Elizabeth Hefley Pharm.D. Bcacp Email and Phone Number
trategic and results-driven healthcare professional with a proven track record in building and nurturing client relationships, delivering exceptional service, and surpassing sales and retention goals within the dynamic healthcare industry. I excel in data-driven analytics, clinical management, and cost containment strategies, bringing exceptional communication, presentation, and negotiation skills to the table. I have extensive experience managing multiple lines of business, including Medicare, Medicaid, Health Exchange, and Commercial clients.With advanced analytical skills and business acumen, I specialize in crafting innovative solutions to complex pharmacy clinical challenges. My areas of expertise include:Reviewing Prior Authorization policies to ensure rebate and industry compliance. Designing sophisticated systems and leading large-scale Pharmacy Clinical Consulting projects. Managing strategic projects with a focus on client satisfaction, acting as the primary contact for clinical, formulary, financial, and trend evaluation initiatives. Developing and implementing clinical business plans, overseeing results evaluation, and ensuring comprehensive management of clinical programs. Creating and disseminating enterprise tools, best practices, and quality standards across the organization.Recognized as an industry-wide clinical authority, I represent the organization externally and identify strategic issues and opportunities that impact growth and profitability. My approach is rooted in innovative and breakthrough thinking, consistently aiming to develop new markets, technologies, and services with long-term strategic impact. Data-driven analytics play a pivotal role in driving results and making informed decisions for sales.I am also a Board Certified Ambulatory Care Pharmacist, continually enhancing my expertise to better serve clients and drive organizational success.
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Principal, Clinical Consultant, Strategic MarketsThe Cigna Group Feb 2024 - PresentRemote-Apply advanced analytical skills, business judgment, and expertise to create solutions to the most complex Pharmacy Clinical problems that have little or no organizational precedent. -Reviews Prior Authorization policies for rebate and industry compliance working with GPO.-Designs highly complex systems and leads the largest Pharmacy Clinical Consulting projects and initiatives, -Manages a heightened strategic project management role. Serves clients as the primary contact for all clinical, formulary related initiatives, financial /rebate and clinical modeling, trend evaluation, clinical business plan development consultation, implementation and oversight, results evaluation, and follow-up related to the comprehensive management of clinical programs and initiatives regarding programs. -Develops and disseminates enterprise tools, best practices and quality standards.-Possesses industry-wide clinical authority and represents the organization externally. -Responsible for identifying internal and external strategic issues and opportunities that could affect growth and profitability of the organization. -Regularly engages in innovative and breakthrough thinking to develop new markets, technologies, or services which will have a long-term strategic impact. -
Senior Clinical Account ExecutiveThe Cigna Group Nov 2020 - Feb 2024Remote•Achieved $1M in Commerical Upsales in 2023 for Key Accounts, National Accounts, Coalition Accounts•Successfully managed 22 clients, including unions, EGWP, coalitions, key accounts and national accounts.•Collaborated on the Clinical Action Board Committee to enhance onboarding for new account team members.•Upsold $3Million narrow network, Upsold PDL and PA management program for Medicaid 2022•Upsold Medical Drug Management Program and Policies to client improving medical & pharmacy data integration•Led Rebate modeling and implementation effortsProgram up-sale and SPARC presentations•Delivered presentations to ESI leadership (VP, product) on Medicaid PDL management product opportunity•Analyzed and updated drug lists to enhance cost savings and patient adherence •Implemented initiatives to improve HEDIS and STAR measures for Medicaid/Medicare plans managed•Supervised four lines of business (Medicaid, Medicare, Health Exchange and Commercial), •Collaborated to implement of a health plan•Improved and remodeled the custom PA processes between client and ESI•Remodeled the operational management and coding of state PDL file and rewrote the SOP process•Led cross-functional teams to improve PA and formulary implementation process (CRD, PA, ClinOps, IT, CBA)•Spearheaded 14 commercial clients and upsold products including Safeguard, AUM, AOM, Embarc, SaveOn•Successfully Onboarded and managed two new commercial and Commercial/EGWP clients -
Senior Clinical Account ManagerCigna Mar 2019 - Nov 2020Remote• Achieved $3Million in upsells annually across a book of business consisting of 40 clients • Led new sales teams with finalist meetings, Value of Integration meetings, and Carve-in meetings• Managed 40 Regional accounts (over 5000 employees’ lives) in the California Marketplace, and 5 National Account (over 10,000 lives) clients’ pharmacy needs and upsells.• Successfully handled RFP’s for new sales and renewals• Analyzed clinical data to discuss trends and outcomes for clients in the U500, O500 and National markets• Managed Medical specialty pharmacy carve-out prevention tactics• Trained new Clinical Account Executives and served as a mentor for non-clinical colleagues• Delivered presentations during consultant meetings and discussions.
