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Spotlight Magellan Health: Sharon Butler

Sharon Butler is our leader of people strategies at Magellan Rx Management and is an integral part of our thriving culture. She inspires our teams to use their strengths to overcome challenges and deliver a pharmacy experience unlike any other. We sat down with Sharon to talk about her love of human resources, the current state of the industry, how the pandemic has affected HR professionals and how people make the difference in any organization.

What’s your background, and how did you get into Human Resources?

I love sharing this story because it’s the last place I thought I would be. I grew up in a poor neighborhood in Albany, NY in a family that didn’t value education. It wasn’t until I had the opportunity to attend college later in life that I met so many people who were resetting their path and going back to school after finding themselves in a job that didn’t fulfill them. It was then and there I realized my passion for people and believe there is so much more to illuminate a person if they are exactly where they want to be versus where they can be.

This realization led me to study organizations and leadership, dedicating my career to understanding the power of giving people an opportunity to do great things. There’s not an organization out there that’s great because of something other than people. If you think about it, organizations can’t achieve anything without people driving change.

How do you think your life experiences have shaped your work as a Human Resources professional?

I have learned through personal experience that some of the hurdles in your life are the ones you create and put in your own way. You can do anything if you have the passion and power to do it. You can’t just dream it. A dream isn’t a strategy, it’s the motivation that pushes you forward.

I’ve also learned that your career can have a huge impact on your overall wellbeing.

I have now been with Magellan for 14 years, and I’ve seen firsthand that when you tap into someone’s personal strengths, you unleash an incredible amount of potential within not only yourself, but your team as well. As a leader or manager, placing people in the right seat creates a highway for growth and development.

Our data tells us that we’ve had 455 internal promotions over the last 12 months and that we continue to focus on supporting effective career conversations and encourage every employee to start a conversation. I’ve seen a correlation between employee driven career discussions and success of achieving aspirational goals.

We can’t impact what we don’t measure. We are focused on pulsing engagement and investing in what makes our employees feel valued. Our pulse surveys provide us with data for leaders to use to ensure they are having the impact intended. This is one tool that should be used with a variety of tools to ensure we continue to understand each other regardless of role. These surveys allow us to have impactful conversations to gauge overall organizational wellbeing. Now that we are far more virtual than ever before, we must continue to create connectedness, check in with each other in a variety of ways and respond to the ever-changing climate of our work.

How has the pandemic impacted Human Resources professionals?

HR professionals have really had to stretch outside their comfort zones, beyond the predictable outcomes they are used to. What we’ve all seen happen over the last few years in our communities with regulations, politics, human behaviors and attitudes changing is also happening within organizations. We can’t build a policy to navigate it, we must lean in and care about it.

We have had to consider every perspective to make the right decisions for us as an employer, and to make the right recommendations for employees as one size does not fit all. While some organizations have used this as an opportunity to be defined by their policies, we’ve found that we’re too complex and dynamic to pick one side or another on many points related to the pandemic. The passionate people at Magellan Rx are navigating through every circumstance in the most caring way possible.

These last few years have impacted everyone. Leaders, managers and employees are recognizing the need to practice self-care first before care for others. I’ve been starting my day with MAGIC Mornings, which I’ve recoined for myself ‘Miracle Mornings,’ this practice affords me a margin of time to focus on myself and set my day through exercise, meditative prayer, affirmational writings, gratitude journaling and intention or goal setting. I’ve been doing this for four months now and have noticed a complete shift in how I approach and move throughout my day. I encourage teams and individuals to rethink how they start their days and prioritize their wellbeing to avoid burnout.

What’s your perspective on the Great Resignation?

My observation of what the data suggests is that people are reacting to what adds value to their lives. The notion of an employee leaving their job, and possibly their career, is changing attitudes and expectations. Employees have more of a voice than ever before in what they are willing to do, and not do, for a paycheck. We need to listen.

Do you think organizational culture plays a role in the Great Resignation?

Absolutely. For a long time, organizations have been trying to define an attractive culture with policies and programs like education reimbursement, wellness credits and unlimited PTO. What we are seeing during this Great Resignation is a shift in focusing on employee’s wellbeing and how they are treated. Cultures are formed by how leaders behave and employees feeling truly valued. It isn’t about a program; it’s about behavior.

