Raymond Risman Email & Phone Number

Dallas, Texas, Us

Philadelphia, Pennsylvania, Us

Us

● Provide guidance to life science organizations around value based contracting, market access, P&T designations, payer relations and marketing strategies● Combine Optum’s broad data assets with Payer expertise to develop meaningful pharmaceutical marketing and pricing strategies that align with the current clinical and financial trends of the healthcare landscape● Provide strategic data and contracting support for United Healthcare and OptumRx’ s efforts in the design and implementation of value based contracts across multiple therapeutic areas● Responsible for the finances, design, development and implementation of Optum Life Sciences Value Based Contracting and Payer Review products and services● Developed internal business processes to support the Value Based Contracting and Payer Review products from project implementation to final deliverables● Orchestrated the Value Based Contracting collaborative partnership between OptumRx, United Healthcare and Optum Life Sciences ● Primary trade relations, market access, contracting, and pharmaceutical negotiation subject matter expert

Us

● Establish, develop and maintain business relationships with payers and pharmaceutical manufacturers to negotiate rebate contracts for a PBM servicing over 50 million lives● Consult pharmaceutical manufacturers on the clinical, financial and business requirements needed to gain formulary access ● Provide strategic insight on the managed market landscape to align payer strategies with manufacturer’s business goals● Contribute to formulary development and benefit design strategies for Medicare Part D and commercial clients● Ensure pharmaceutical agreements are in compliance with clinical requirements, government regulations, company contract standards, and key processes to minimize and control risk for OptumRx and its associated clients ● Identify, develop and implement negotiation strategies to maximize rebate opportunities and reduce client risk ● Provide forecasting, analytics and insight on the pharmaceutical market landscape to identify business opportunities and innovative strategies to support client needs● Support and maintain multi-department operations to ensure seamless execution and maintenance of pharmaceutical agreements● Led collaboration with OptumInsight and UnitedHealthcare Medicare and Retirement on the development and implementation of the OptumRx Industry Relations Web Portal to further enhance and streamline the rebate submission process● Coordinate with the Legal and Contracting units to update and maintain the Industry Relations Web Portal to increase efficiency and minimize risk to major stakeholders● Oversee the timeline, launch and completion of the annual Medicare Part D web based rebate bid submission process ● Led the development and distribution of the CMS Star Ratings Survey to identify prospective opportunities and collaborations to improve client CMS Star Ratings● Primary preceptor for the Industry Relations Pharmacy Residents rotation

Us

Us

• Manage, support, maintain and enforce the Core Formulary for all Los Angeles County run healthcare facilities (e.g. 4 major hospitals, 10 clinics), servicing approximately 11 million lives with an estimated $160 million pharmacy budget • Provide pharmacotherapy expertise in leading the development of evidence-based drug reviews and discussions for Core P&T Committee consideration• Organize, maintain and facilitate medical expert panel meetings (e.g. oncology, rheumatology, neurology) to develop recommendations for the Core P&T Committee• Develop and utilize cost benefit/effective models, drug utilization policies, therapeutic class reviews, pharmaceutical pipeline evaluations and formulary performance audits to identify formulary enhancement, contracting and cost savings opportunities• Coordinate and develop education programs and materials to promote and support formulary restriction changes (e.g. in-services, treatment guidelines, information handouts)• Communicate with system key opinion leaders to ensure acceptance and smooth implementation of changes in formulary design• Develop and determine clinical restrictions to negotiate market share goals for pharmaceutical purchase agreements• Implemented formulary initiatives that will potentially result in approximately $2 million in annual savings for the Los Angeles County Health System, reducing some therapeutic class expenditures up to 40%• Established standardized levels of competency for all Los Angeles County pharmacy staff in the areas of pharmacology, pharmaceutical calculations, pharmacy law and pharmacy regulations

• Develop, produce and update formulary dossiers for pharmaceutical manufacturers • Collaborate with managed market teams to appropriately review clinical data for dossier inclusion• Review and analyze Request for Proposals (RFP) submissions for Pharmacy Benefit Management (PBM) benchmarking • Provide support for advisory boards, developing meeting reviews and synopsis of advisory board recommendations

Us

• Extensive managed care exposure with practical experience in clinical programs, clinical formulary management, prior authorization, mail service, specialty pharmacy, client management, claims analytics, industry relations, disease therapy management and Medicare part D operations• In depth exposure to CMS Medicare Part D formulary guidelines and restrictions• Gained exposure to and supported the negotiation and implementation of contracts with pharmaceutical manufacturers• Developed physician and member education materials addressing clinical safety and efficacy updates• Developed prior authorization guidelines to promote clinically appropriate drug use and support formulary needs• Provided responses to drug information inquiries • Conducted pharmacoeconomics and health outcomes research • Constructed individualized care plans for members participating in Disease Therapy Management Programs• Developed and presented continuing education materials to the clinical staff• Developed monographs for use by the national P&T committee • Prepared and provided clinical responses and rationale for Request For Proposal (RFP) questions and concerns• Conducted analysis and reporting of client requested benefit design inquiries• Contributed to the development of clinical decision algorithms for mail and specialty operations

Pharm.D., Pharmacy Practice

M.S., Regulatory Sciences

B.S., Bioengineering

B.S., Biochemistry