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Senior Clinical Account Manager/Manager Of Clinical Outcomes Silversummit Health PlanCentene Corporation Jun 2017 - Nov 2018Remote•Managed seven health plans (Medicaid, ACA, Commercial) across four states managing three million lives.•Managed and trained a team of three employees•Oversaw the Request for Proposals (RFP) Management and review process•Led formulary change implementation, plan implementation, clinical changes, custom prior authorization creation•Developed clinical strategy for the annual and quarterly reviews to achieve cost savings •Utilized data analytics to recommend clinical offerings, formulary management and cost-effective clinical solutions•Coordinated clinical project plans with account management•Identified client-specific and emerging clinical industry trends to support development of savings initiatives•Created and analyzed reports to detail trends in drug utilization and cost•Implemented outreach initiatives for providers and develop tracking algorithms to analyze outcomes•Presented clinical data and analysis results to senior leadership, partner organizations and State of Nevada•Served on P&T, and Quality Improvement Committee, Lead Performance Improvement Team•Assisted in NCQA accreditation and manage NCQA SharePoint site while serving as an agency educator on NCQA •Implemented Performance and Quality Improvement Project oversight-Nevada Quality Strategy, and oversight•Implement and monitor HEDIS and CAHPS improvement projects, conducted analysis to decipher gaps and barriers -
Medication Therapy Management PharmacistWellcare Pharmacy Jul 2014 - Jun 2017Las Vegas, Nevada, United States•Collaborated with hospitalists and specialists to improve the quality of care and reduce readmissions for high-risk patients across various health systems•Addressed non-compliance, simplified medication regimens, assessed outcomes of medication therapies, and modify therapies based on evidence-based guidelines•Assisted with prior authorizations to drive care and cost savings -
Clinical Pharmacist, Outpatient Ambulatory Care Anticoagulation Pharmacist,Providence Health & Services Nov 2006 - May 2013Newberg, Oregon, United States•Developed and managed a preceptor program managing pharmacy interns.•Worked in various pharmacy settings including inpatient/outpatient, anticoagulation clinic pharmacist, inpatient/outpatient pharmacist, oncology, trauma, burn, Cardiology, ER, Pediatrics•Redesigned the inpatient pharmacy layout to increase efficiency and flow by 25% •Developed a program for inpatient education, discharge medication education and intern training
Elizabeth Hefley Pharm.D. Bcacp Education Details
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International Business/Trade/Commerce -
Biochemistry, Biophysics And Molecular Biology -
Pharmacy -
BpsBoard Certification In Ambulatory Care Pharmacy -
Doctor Of Pharmacy - Pharmd -
Doctor Of Pharmacy - Pharmd -
Bachelor Of Science - Bs -
International Business -
Anticoagulation
Frequently Asked Questions about Elizabeth Hefley Pharm.D. Bcacp
What company does Elizabeth Hefley Pharm.D. Bcacp work for?
Elizabeth Hefley Pharm.D. Bcacp works for The Cigna Group
What is Elizabeth Hefley Pharm.D. Bcacp's role at the current company?
Elizabeth Hefley Pharm.D. Bcacp's current role is Senior Clinical Director.
What schools did Elizabeth Hefley Pharm.D. Bcacp attend?
Elizabeth Hefley Pharm.D. Bcacp attended University Of Hartford, Oregon State University, Oregon State University, Oregon Health & Science University, Bps, Oregon Health & Science University, Oregon Health & Science University, Oregon State University, University Of Hartford, University Of Southern Indiana.
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