What we’ve noticed at Magellan is that while our turnover rate has inched up, it isn’t at the national average, and we are still able to attract talent to our positions. We believe that this is a direct reflection of our strong culture of caring people who are leveraging their strengths in their everyday work and modeling positive behaviors.

What do you think is needed to create a thriving culture? 

First and foremost, authenticity and accountability from leaders. Then, you must focus on people because people make the difference. You do this by unlocking their strengths and unleashing their potential. Mix that with a little fun, and you’ve got a solid foundation to build a thriving culture.

Our secret sauce at Magellan Rx is that we don’t have a one size fits all strategy for any person. We start by focusing on an individual’s core strengths, which allows leaders and employees to deploy very tailored career development, growth performance and learning opportunities.

How do you think teams have remained resilient these last few years while some haven’t?

I think there is a lot of masked resiliencies happening right now – pushing through versus truly evolving through the challenges – which can be very dangerous because it means we are closer to burnout than we know.

You can tell resiliency is occurring when you are faced with the next challenge, and it energizes you because you learned from the last challenge and are able to use your learnings to evolve through the next obstacle.

For those that haven’t, do you have any advice?

There is no time like the present to pause and take inventory of all the things that you have pushed through, map those things to what you have learned, and really understand the impact of your work. When you are focused solely on what’s ahead and what’s not done, you deprive yourself the opportunity to pause and learn. Look back at the path you’ve laid and the wake you’ve made.

What should organizations do to invest in their people?
Create safe spaces and support systems for employees to stretch, learn and grow in their careers.

Think about their world, their environment and what they are trying to transform. Don’t forget to ask their opinion on what great looks like and listen, because at the end of the day it’s the people who make the difference in any organization.




Spotlight Magellan Health: Haita Makanji

Haita Makanji, vice president, clinical strategy and innovation supporting the specialty division of Magellan Rx Management, has worked for MRx for nearly 10 years, where she has focused on helping to support payers as they navigate the pharmacy space. Makanji, who is based out of Massachusetts, leads a team of highly trained pharmacists and experts in development and implementation of clinical solutions for customers in various high-cost specialty conditions across both the medical and pharmacy benefits including but not limited to cancer, hemophilia, and rare diseases. Her team focuses on utilization management, dose optimization, care management and technology-based programs for commercial, Medicare and Medicaid patients across the country. Continue reading to learn more about the innovative projects Makanji and her team are working on in the pharmacy space:

What sort of projects are you currently working on?

I’m passionate about working closely with payers and supporting them as they navigate the evolving landscape of new, expensive treatments, while also helping to deliver the highest quality of care to patients. For exceedingly high-cost specialty conditions, our emphasis is always on value through delivering clinical solutions that offer the most appropriate treatment to patients while combating the rising spend payers are facing.

For example, a recent project centers on a one-of-a-kind solution for payers focused on precision medicine in the oncology space, which is the highest-spend category for specialty drugs on the medical benefit for over 10 years. This is an exciting, next-generation pharmacy initiative where we will be combining genomic testing with drug selection for providers who treat cancer patients and meeting a critical need for payers who are looking for more complete solutions on both the medical and pharmacy benefit.

In 2021, we launched a comprehensive high-cost therapy program to provide enhanced utilization management strategies and case management referral for ultra-rare diseases. Payers often struggle to identify specialized experts, either internally or within their network, so our ability to leverage our MRx Expert Clinical Network of more than 175 key opinion leaders who practice various specialties, combined with our team of experts, offers a unique opportunity to support treatment decisions that leads to better health outcomes.

Why is Magellan the best place for these projects?

I’m proud to work for an organization that has a deep understanding of medical and pharmacy trends and a history of pioneering industry-first solutions for specialty drug management. With 17 years of experience in managing specialty conditions, we are unique in the marketplace.  Our customers routinely expand their collaborations with us because we continuously elevate our suite of solutions with innovative and forward-thinking approaches. Our mission is to help patients live healthy, vibrant lives and we accomplish this by ensuring that the right patients receive the right therapies at the right time.

