Lori W. Email & Phone Number

California, United States

San Diego, California

San Diego, California

West Covina California

Winnetka Ca

BeneSys is a team of dedicated Taft-Hartley Trust Fund Specialists. BeneSys understands the nuances of Taft-Hartley benefit plans. We are experienced and accustomed to programming and administering plans that have unusual benefit plan parameters. Our software system Benefitdriven.com is dedicated to providing our clients and their plan participants with the most efficient tools for self-administering trust fund accounts. Our benefits administration software was developed by administrators, for administrators.My primary responsibility is new business development specializing in the Taft Hartley Trust Fund multi-employer group business and public sector in the Western States market. The company’s primary lines of business provided to union trust funds and the members those entities serve include: Health and Welfare Plans; Claims Processing; Medical Reimbursement Accounts; Eligibility Processing; COBRA Administration; Defined Benefit Pension Plans; Loan Programs; Government Filings; and VEBA Administration.

Winnetka, Ca

At Magellan Rx Management, we specialize in solving complex pharmacy challenges for our customers. We believe in developing and executing smart solutions that leverage our industry-leading experience and technology to exceed expectations.Employer and Labor Market• 40+ years complex implementation experience• Customer-first, partnership culture where we work together with our clients to address specific population needs• Flexible, full-service PBM that owns our own systems and takes pride in our client service• Flexible cost management options beyond discounts and rebates• Leading-edge pre and post sale tools and analytics• Clinical programs that use a smart approach to population management, leveraging our vast library of clinical algorithms and solutions• Employer Group Waiver Plan (EGWP) & Retiree Drug Subsidy (RDS) program support• Maximizing client savings by focusing on the right drug at the right price for the right conditionPioneers and thought-leaders in medical specialty pharmacy for 12+ years with over 10+ million lives under management Medical pharmacy (employer) program resulting in significant savingsIntegrated approach that leverages our scale and experience in managing total drug spendPatient engagement experts that harness our behavioral health expertise (motivational interviewing, MRx Cares Program) and technology (QR codes) to deliver the best information to patients and physicians to achieve greater adherence and reduced costs. We’ll now be able to bring you an industry leading, patient-focused specialty pharmacy, featuring proven cost savings by integrating medical and pharmacy data for improved compliance and treatment outcomes.

Charlotte, North Carolina Area

inVentiv Medical Management (iMM) delivers industry leading physician directed, nurse supported, technology enabled medical management solutions to third party administrators, Unions, self-funded or fully insured plans, Accountable Care Organizations (ACOs), employer groups, managing general underwriters and insurance carriers. Our mission is focused on the objective of promoting appropriate care at the appropriate prices resulting in the best clinical and financial outcomes for all stakeholders involved. Our full suite of integrated services across the care-cost continuum is THE 360° solution.The inFinitē platform supports our multi-disciplinary medical management team who supply the high clinical touch and promotion of evidence based medicine. This combination of high technology and high touch makes our approach to medical management a complete medical management solution.

Winnetka Ca

Sales and new business development both direct and through broker and consultant channel. Primary function involves managing the sales process in the assigned territory for prospective clients and strategic existing account renewals. Develop and execute strategies and tactics for territory planning, pre-RFP prospecting and relationship development, proposal development, pricing development, presentation and delivery, negotiations, closing and contracting. Other responsibilities include the development of the annual sales plan, the development of the overall sales strategy and long- term projections. Participate in major pricing decisions. Develop and maintain professional relationships with clients and prospective clients

Work to expand/develop/strengthen relationships with Employee Benefit Advisors within our Strategic Relations Team and aligned with Express Scripts Sales Directors, covering the West Coast markets. Deliver Continuing Education (CE) Presentations within Pharmacy Benefit space to consultants and brokers.Also responsible for several Key National Benefit Advisor Relationship Assignments: ensuring Global Issue Resolution, strengthening strategic partnerships, end goal of fostering future new business growth and improving overall win rates- Manage and enhance key broker and consultant relationships.- Serve as a point of contact and resource for brokers and consultants throughout the region.- Help maximize opportunities through efforts including outreach, education, training, and general service.- Coordinate with the local Sales Director to provide targeted, meaningful support and service.

