Andrew Macquarrie Email & Phone Number

Boston, Ma, Us

Greater Boston

• Responsible for the development, integration, and implementation of various Cash Ecosystem solutions focused on driving lower out-of-pocket costs for patients, while maximizing reimbursement for pharmacies and payer organizations.• Product Manager of PriceCheck, a comparative Cash Discount Card tool which allows pharmacies to seamlessly identify best out-of-pocket Rx prices, while mitigating exorbitant administrative fees.• Product Manager of Benefit Cost Compare (BCC), an Rx-based solution that converts high copay benefit prescriptions to Cash Discount Cards, while also providing PBMs with the information needed to attribute these cash payments to patient deductibles and accumulators.• Launched Benefit Cost Compare as an MVP, with roadmap and line of sight to implementing a Generally Available solution.• P&L owner of multiple products.• Designed and released pharmacy membership and patient opt-in programs.• Driving iterative improvements through Agile methodology to enhance revenue, customer, and end user satisfaction. • Collaborating cross-functionally with Business Development, Product Owners, Development, Sales, and Implementation teams to efficiently innovate and market new product ideas and offerings.• Active participant in NCPDP work groups to apply industry knowledge and learnings to improve emerging and core product capabilities.

Boston, Massachusetts

• Leader of several high-profile healthcare provider projects to simultaneously improve provider experience satisfaction and reduce internal cycle times.• Product owner for new provider application portal, driving continuous enhancements and speed-to-market through cross-functional partnerships with IT and functional SMES.• Created and performed cost analyses on key project roadmaps (i.e. provider application portal) to strategize and operationalize incentive programs.• Responsible for the design and implementation of a practitioner-facing application status dashboard, a first-in-class product type for Beacon Health Options and Anthem.• Led the initiative to address and correct gaps in practitioner network disenrollment, ensuring minimal disruption to impacted stakeholders and patients.• Leveraged project management and process improvement methodologies to yield results in a rapidly changing behavioral and mental healthcare landscape.• Optimized workflow efficiencies related to credentialing processes through extensive research and inter-departmental resource allocation.

Woonsocket, Ri

• Identified issues facing CVS Health as a pharmacy provider, while leveraging technology (internal and vendor partners) to develop and implement solutions.• Managed strategic partnerships with Industry-leading claims adjudication services vendors (RelayHealth, Change Healthcare, Omnicare).• Designed and implemented pharmacy system enhancements to ensure prescription transactions are compliant with state and federal regulations (including Medicaid and Medicare Part D), as well as the NCPDP standard.• Product manager responsible for owning and maintaining portfolio of prescription adjudication products and services, while continuously improving upon their capabilities and ensuring ease of interoperability between multiple vendor platforms.• Product owner of vaccine medical billing program, working cross-functionally with key stakeholders to maximize patient accessibility to otherwise inaccessible vaccines at retail pharmacy.• Collaborated with external IT partners to improve earnings from revenue-generating programs, while pursuing participation and/or development of new value-add opportunities to maximize direct cash payments.• Identified talent, led, and developed a driven team of high performers, encouraging and promoting growth.

Woonsocket, Ri

• Responsible for managing, maintaining, and furthering relationships with several reputable technology vendor partners; leveraging their products to drive pharmacy program efficiency.• Led team of analysts and system administrators to identify and address areas of opportunity related to financial and operational performance.• Owner of key projects and product lines that yield direct value to the CVS Health enterprise (e.g. network connectivity between retail pharmacy and PBMs, switch vendor services, Rx claims rejection mitigation).• Developed and implemented medical billing project plan, providing better access to patient insurance benefit coverage.• Identified and implemented opportunities for compliant Medicaid and Medicare (Part D, B) claims processing.

Woonsocket, Ri

• Responsible for analyzing third party PBM data, including analysis concerning pharmacy Rx adjudication rejections and providing solutions.• Created intuitive dashboards to communicate payer performance rates, value-add service outputs, CVS trends to market, etc.• Deployed and communicated analytical solutions to improve adjudication business models.

Woonsocket, Ri

• Responsible for setup, testing, and implementation of new PBM plans for claims adjudication• Collaborated with technology vendors to apply new system functionality to mitigate number of incorrectly billed prescriptions