JILL LECHEMINANT
Myrtle Beach
Summary
Strategic and solutions-oriented healthcare leader with deep experience in payer access strategy, formulary governance, institutional engagement, and evidence-based policy development. Adept at optimizing care pathways, resolving real-world access barriers, and influencing clinical, administrative, and financial stakeholders across complex health-system environments. Proven success leading end-to-end formulary review and P&T processes, guiding coverage decisions for diverse therapeutic areas—including neurology-related classes—and driving downstream adoption through strong communication and cross-functional alignment. Recognized for the ability to translate clinical evidence, operational constraints, and financial impacts into clear, actionable strategies that improve patient access and system performance. Brings a unique, highly transferable blend of payer, clinical, and operational expertise ideally suited for Priority Accounts, Institutional Strategy, Access & Reimbursement, and Account Leadership roles in the pharmaceutical industry.
Overview
9
9
years of professional experience
Work History
Clinical Consultant Pharmacist
OptumRx
06.2021 - Current
- Strategic Access & Formulary Leadership
- Lead clinical strategy, formulary design, and utilization management across large public-sector populations, ensuring evidence-driven and financially responsible coverage decisions.
- Direct the full P&T governance cycle—agenda creation, clinical review, recommendations, alignment, meeting facilitation, implementation, and system validation.
- Build alignment across medical, administrative, and financial decision-makers to implement sustainable access strategies for specialty and high-impact therapies.
- Conduct comprehensive reviews of neurology-related classes (e.g., CGRPs, behavioral health, pain, epilepsy, MS categories), optimizing coverage criteria and reducing provider friction.
- Care-Pathway Optimization & Stakeholder Support
- Collaborate with provider-liaison teams to address system-level access challenges across hospitals, pharmacies, and outpatient clinics.
- Diagnose and resolve workflow gaps—documentation issues, PA bottlenecks, coding mismatches, new generics, drug shortages—reducing delays and improving patient access.
- Serve as a trusted point of contact for providers, health systems, and industry partners seeking clarity on coverage criteria or real-world utilization challenges.
- End-to-End Pull-Through Execution
- Drive full lifecycle pull-through for coverage changes: bid review → modeling → recommendation → approval → coding → testing → provider communication → real-world troubleshooting.
- Partner with pharma account executives and field teams to clarify coverage behavior, explain PA outcomes, and resolve misunderstood or misrouted access barriers.
- Achieve high success in downstream adoption by ensuring accurate coding, proactive education, and ongoing engagement with system stakeholders.
- Clinical Expertise & Evidence Integration
- Review every therapeutic class on a rigorous recurring cycle, maintaining deep comparative knowledge across neurology, rare disease, immunology, endocrinology, and more.
- Integrate clinical evidence, HEOR considerations, safety data, and financial modeling into clear coverage recommendations used by executive decision-makers.
- (Government, Public Sector & Managed Care Programs)
Client Account Executive (Clinical & Formulary Strategy)
Elixir
05.2017 - 06.2021
- Clinical & Strategic Leadership
- Managed clinical components of key accounts, serving as a primary liaison for formulary, coverage policy, and specialty drug strategy.
- Selected to serve as Acting Pharmacy Director for a client (with company approval) based on strong clinical judgment, operational leadership, and credibility with executive stakeholders.
- Cross-Functional Collaboration & Execution
- Partnered with medical directors, operations, finance, specialty pharmacy teams, and provider networks to ensure accurate adoption of coverage policies and resolve emerging issues.
- Authored clinical guidelines, PA criteria, step-therapy protocols, and DUR recommendations across multiple therapeutic areas.
- Provider & System Support
- Supported providers and partner organizations by clarifying coverage logic, addressing claim discrepancies, and improving workflow efficiency.
Education
PharmD -
University of Utah
Licensed Pharmacist - undefined
Utah
Skills
- Claims & Coding Systems
- Drug Information Tools
- Evidence Review Platforms
- Microsoft Office
Accomplishments
- Improved access to neurology-related therapies by removing unnecessary CGRP restrictions, streamlining criteria, and reducing denial rates.
- Resolved high-impact operational issues by identifying coding errors, PA misrouting, and documentation gaps, accelerating patient access and reducing provider frustration.
- Led complex formulary overhauls balancing clinical rigor, cost-effectiveness, and patient access across diverse therapeutic categories.
CORE COMPETENCIES
- Health-System Strategy
- Payer Access & Reimbursement
- Cross-Functional Leadership
- Formulary & P&T Governance
- Prior Authorization / UM Strategy
- Provider Engagement
- Care-Pathway Optimization
- Pull-Through Execution
- Evidence Review & Synthesis
- Rare Disease & Specialty Therapeutics
- Neurology Class Review Experience
- Coding & Claims Logic Alignment
- Bid/Contract Review
- Stakeholder Communication
Timeline
Clinical Consultant Pharmacist
OptumRx
06.2021 - Current
Client Account Executive (Clinical & Formulary Strategy)
Elixir
05.2017 - 06.2021
Licensed Pharmacist - undefined
Utah
PharmD -
University of Utah