What are your thoughts on the culture here at Magellan? How has that culture impacted your work?

We have a family-oriented culture where we collaborate and have a true understanding and trust of each other. Magellan fosters an environment that encourages open, honest feedback in all teams. Magellan also provides employees with the opportunity to challenge themselves and embrace new opportunities. This is imperative as we innovate and bring new programs to the market.

What exciting trends are you noticing in the healthcare industry? In what direction do you see healthcare going and what lessons are there to learn from other industries that can be applied to healthcare?

I’m energized by how quickly our industry is adapting to new technologies and advancements in the delivery of healthcare. Particularly in digital health solutions with the shift towards value-based care strategies and the pivot to personalized medicine.

The market will need to be laser-focused on providing clinically appropriate, personalized care at the lowest cost for both payers and patients.

One lesson we can take from other industries is the ability to be nimble and flexible. Disruptors in every sector of healthcare are bringing new offerings directly to consumers in the hopes that simplicity and transparency will cultivate consumer loyalty. We can take advantage of the availability of data and deployment of new technologies to respond quickly to changing market dynamics and the needs of our customers and their unique patient populations. While we have a proven track record and hundreds of successful case studies across our suite of solutions, it’s important that we never stop innovating!

 




October is American Pharmacists Month

October is American Pharmacists Month and an excellent opportunity for us to celebrate all of our Magellan Rx pharmacy heroes that help our members live healthy, vibrant lives! To kick off American Pharmacists Month, we wanted to shine a spotlight on our two pharmacy residents. We will be taking you behind the scenes to find out what got them interested in pharmacy and what they love most about their residency program.

Magellan Rx: Why did you decide you wanted to become a pharmacist?

Shyra Bias, PharmD: I decided at a young age that I wanted to be the drug expert in my family after witnessing a family member suffer from the complications of extremely uncontrolled latent autoimmune diabetes in adults (LADA). My desire to help my family led to a passion to improve many patients’ lives by ensuring that they can receive the medications they need at a cost they can afford.

Alaka’i Montalbo, PharmD: Growing up, I played a lot of sports and was always in the gym. As an athlete, you learn about sports supplements and how they can help you. In high school, I loved diving into the science of supplements. I later learned in life that the “science” of supplements was not backed by clinical data. After having my dreams crushed, I was working in the hospital and one of the nurses asked me if I had ever considered being a pharmacist? She knew I enjoyed talking about supplements and learning how different medications worked in the body. After researching what pharmacists do, I realized this was exactly what I wanted to do, and I have not looked back since.

Magellan Rx: What advice would you give to someone who wants to become a pharmacist?

Shyra Bias, PharmD: Keep your eye on the prize! The road to PharmD is not an easy one, but if you are truly passionate about the profession, you will get through it. Also, pharmacy is a very small world, so be intentional about making connections because you never know who may be able to change the trajectory of your career.

Alaka’i Montalbo, PharmD: Find joy in your journey. While pharmacy school is a long journey, it will fly by in the grand scheme of life. Don’t give up and never stop believing that you can do it. Don’t fall into the trap of saying to yourself I’m not ready yet. Right now, start making connections with pharmacists and current pharmacy students.

Magellan Rx: What different career paths can you do as a PharmD?

Shyra Bias, PharmD: There are many options for Pharmacists; many do not come to mind immediately when someone thinks of the traditional roles of a pharmacist. Some of the first paths that come to my mind include industry pharmacy, nuclear pharmacy, managed care pharmacy, and clinical pharmacy (hospital setting) to name a few.

Alaka’i Montalbo, PharmD: During pharmacy school, I had the opportunity to go to local high schools and talk about the profession of pharmacy. There are so many different careers Pharmacists can choose and every route is unique. There are traditional roles like retail, hospital pharmacy, and then some non-traditional roles are academia, nuclear (chemotherapy) pharmacy, FDA pharmacists, and Indian health services.

Magellan Rx: What made you choose managed care pharmacy?

Shyra Bias, PharmD: I chose managed care because I really enjoy the population health aspect of the industry. It gives me a true feeling of gratitude to change millions of lives with “the click of a button.”

