Medicare Stand-Alone Part D Pricing Lead. I'm responsible for leading a team that will submit accurate and timely bids to CMS, respond to desk reviews or audits that arise, as well as supporting strategic business decisions made by the executive leadership team, providing feedback to requests for proposed regulation changes, financial planning and internal client requests.

Medicare Stand-Alone Part D Pricing Lead. I acted as point person on a team that submitted accurate and timely bids to CMS, responded to desk reviews or audits, as well as supported financial planning and internal client requests.

Medicare Pharmacy Cost of Care: I supported Medicare Part D bid activities for Stand-Alone Part D and MAPD through trend development and ad hoc pricing requests, determined significant trend components for senior business, collaborated with clinicians on significant new drugs and estimated the future costs, and supported contract negotiations with the Pharmacy Benefit Manager for contract updates, market check analysis and changes to contracts due to CMS regulation changes.

Indiana Valuation and Forecasting: Developed KY, IN and FEP reserves using a mixed completion factor and projection method, developed aggregate stop loss, specific stop loss and premium stabilization reserves using various methods. I completed actuarial components of the KY and IN Annual Statements, footnotes, interrogatories and HRBC filings for KY, IN and OH. Additionally, I communicated results to a wide range of clients on a regular basis including other members of the Valuation… Show more Indiana Valuation and Forecasting: Developed KY, IN and FEP reserves using a mixed completion factor and projection method, developed aggregate stop loss, specific stop loss and premium stabilization reserves using various methods. I completed actuarial components of the KY and IN Annual Statements, footnotes, interrogatories and HRBC filings for KY, IN and OH. Additionally, I communicated results to a wide range of clients on a regular basis including other members of the Valuation department, non-Valuation actuaries, and the Indiana business unit. Show less

Health Network Evaluation Analyst: I determined the expected overall increase in provide costs through reimbursement changes, I supported hospital contract negotiations and network changes by region and provided support for the quarterly commercial trend development process.