Alan Bayham Email and Phone Number
Alan Bayham work email
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Alan Bayham personal email
Alan’s managed care experience includes Self-Funded Employer health plans, Commercial health plans, Managed Medicaid health plans, Medicare-Advantage health plans, and working with Provider Groups that are globally capitated or that are at risk for medical and pharmacy services, including Quality Measures and Star Ratings. In fact, he has spent the last 20 years in managed care as a director and vice-president over such pertinent functions as Member Services, Appeals and Grievances, Patient Safety, Compliance, Accreditation, Pharmacy Services, Medical Management, Quality Improvement, and Utilization Management. Alan had worked with health plans from Puerto Rico to the Canadian border and from the Atlantic Ocean to the Pacific Northwest. He has successfully helped health plans in all stages of their life cycle: from conception, funding, planning, development, and implementation to management and operations, including merger and transition to close out and shut down.
Ochsner Health Plan
View- Website:
- ochsnerhealthplan.com
- Employees:
- 31
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Avp, Medical AffairsOchsner Health Plan Jan 2021 - Present -
Pharmacy Program Manager, Ochsner Health NetworkOchsner Health System Jan 2017 - Jan 2021Ochsner Health Network - Elmwood1. Formulary development and management for Ochsner Health Network (OHN) .2. Pharmacy Benefit Management; Organizational liaison with third party administrator (PBM).3. Drug Information resource for providers and prescribers .4. Chair of Pharmacy and Therapeutics Committee (P&T). -
PresidentBayham Consulting, Llc Mar 2006 - Jan 2017Louisiana, Ohio, Virginia, New Jersey, Oregon, And Elsewhere• Leadership role in many functional areas of Health Plan Management resulted in meeting all goals, budgets, and deadlines while also increasing employee satisfaction and reducing employee turn-over.• Awarded CMS/HHS contract for new Medicare-Advantage Plan.• Awarded multi-million dollar loan grant from CMS/HHS for multiple new Health Cooperatives (health plans) as part of the Affordable Care Act (ACA).• Obtained various health plan licenses by working effectively with several State Departments of Insurance.• Successfully met all CMS/HHS implementation milestones within budget, while meeting national deadline for new Medicare-Advantage Plan.• Effectively met all CMS/HHS implementation milestones within budget, while meeting national deadlines for new Health Care Co-Op on Federally Facilitated State Exchange.• Achieved successful start-up of new plans or new vendors for existing plans without incident.• CMS audits of responsible functional errors never received any deficiencies.• Obtained New Health Plan (NHP) accreditation from the National Committee on Quality Assurance (NCQA) with near perfect score (>99%).• Assisted various new Health Plans receive Qualified Health Plan (QHP) designation from CMS/HHS as required by the ACA within budget and national deadlines.• Developed and successfully implemented new Asthma Medication Treatment Program for large “at risk” Integrated Health System.• Developed and successfully implemented new Clinical Pharmacy “Anti-Detailing” Program for large Medicare-Advantage Health Plan.• Developed and successfully implemented new Generics Alternatives program for large “at risk” Integrated Health System that increased the Generic Dispensing Rate from 70% to 90%.• Conducted Pharmacy Benefits Manager RFPs for several health plans (Commercial, Medicare-Advantage, and Medicaid) that resulted in millions of dollars in savings per year at each plan.
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Director, Pharmacy And Member ServicesPeoples Health Dec 2002 - Mar 2006Greater New Orleans AreaDirector of Pharmacy Services Staff (Operations and Clinical), Director of Member Services (Operations, Appeals, Grievances, and Complaints). Meet all Federal and State regulations, as well as Accreditation standards. Managed staff. Planned, directed, and monitored all financial, operational, professional, and clinical activities of Pharmacy Programs in accordance to federal and state laws. -
Pharmacy DirectorOchsner Health Plan Mar 1999 - Dec 2002Greater New Orleans AreaDirector of Pharmacy Services Staff (Operations and Clinical), Meet all Federal and State regulations, as well as Accreditation standards. Managed staff. Planned, directed, and monitored all financial, operational, professional, and clinical activities of Pharmacy Programs in accordance to federal and state laws. -
Chief Consultant PharmacistPontchartrain Pharmacy Jun 1998 - Mar 1999LouisianaOperations and Dispensing. Patient chart reviews in various nursing homes across Southeast Louisiana. Managed Pharmacists and Pharmacy Technicians. Planned, directed, and monitored all operational, professional, and clinical activities of Clinical Pharmacist Programs in accordance to federal and state laws. -
District Specialist/Medical Liaison/Long-Term Care SpecialistAbbott Laboratories Sep 1978 - Jun 1998LouisianaDevelop key opinion leaders, conduct medical research to submit to FDA, service retail, hospital, and LTC pharmacies.
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Chief Pharmacist And Pharmacist-In-ChargeMontelepre Memorial Hospital Jul 1976 - Sep 1978Greater New Orleans AreaPlanned, directed, and monitored all financial, operational, professional, and clinical activities of Pharmacy Programs in accordance to federal and state laws. Dispensing. Pharmacist in charge. Managed staff.
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Vice-President/Store Manager/Pharmacist-In-ChargeGrun'S Drugs Sep 1972 - Jul 1976Greater New Orleans AreaPlanned, directed, and monitored all financial, operational, professional, and clinical activities of Pharmacy Programs in accordance to federal and state laws. Dispensing. Pharmacist in charge. Managed staff.
Alan Bayham Skills
Alan Bayham Education Details
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University Of Phoenix - Metairie, Louisiana CampusOrganizational Management -
Pharmacy
Frequently Asked Questions about Alan Bayham
What company does Alan Bayham work for?
Alan Bayham works for Ochsner Health Plan
What is Alan Bayham's role at the current company?
Alan Bayham's current role is AVP, Medical Affairs, Ochsner Health Plan.
What is Alan Bayham's email address?
Alan Bayham's email address is al****@****ing.com
What schools did Alan Bayham attend?
Alan Bayham attended University Of Phoenix - Metairie, Louisiana Campus, Xavier University Of Louisiana.
What skills is Alan Bayham known for?
Alan Bayham has skills like Managed Care, Healthcare, Medicaid, Disease Management, Medicare, Health Policy, Health Insurance, Hipaa, Pharmacy Benefit Management, Utilization Management, Medical Billing, Healthcare Industry.
Not the Alan Bayham you were looking for?
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1azbar.org
12 +160241XXXXX
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1bayhamconsulting.com
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Alan Bayham
Covington, La1bayhamconsulting.com -
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