Alaka’i Montalbo, PharmD: Managed care is the perfect balance between using clinical data and real-world efficacy to help patients manage their disease states. One of my favorite quotes about pharmacy is from Everett Koop, “Drugs don’t work in patients who don’t take them.” I would add to this quote, also with patients who can’t afford them. Managed care is that perfect bridge between both worlds of pharmacy, and I feel like I am making a huge difference every day, not just for one patient but for entire populations.

Magellan Rx: How do you like your residency at Magellan Rx?

Shyra Bias, PharmD: I am grateful beyond words to have been matched with Magellan Rx. The company culture makes me feel extremely welcomed, and the variety of experiences that we are exposed to through our rotations will allow us to succeed no matter where I end up in the managed care industry.

Alaka’i Montalbo, PharmD: Being Native Hawaiian, Ohana (family) means everything to me, and family means no one gets left behind or forgotten. Magellan Rx is one big Ohana and every day, I get to stand on the shoulders of giants. I feel so blessed to be a part of this company and everyone in this residency program is always willing to stop what they are doing, take time out of their busy schedules to help me grow! I cannot express my gratitude enough and I look forward to paying it forward in my career.

Don’t forget to follow us on LinkedIn and Twitter where we will be featuring different pharmacists and pharmacy techs throughout October. #MRxAmericanPharmacistMonth




From Compassion to Action: Solving Complex Pharmacy Challenges through the MRx Cares Program

The following is an excerpt from the 2018 Community Impact Report.

The MRx Cares program, developed by Magellan Rx Management, is one great example where we deliver – value and results!

Helping when life is complex

As a next-generation pharmacy benefit manager (PBM), Magellan Rx Management leans into the complex pharmacy challenges facing our members. One such challenge is specialty pharmacy. MRx  Cares is available to members who live with complex chronic conditions— like Crohn’s Disease, Cystic Fibrosis, HIV, Rheumatoid Arthritis and the aftermath of organ transplants—and are currently receiving their medication through Magellan Rx Specialty Pharmacy.

When members first fill a specialty medication, they are automatically enrolled in MRx Cares at no cost. Members receive an easy-to-understand welcome kit specific to their medications and conditions. Soon after, a personal health coach reaches out.

Our MRx Cares program offers a unique approach to member management with Motivational Interviewing-based health coaching. Motivational Interviewing is a counseling method that helps patients resolve ambivalent feelings and insecurities to find the internal motivation to change their behavior and meet their personal goals.
Providing personalized support from  caring experts

The MRx Cares program is led by specially trained nurses and pharmacists. These expert health coaches work closely, one on one, with each individual. Together, they develop a personalized care plan with achievable goals. The health coaches check in monthly, or more if needed, via calls, texts or video consultations.

Helping improve drug adherence

In addition to 24/7 access to nurses and pharmacists who understand the member’s situation, the program offers monthly refill reminders to improve drug adherence. The health coaches are also there to help if members need assistance with the cost of their medications. They can help connect members to opportunities for financial assistance and community support groups.In the most recent participant survey, 99% of respondents indicated they were highly satisfied with the benefits of MRx Cares and the services they receive.




Living Well With Diabetes

Having type 2 diabetes can be overwhelming. The good news? While everyone’s treatment plan will be different, there’s a good chance you can manage your type 2 diabetes by making healthy choices. Convinced, but still struggling to work good choices into your real life? Start here for tips on treating type 2 diabetes.

The key to treating type 2 diabetes is to keep blood sugar levels controlled and in your target range.

All of the following help to lower blood sugar:

  • Making healthy food choices. Try to manage the amount of carbohydrates you eat by spreading them out over the day.
  • Losing weight, if you are overweight
  • Getting regular exercise
  • Taking medicines, if you need them

It’s also important to:

  • See your doctor. Regular checkups are important to monitor your health.
  • Test your blood sugar levels. You have a better chance of keeping your blood sugar in your target range if you know what your levels are from day to day.
  • Keep high blood pressure and high cholesterol under control. This can help you lower your risk of heart and large blood vessel disease.
  • Quit smoking. This can help you reduce your risk of heart disease and stroke.

