Nancy Gilbride Email & Phone Number

Senior healthcare executive providing expertise in strategic planning, growth and operational initiatives to healthcare systems, managed healthcare companies, startup healthcare companies and pharmacy benefit managers. National expert in TRICARE Pharmacy Program from contractor perspective; adept at operational execution of program deliverables, contract compliance and achieving sustainable growth in partnership with Defense Health Agency leadership. Major Projects Include:•Partnered with one of the country's largest Integrated Delivery Networks to assess PBM contract and business strategy to internalize functions and execute on growth initiatives.•Reimagined current strategic plan and recommended best practices for health system owned PBM and Specialty Pharmacy to include identification of growth and client management initiatives, target markets and adjacent business opportunities for partnership or acquisition.•Evaluated strategic and operational pursuit of two multi-billion dollar federal contracts for leadership team of Fortune 50 managed healthcare company.

At RxClarity Group, we are Executive Pharmacy Advisors who demand high touch client services, compassionate patient care and transparency in your pharmacy programs. We serve those looking for better - brokers, employers, captive insurance companies, government entities and health systems as well as those offering real solutions - health system pharmacy, pharmacy solution providers and transparent PBMs. My responsibilities include business development, strategic partnerships, procurement services, customer strategy and growth management services, marketing and product development. Additionally, I recruit pharmacy and PBM talent for our staff augmentation .We Offer:*Strategic Partnership and Procurement Services*Specialty Medication | High Cost Medication Management Services*Staff Augmentation for pharmacy benefit services*Growth and Customer-Centric Strategy and Execution Services Visit Us at us at https://www.rxclaritygroup.com And Please Follow Us on LinkedIn at RxClarity Group LLC!

Morristown, Nj, Us

Developed and executed the PBM business plan to reach customers and achieve competitive advantage with direct responsibility for sales, account management, proposals, consultant/broker relations and sales analytics and effectiveness initiatives. Responsible for all PBM target markets including Anthem Commercial and Government (Medicaid, Medicare) Integrated business and IngenioRx stand-alone PBM business. Provided leadership, strategic direction and resources; responsible for overall achievement of sales and retention goals across 18 M members representing $25B+ operating revenue and $1.6B operating gain.•Developed, launched and led Integrated Pharmacy Growth Council in partnership with Anthem medical to drive Commercial fee-based business penetration rates by improving sales pipeline, retention and win rates. Increased new sales membership by 300% in one year.•Implemented multiple best practices, metrics and repeatable processes across sales, account management and proposal teams to stabilize, maintain and grow the business, resulting in improvement of finalist rate by 85% and win rate by 400% as well as 700 basis point improvement in customer retention rates.•Redesigned entire operating model of $26M organization to optimize results which included developing and driving sales culture, increasing staffing by 28%, upgrading talent and implementing performance compensation and incentives at producer level to align behaviors with desired results.

Minneapolis, Minnesota, Us

Offering outsourced management of cell and gene therapy treatments for health care payers by streamlining the supply chain and simplifying the management of these complex emerging therapy treatments. Services offered include pipeline analytics, medical services, contract placement, claims adjudication, patient management, analysis and reporting. We remove barriers in management, reimbursement and financing, offering a higher level of business continuity and efficiency in emerging cell and gene therapies.

Saint Louis, Mo, Us

Led Centene’s comprehensive portfolio of supplemental health benefit services (behavioral health, nurse advice line, health and wellness, lifestyle and condition management coaching, dental, vision, correctional facility healthcare, pharmacy benefit management and specialty pharmacy offerings) for partners nationwide. Customers included Medicaid and Medicare Health Plans, State Exchanges and Commercial lines of business. Responsible for the strategic direction, business development efforts, customer management, product development, marketing, operations, legal and finance units for the $11B subsidiary comprised of 4,500 employees nationwide. •Delivered a $400M improvement in rebate value over 3-year period from Pharmacy Benefit Management/Specialty Pharmacy units and $100M-$200M annually in pharmacy network savings value. •Executive Sponsor of turnaround effort on behavioral health unit delivering $36M in medical savings over a 12-month period via process improvement initiatives on key operations. Improved customer experience via claims project resolution time reduction by 38%. Integrated standalone behavioral health services into health plan partner operations, advancing an industry leading business model.•Achieved financial improvements for Envolve overall; increasing Y-O-Y revenue by 34%, with a 59% profit improvement while delivering a 3.3% decline in G&A over same time period.

