• Develop and implement multiple pricing strategies and methodologies across Commercial/HIM, Medicare, and Medicaid lines of business.• Enhanced pricing models and processes to accommodate emerging services and accuracy of current service offerings.• Develop pricing for new services and implement contractual language supporting pricing and services.• Lead presentations with Blue Cross Blue Shield plans regarding contractual changes and financial performance.• Support Client Engagement through fulfilling client ad hoc reporting requests, participating in client meetings, and providing client pricing expertise.• Successfully collaborate cross functionally with multiple areas throughout Prime to accomplish a variety of tasks including extensive annual budget development, financial value reporting, and accurate invoicing of services.• Interpret and analyze a variety of financial information to identify meaningful trends and opportunities for improvement.

• Strategic management of two medical plans covering a combined total of 24,000+ lives and $95M in annual claims.• Lead pharmacy strategy initiatives by partnering with contracted PBM as well as third party vendors.• Lead initiative to evaluate and implement a pharmacy adherence program including multiple third party vendor solutions.• Team representative and thought partner for department projects within Pay & Benefits.• Attend conferences relative to current industry trends.

• Led end to end negotiations with large to mid-size PBMs.• Partnered with analytics and operations teams to ensure accurate negotiations and subsequent plan set up.• Develop carrier engagement strategies to deepen relationships with key strategic payer partners in order to drive sales and profitability for Target Pharmacy.• Evaluate and partner with payers on advantage pharmacy networks where Target Pharmacy is positioned advantageously over other pharmacies for the benefit of the guest. Co-led the initiative providing thought leadership and development of the Advantage Network evaluation process.• Developed and executed a medical billing strategy to expand Target Pharmacy’s reach to additional guests who have covered services through medical benefits.

• Manage and maintain strategic provider relationships, which includes provider contracting, financial analysis, and operations management.• Responsible for negotiating provider contracts including small primary care providers, large specialty providers, and large multispecialty providers.• Responsible for developing and maintaining the departments negotiating budget file which is presented to senior leadership.• Monitor, analyze and interpret provider financial and utilization patterns and implement corrective action strategies, as appropriate.• Support health plan Medical Directors in establishing and maintaining positive provider relationships.• Key contact/support for multiple department software applications.