Launched start-up full-service Pharmacy Benefit Manager (PBM) from initial funding through “go live” and on-going servicing. Run day-to-day operations, pricing, sales support, product development and IT. Report to CEO.

Hired to lead account management and bring stability to new company. Sold, contracted, installed, and serviced all new and existing business. Oversaw end-to-end client and member servicing and managed supplier performance. Reported to President.

Provided professional consulting services to prescription benefit, health plan, and pharmaceutical manufacturer clients.

Managed Coventry’s Medicare Part D product (PDP) and day-to-day operations for the fifth largest PDP in the US. Directed the Centers for Medicare & Medicaid Services (CMS) annual bid process. Managed the CMS Plan Benefit Package process, annual member materials, CMS and internal part D data reporting, clinical quality and performance management. Developed and managed department budget of $2M. Reported to Senior Vice President.▪ Brought product from non-compliant to compliant operations and moved margins from negative to profitable.▪ Drove the member experience quality initiatives, making improvements to complaints and grievances through effective root-cause analysis and preventive measure implementation.▪ Drove improved quality, working collaboratively with Internal Performance Management (Stars team), Corporate QI (HEDIS), and Pharmacy Management (patient safety).▪ Improved year-over-year (YOY) results for the annual CMS Part D Data Validation Audit.

Managed operations for the Medco and Express Scripts Medicare prescription drug plans (PDP), the 4th largest Medicare PDP with $7B annual revenue, including member enrollment, premium billing, CMS subsidy, reconciliation, customer service, complaints and quality, including both employer group (EGWP) plan and individual member enrollment. Oversaw internal staff of 50 and outsourced operations of ~150 employees. Reported to Senior Vice President, Medicare.

Reconciled CMS to Medco enrollment data.

Oversaw $20M+ development project for the Medicare Part D drug benefit business line and for Medicaid and coordination of benefit projects. Managed budget and staffing plan for 40 development and testing teams with 100+ full-time employees. Led all systems design, development, testing, deployment, and project management activities. Created high-level systems designs and project cost estimates. Represented Medco in all technical matters with CMS.

Business Analyst for Professional Liability Claims Management.