It seems like a lot to do—especially at first. You might start with one or two changes. Focus on checking your blood sugar regularly and being active more often. Work on other tasks as you can.

It can be hard to accept that you have diabetes. It’s normal to feel sad or angry. You may even feel grief. Talking about your feelings can help. Your doctor or other health professionals can help you cope.

 

With a little support and guidance, patients with diabetes can live healthy, vibrant lives. Our Live Vibrantly: Diabetes care program helps manage all aspects of diabetes from improving wellness, diet, and exercise to optimizing medication use. To learn more about Live Vibrantly: Diabetes, click here.

 

©1995–2019, Healthwise, Incorporated

Read the full article here:  https://www.healthwise.net/magellanhealth/Content/StdDocument.aspx?DOCHWID=hw135189#hw135192

This document is for your information only. It is not meant to give medical advice. It should not be used to replace a visit with a provider. Magellan Health does not endorse other resources that may be mentioned here.




Smart Snacking with Diabetes

Follow your body’s hunger and fullness signals. Smart snacking can help you keep your blood sugar levels stable, especially if you are taking medicine for diabetes.

Try these tips:

  • Enjoy eating the right portion. Try using a smaller plate, bowl, or glass while you slowly eat your snack.
  • Make healthy choices. Eat a piece of fresh fruit. Or combine that fruit with some protein, such as a small apple and a tablespoon of peanut butter. Or try dipping your fruit in some light yogurt.
  • Be prepared. Keep cut-up raw vegetables in your refrigerator. If these are ready to eat, you’re more likely to grab them than something else. Try a low-fat dip on the side.
  • Eat nuts. Try a small handful of almonds, walnuts, or pecans. These treats each have less than 15 grams of carbohydrate.
  • Choose filling foods that can satisfy your hunger without a lot of calories. Try a hard-boiled egg or an ounce of reduced-fat cheese, such as string cheese.
  • Skip high-fat dips. Instead, mix plain yogurt, fat-free mayonnaise, cottage cheese, or fat-free sour cream with a small amount of dry soup mix. Or try a bean dip made with fat-free refried beans, topped with salsa.
  • Get more fiber. Put that turkey sandwich on whole wheat bread. Mix wheat germ into yogurt or sprinkle it on salads. Choose whole-grain breads and cereals.
  • Try something new. Make a pita pizza with a piece of whole wheat pita bread, tomato sauce, and a sprinkling of reduced-fat cheese. Top with sliced zucchini or mushrooms. Bake until cheese is melted. Enjoy!

And remember:

  • Don’t eat out of the bag or box. Take a single serving, and eat from a plate or bowl. It’s easy to eat more than you need or want when the bag is open in front of you.
  • Don’t buy snacks that aren’t healthy choices. If unhealthy snacks aren’t around, you won’t eat them.
  • Keep an eye on the nutrition facts label, especially in low-fat or fat-free foods. To make up for flavor, sugar and salt is often added when fat is taken out.

 

With a little support and guidance, patients with diabetes can live healthy, vibrant lives. Our Live Vibrantly: Diabetes care program helps manage all aspects of diabetes from improving wellness, diet, and exercise to optimizing medication use. To learn more about Live Vibrantly: Diabetes, click here.

 

©1995–2019, Healthwise, Incorporated

Read the full article here:  https://www.healthwise.net/magellanhealth/Content/StdDocument.aspx?DOCHWID=av2453

This document is for your information only. It is not meant to give medical advice. It should not be used to replace a visit with a provider. Magellan Health does not endorse other resources that may be mentioned here.




What is Precision Medicine

Precision medicine is the concept of tailoring disease treatment and prevention to account for differences in genetic, environmental, or even lifestyle factors specific to groups of people.1 Precision medicine takes genetic and biochemical information unique to a group of patients and uses that information to develop more specific and streamlined medications or treatments. The goal is to ensure that each medication or treatment is best suited to treat the individual, resulting in decreased side effects and increased effectiveness.2

Precision vs Personalized Medicine

Although the terms precision medicine and personalized medicine are used interchangeably, there can be nuanced differences. The National Research Council (NRC) issued a statement saying that the term “personalized medicine” can refer to a treatment that may be completely individualized to a specific patient, which is not the true definition of precision medicine.3 The difference here is that precision medicine seeks to create treatments that are applicable to groups of individuals who meet certain characteristics. This is different from “personalized medicine,” which implies individualized treatments available for every unique patient.