Targeted opportunities that created long-term value through building strong relationships, skillfully managing financial and operational performance, and creating a culture of integrity and accountability.

St. Louis, Mo, Us

Chosen to become senior executive of expanded division covering over 10 M lives following acquisition of Medco Health Solutions. Responsible for client retention, satisfaction and P & L for $10B business division including FEHB health plans. Provided leadership and strategic direction for 3,000 employees (90 direct reports), including business development, technology, operations, supply chain, finance and legal resources. Member of sales executive leadership team.•Led 3-year enterprise-wide effort to win next generation Department of Defense contract, valued at $63.2B over 7-year term. Achieved full integration of direct and purchased care pharmacy systems, while creating new profit streams.•Led 12-month, enterprise-wide project to implement Department of Defense contract, a $60M effort.•Exceeded profit targets by 180% on 5-year Department of Defense contract.

St. Louis, Mo, Us

Promoted to senior executive responsible for contract with Department of Defense. Led client retention and growth, program management, contract administration and P&L for $5.8B business division, covering 9.3M lives. Directly managed team of 50 professionals and member of sales executive leadership team.•Created vision and directed implementation of rolling 3-year strategic plan, which yielded compound growth rate of 6% annually in federal business sector (recognized as corporate best practice).•Dramatically improved financials by 143% over prior contracts.•Launched successful contract performance turnaround effort based on customer feedback. Achieved 157% improvement in customer ratings.

St. Louis, Mo, Us

Led development and expansion of new division dedicated to administering Department of Defense contracts, including mail order and retail prescription services valued at $5B and covering 9.2M lives. •Led corporate effort to win next generation contract valued at $25B over 5-year term and representing major expansion of pharmacy services. •Negotiated 19-month extension, bringing mail order pharmacy contract out of a loss position.•Successfully achieved operational performance turnaround in 1 year, resulting in 32% increase in client satisfaction rate through enterprise-wide contract education and process modification.

St. Louis, Mo, Us

Responsible for client retention, satisfaction and gross margin growth in company’s newly created Public Sector Division (State, Federal, Medicaid and Large Local Government clients), representing $300M in annual gross margin (28% of company’s margin) and a $5.2M operating budget. Member of public sector leadership team. •Achieved a 98% client renewal rate, while maintaining the highest client satisfaction rates for account management across all business divisions (12 consecutive quarters).•Increased gross margin by 27% over 3 years through sales of new products and services to client base.

St. Louis, Mo, Us

Created strategic vision for clinical program development and led design, delivery and management of all clinical products and services. Managed a team of more than 20 clinical pharmacists, analysts and support staff responsible for developing and proactively selling client-specific clinical strategies, including implementation and ongoing results evaluation to ensure achievement of client-specific goals. •Developed processes, new key clinical positions and formulary management initiatives that led to a 150% increase in clinical services implemented across the National Employer Division client base from 2000 to 2002.

St. Louis, Mo, Us

Developed and led clinical program management function following acquisition of ValueRx in April 1998. Delivered proactive and consultative clinical services, while demonstrating program value and results for clients. Converted clinical programs based on acquisition strategy and targets. •Led clinical integration initiatives resulting in a 200 percent increase in clinical services implemented from 1998 to 2000.

Greenwich, Ct, Us

Prior experience includes progressive clinical and sales positions (manager, director and senior director) within managed healthcare and hospital settings. Employers included ValueRx, SmithKline Beecham, Diversified Pharmaceutical Services and the University of Wisconsin Hospitals and Clinics.

Residency Training, General And Specialized Hospital Pharmacy Administration

Master Of Science, Hospital Pharmacy Administration

Bachelor Of Science, Pharmacy

Post Graduate Internship, Pharmacy And Educational Affairs