodriguez, PharmD, FAMCP is the pharmacy director of clinical innovation for Moda Health. In this role, she provides strategic leadership for clinical initiatives, operations, innovation, and the integration and management of medications across pharmacy and medical benefits. Her areas of expertise include formulary management, cost-savings and utilization management strategies, specialty drug management, benefit design, and medical pharmacy. She has presented to a variety of audiences on important topics in managed care, such as specialty pharmacy, data integration, and trend management. Carly received her PharmD from the University of Washington, School of Pharmacy, along with a certificate in biomedical and regulatory affairs.
In addition to being an intern alumna herself, Dr. Rodriguez has also served as a preceptor to AMCP Foundation interns. She was recognized as a Fellow of AMCP (FAMCP) in 2019 for exceptional contribution, commitment, and sustained excellence in managed care pharmacy. Carly currently serves as a Director on the AMCP Board of Directors.
What does a typical day look like?
One of my favorite things about being a Managed Care Pharmacist is that there usually is no such thing as a 'typical day.' At this point in my career I spend the majority of my time collaborating with others, both internally within my company and externally, to evolve pharmacy benefit designs and programs to best serve the needs of our clients and members. This includes working with other pharmacy team members, analysts, actuaries, product development teams, clients, pharmacies, providers, and others.
I am fortunate to lead our clinical, operations, and industry relations teams, so I work closely with other leaders to evaluate cost and utilization trends, as well as performance metrics, to track the overall performance of our pharmacy and medical pharmacy programs. I also have the pleasure of working closely with many of our customers to help provide strategic consultation and recommendations for how to control their pharmacy trends.
What types of managed care practices do you use in your work?
I use numerous managed care practices in my everyday work. Formulary and utilization management are two primary areas of responsibility for me, which are driven by evidence-based literature evaluation and understanding the different levers that influence treatment selection. Interpreting pharmacy and medical claims data is a critical skill that I use nearly every day to identify drug therapy problems, trend drivers, and outliers which ultimately inform the development of new clinical programs or benefit designs to improve overall drug utilization patterns.
As provider-administered medication (i.e. medical pharmacy) continue to make up a larger portion of total drug spend, understanding reimbursement methodologies as well as channel management and site or care strategies are crucial for successful management of these therapies.
How did the Foundation internship prepare you for your career?
My Foundation internship was fundamental in shaping my chosen pharmacy career path. I learned critical managed care skills, such as critical evidence appraisal, drug monograph and coverage criteria development, claims analysis, time management, and project management. The opportunity to work with health plan pharmacists at Regence, a Medical Outcomes Specialist at Pfizer, and AMCP staff in Virginia gave me a well-rounded glimpse into the many facets of managed care pharmacy. I've said it before, and I'm sure I will say it many more times, but I would not be sitting where I am today without my AMCP Foundation/Pfizer summer internship.
Anything else you'd like to add?
AMCP affords so many great opportunities for student pharmacists. From online resources to student programming at conferences to Foundation internships and P&T competitions, there is no shortage of activities that students can engage in to expand their knowledge base and build their skillsets. I encourage all pharmacy students to explore these opportunities and participate in as many of them as possible, which will help develop the foundation needed to pursue a career in managed care.
Originally published in the June 2020 AMCP Foundation Insights e-newsletter.