Current Landscape

In 2015, the Precision Medicine Initiative (PMI) was launched, with $215 million dollars invested into precision medicine research.4 A new program was created—All of Us Research Program—which had the goal of recruiting 1 million Americans and creating a nationwide database for research.5 Other examples of precision medicine initiatives include the Geisinger Health System’s National Precision Health Initiative, the Partnership for Accelerating Cancer Therapies (PACT), and Cancer Moonshot.1 There has been particular success in the field of cancer, with new medications developed for a specific cancer types with certain genetic characteristics. With increased funding, decreased costs to sequence DNA and analyze genetic information, and improved data analytics, many believe precision medicine to be the future of healthcare delivery.

 

  1. Bresnick, Jennifer. 2018. “What Are Precision Medicine and Personalized Medicine?” HealthITAnalytics. HealthITAnalytics. January 11, 2018. https://healthitanalytics.com/features/what-are-precision-medicine-and-personalized-medicine.
  2. Genetics Home Reference. n.d. “What Is the Difference between Precision Medicine and Personalized Medicine? What about Pharmacogenomics?” Genetics Home Reference. Accessed October 11, 2019. https://ghr.nlm.nih.gov/primer/precisionmedicine/precisionvspersonalized
  3. Council, National Research, Committee on a. Framework For Development a. New Taxonomy of Disease, and Others. 2010. Toward Precision Medicine: Building a Knowledge Network for Biomedical Research and a New Taxonomy of Disease. National Academies Press.
  4. “FACT SHEET: President Obama’s Precision Medicine Initiative.” 2015. Whitehouse.gov. January 30, 2015. https://obamawhitehouse.archives.gov/the-press-office/2015/01/30/fact-sheet-president-obama-s-precision-medicine-initiative.
  5. “Program Overview – All of Us | National Institutes of Health.” n.d. Accessed October 11, 2019. https://allofus.nih.gov/about/all-us-research-program-overview.



Leveraging Technology and Evidence to Support Primary Care Providers

Primary care providers can be responsible for everything from first line dermatology to behavioral health to musculoskeletal injuries. In a world of rapidly changing technologies, and in which new therapies can cure or alter diseases that only a few years ago would have never been thought possible, the basics still matter. As a clinician, I’ve practiced internal medicine and psychiatry, and still have the opportunity to work with a FQHC in building integrated care. Those experiences and my national view of utilization and prescribing patterns highlight the need for provider support to care for persons with mental health conditions, including opioid use and abuse.

It is often challenging to translate new medical knowledge to the clinic setting. How does a provider care for the individual on a potentially lethal combination of opioids, benzodiazepines, and muscle relaxants? Or, how does one address the young child who has been placed on a combination of psychotropic medications.

In our current health system, primary care providers are in the best place to begin patient care journey or change the course of an already established treatment plan. An effective solution for supporting providers in delivering high quality care is in the form of provider support, especially through programs that involve data analytics, followed by one on one academic detailing. PBMs are in a unique position, having the ability to assist providers in working with patients on complex behavioral health or opioid regimens. PBMs have access to data that allows for identifying outlier member and provider behavior and finding patients who are at risk for adverse outcomes. While PBMs don’t have access to prescription drug monitoring programs, they can see what prescriptions are filled, where there is overlap, and where there are multiple providers interacting with a patient.

Magellan Rx developed the Live Vibrantly: Whole Health program to address those outlier providers and members, with the goal of achieving higher quality care. This program uses evidence-based algorithms to find members who may be at risk for adverse outcomes, and targets prescribers who may be over-prescribing. We become the provider’s go-to source for translating the evidence to the bedside through assistance with difficult issues, such as withdrawing an individual from high dose opioids. Through taking an approach to support providers in delivering high quality care, we’ve been able to truly partner in leading our members to leading more healthy vibrant lives.