Serves as lead author of medical policy clinical criteria which includes the development, updating, and maintenance of decision tree logic used to support phone, fax, and web-based authorizations; includes consistency of authorization requirements within therapy classes; and includes monitoring the results of the authorization process (i.e., authorization, denial, and appeal rates) for the purpose of ensuring BCBSLA's drug utilization management programs are current, clinically sound, efficient, and cost-effective. Serve as companywide subject matter expert regarding specialty drug management strategies of medications covered under both the pharmacy and medical benefits, including specialty pharmacy pipeline monitoring to identify new products that are expected to have major clinical and financial impacts on drug trend, for the purpose of ensuring BCBSLA's coverage of specialty drugs are current, clinically sound, and cost-effective.