Primary function includes managing the sales process in the territory assigned for prospective groups and strategic existing account renewals. Develop and execute strategies and/or tactics for territory planning, pre-RFP prospecting and relationship development, proposal development, pricing development, presentation and delivery, negotiations, closing and contracting. Other responsibilities include the development of the annual sales plan, the development of the overall sales strategy and long- term projections. Participate in major pricing decisions. Develop and maintain professional relationships with clients and prospective clients.

Develop and maintain a professional relationship with clients and prospective clients. Work directly with the sales team to identify and set up introductions with key individuals. Responsible for strategic renewals and strategic planning for selected clients for the Chicago, St. Louis, and California satellite offices. Identify areas of concern, create solutions, and communicate to the boards, attorneys, consultants, and administration office for buy in and implementation. Complete responsibility for opening a satellite office in southern California, running the office, and hiring the staff.

Develop and maintain a professional relationship with clients. Identify plan enhancements, competitive pricing, respond to RFP with current clients, contract renewals, contract language changes, and communicate opportunities to client consultants and administrators. Provide documentation to support plan enhancements where client/member will benefit. Maintain a quick turn around time to the day to day issues with quality response.

Develop/maintain working relationships with the Local Operating Units, Medical Directors, Network Development, Legal Department and law enforcement; create/maintain all documentation in an organized, objective and confidential manner; create, maintain, and report all audit results and investigation information as required by corporate standards, state and federal laws.

Served as primary liaison for Network Administration Department and National Accounts. Responsible for the analysis and development of network quality management reports and development and implementation of quality action plans. Responsibilities included managing network recruitment efforts to fulfill client access and density standards, problem-solving and implementing resolution to meet the customer needs, and directly working in conjunction with account management teams to meet the demands of client organizations.

Responsible for five specialists in the Quality Improvement group, identifying quality improvement methods for internal and external customers. Developed, published and maintained a quality improvement program. Responsible for staff located in Columbia, Maryland and St. Louis, Missouri.• Managed the auditing department, including directing all internal and external client audits. Identified and implemented action plans for audit failures.• Directed all quality improvement and productivity measures, including auditing to identify and analyze performance indicators.• Developed and implemented the Quality Improvement Program for Network Administration and Network Management. • Successfully developed a program for the Credentialing Verification Organization Accreditation (CVO) site visit, which led to the outcome of being awarded a two-year accreditation for all ten-verification elements from NCQA

Responsible for the supervision of ten employees in a provider relation’s information/complaint center. Improved customer service factor by a measurable 30% + rate through careful restructuring of service delivery methods.• Designed and developed a streamline database response system, which improved voice response time by 82%.• Eliminated voice mails “response system” and introduced live-call mode with hold option, which increased total service factor by a measurable 30%+ and decreased abandonment rate by 15%.• Maintained an average abandonment rate of 1% and a total service factor of 98%. • Introduced customer service training system, which included silent monitoring as a means of improving representative’s skills.• Introduced, implemented and chaired a weekly conference call involving 15 Regional Service Centers in Network Management to create effective communication, implement consistent policies and procedures, and improve customer satisfaction.

Management of the physician staff, credentialing/scheduling staff, and client accounts. Additional responsibilities included being the primary Human Resource liaison for Legatus Emergency Services and Palmaris Imaging. Responsibilities included Development of all standard and operating polices for ACR, maintaining system accuracy and industry requirements for Teleradiology, creating and implementing job descriptions, hiring, development of Standard operating procedures, Physician Scheduling and relocation, development and publishing the employee handbook, Employee Benefits/Vendor relations, and creating company and departmental policies and procedures.