Richard Luth Email & Phone Number

Hartford, Connecticut Area

- Led the Operations and Client Services organization pre-close planning, strategy development and execution of post close merger activities and synergy realization.- Drove the design and market analysis/assessment of new pharmacy services model/solution creation the evaluation construct- Managed the plan development of the Aetna/Humana Pharmacy Integration plan including member services model, digital strategy, Mail Order/Specialty Pharmacy operations and Program Management Office.- Architect for Rx Program Management Office Integration Governance Structure, developed Command Center strategy and led all Aetna operations Day 1 Readiness planning activity.- Led design and implementation plan for new Rx member service model

Hartford, Connecticut Area

Managed both Aetna Pharmacy Benefit Managers (PBM) (ESI and CVS Caremark) member services call centers including both commercial and Medicare lines of business: 13M members. Oversight for >600 vendor employees. Responsible for Aetna Pharmacy Management (APM) Performance Guarantee Program including negotiation of penalty payments. Led Pharmacy Benefits Manager vendor contract. Business program lead for multi-line business PBM platform transition.- Created and deployed Member Satisfaction Innovation Program improving results by 5 percentage points within 6 months, and impacting improvements in management processes, operations & call servicing.- Led creation and implementation of new organization responsible for the oversight/management of Aetna pharmacy vendor(s)- Vendor and cross-organizational leadership, influence, direction and consulting (e.g. Information Technology, production support, Account Mgmt and PBM partner)- Managed the second largest enterprise outsourced contract requiring multi-disciplined expertise (including commercial and Medicare LOBs and a variety of business protocols & compliance standards.) - Designed and executed operating model and governance structure for delegated outsourcing responsibilities and identified key processes and procedures- Supported development of Aetna CVS Caremark Execution (ACE) Program Management Office (PMO) governance model- Key participant in contract negotiation and language; influenced critical components of numerous schedules for market check/contract rewrite. - Leadership of critical ad hoc programs to address remediation and recalibration of operations: e.g.: Pharmacy Trend Initiative, Open Enrollment Readiness and Client migration- Internal Audit leadership, collaboration, and consultation creating a focused and disciplined approach to audit operation, program controls and procedures to ensure contractual compliance.

Hartford, Connecticut Area

Lead Business Consultant (Healthcare Reform Program Management Office) December 2009 – August 2010- Working with PMO Head, led the establishment of the HCR PMO including the development of PMO structure, objectives and governance model- Provided direction and guidance to PMO team project leads and consulting staff.- Accountable for all aspects of the governance model including the development of management and executive meeting structure and materials; provided review of all Sr. Management reporting. - Drove and led the implementation of an HCR reporting package and dashboard within 60 days of legislation enactment- Assumed PMO Lead responsibilities reporting directly to CEO Chief of Staff ; provided for effective transition to new PMO leadership

Hartford, Connecticut Area

- Developed extensive and complex( multi thousand line) Transition Plan to support TRICARE T3 proposal- Designed and built transition plan framework; led and facilitated planning effort of all business function heads to drive plan content, dependency and critical path based on TRICARE requirements - Consulted and led Real Estate strategy and planning for TRICARE Service Centers, including staffing and training plan - solutioning effort to meet TRICARE proposal requirements- Created a comprehensive transition governance structure to support the management of the transition - Led effort to ensure TRICARE contract readiness including facilitation of and develop of contingency plans- Developed TRICARE T3 Transition Plan proposal

- Developed strategies to deploy Aetna’s electronic service options- Led organization to exceed objectives within 6 months in position including increasing ERA claim volume by 19%, paper shut off by 23% and number of provider on paper shut off by 74%.- Co-led/managed the successful implementation of RelayHealth. Worked with segment and network liaisons to insure product implementation met business needs. Provided expertise, mentored and guided project lead and overarching plan and provided salient input to development of communication materials and approach.

- Managed internal consultant team responsible for the successful delivery of long term transformation efforts and implementation of complex, cross organizational initiatives. Efforts include: Provider Service Model (2003- multi-million dollars in annualized savings); development and successful implementation of dedicated Provider Service Centers; overall streamlining and quality improvement processes of Credentialing and Provider Data Services Quality; Team development of Aetna Service Options for Health Care Professionals including strategic assessment, model design, strategy and plan development, and execution.- Consultative lead to integrate new medicare product (potential $1B revenue stream) incorporating integration and enhancements of existing infrastructure, and quality processes supporting both external and internal constituents. - Supported development of Aetna Learning Maps; selected as Regional Learning Map Champion to support rollout.- Co-creator of Network & Provider Services Employee Advisory Council.

Bachelor Of Arts (B.A.), Public Policy And Social Systems

How To Win Friends And Influence People

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