Thomas Leiter Email and Phone Number
~10 years of experience designing, developing, and implementing new tools and processes in the PBM, insurance, and pharmacy staffing industries. My experience has afforded me the opportunity to learn about pharmacy insurance from both the PBM and health plan side. In each role, I have had the opportunity to work on applications/processes that were team specific, department specific, and cross departmental and in various capacities (client, business analyst, project manager, QA/tester, and developer).My work has resulted in my employers saving >$10 million dollars through meeting performance guarantees, staying in compliance, improving accuracy, and reducing overhead.
Holmes Murphy
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Pharmacy Benefits Management ConsultantHolmes Murphy Nov 2023 - PresentDallas, Texas, United States -
Sr. Benefits Relationship ManagerCvs Health Jan 2023 - Aug 2023Lead project to develop standards for requirements intake, configuration, and qualityPerformed audit of formulary and utilization management configuration for client of 10+ yearsConsulted with client on prescription benefit plan design to improve clinical outcomes, experience at point of sale, and achieve lowest net costProvided on-site support for Medicare Part D Program Audit -
Manager - Custom Formulary ConsultantsCvs Health Jun 2021 - Mar 2023Provide recommendations to health plans with the lowest net cost formulary strategy while also considering health outcomes, regulatory requirements, and the health plan's current utilization.Automated data connection resulting in capturing 82% more financial models and 55% more data points per modelAutomated data input and reports saving at least 250 labor hours annually at the director levelCollaborated with data scientists to produce KPIs, trends, and insightsPresented KPIs and rebate trends to executive leadership to help shape strategy -
Sr. Advisor - Clinical Shared ServicesCvs Health May 2019 - Jun 2021Analyzed and implemented 7 custom Medicare Part D formularies for large health plan clientDesigned and developed a tool used to compare formulary data between adjudication and source dataExpanded capabilities of proprietary system to capture utilization management data via screens and importsParticipated as business SME on advisory council responsible for enhancing adjudication -
Advisor - Clinical Shared ServicesCvs Health Oct 2018 - May 2019Dallas, Texas, United StatesProduct owner responsible for finishing and launching a proprietary Formulary Management SystemLead concurrent Scrum teams to work on over 1000 user storiesBuilt business cases to inform future product expansion and drive ROIPartnered with cross-functional teams to promote system adoption and develop training plansDeveloped tools to automate interim business processes while features were under developmentPrevented overpayment of more than $200,000 in service warranties -
Operations Leader - Clinical Pharmacy OperationsAetna Jan 2016 - Oct 2018WfhBuilt database with a GUI to put drug information at fingertips of clinicians and analysts Re-engineered implementation process with PBM resulting in efficiency (+40%) and 100% accuracyAutomated quality validation of formulary and UM programs for Medicare Part D bid submission (~1,000,000 records per round). Oversaw implementation of systematic PA approval based on patient medical history, prescriber, and provider information saving over 100,000 inbound calls per year. -
Recruiter / System AdministratorRx Solutions Lp Jun 2010 - Jul 2016Hurst, Tx** PRN as of August 2012 **Recruiting and Retention Manager - Interview and place pharmacists, pharmacy technicians, and other pharmacy professionals in all pharmacy environments (PBM, retail, LTC, infusion, research, and hospital settings). Maintain schedule of temp staff across many markets. Ensure positive end to end candidate experience. Build and maintain relationships with hiring leaders. Attract new talent through referrals, social media, job boards, e-mail, mail and telemarketing campaigns.Project Manager / System Administrator - Maintain and oversee development of the Salesforce CRM platform. Expanded CRM platform to be used as applicant tracking system and for human resource management.. Conceptualize, plan, and complete projects including programming applications. Planning and launching telemarketing, mail, and e-mail campaigns. Maintaining database of contracts, contractors, leads, applicants, and clients. Perform daily back ups.Director of Marketing - Maintain a company presence on social media sites including, but not limited to, Facebook, Twitter, and LinkedIn. Train marketers to cold call pharmacies to explain and offer staffing services. Negotiate contract terms. Solicit and fulfill needs of new and preexisting clients. Research and set local salary and contract rates for pharmacy professionals.* Lowered operational costs by performing desktop support, developing the applicant tracking system, developing scheduling system, and training teammates on best practices.* Increased hours booked by 117% for 2012 over 2011 along with increased direct placements.* Opened business in 15 new markets, built marketing campaigns and and supported new contracts
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Advisor - Clinical Client OperationsCvs Health Sep 2014 - Nov 2015Advised as a clinical and benefits SME on digitalizing a paper clinical program management form Developed automation to load Medicare D prescription benefit plans into RxClaim at 99.99% accuracy Oversaw formulary and UM projects related to Medicare Part D and Healthcare Exchanges -
Sr. Consultant - Clinical Client OperationsCvs Health Oct 2013 - Sep 2014Irving, TxPerformed platform to platform migrations for prescription drug plans (QL to RxClaim) Acted as Benefits Advisor on first fully implemented Healthcare Exchange plan with new client Collaborated with clients and internal partners to build Med D and Exchange PBPs -
Client Benefits Analyst - Medicare Part DCvs Health Aug 2012 - Oct 2013Irving, TxWork with internal and external partners to interpret client intent from prescription benefit requests. Determine the best operational approach and code the benefits inside of RxClaim (AS/400). Develop and carry out test scenarios. Build and run queries to track and validate changes. Understand and apply the laws, rules, and regulations surrounding Medicare Part D to all prescription plan benefit requests. Pull and analyze claims data for financial or access to care issues resulting from benefits setup issues or system defects. On-board and implement new clients as part of the implementations team.*Received Advanced Medicare Part D Certification -
Laptop EngineerWistron Nov 2009 - Jul 2010Grapevine, TxDiagnosed and corrected software, hardware, and customer errors for Lenovo and HP including but not limited to: Reimaging, flashing BIOS, software installation, software removal, adjusting settings, casing and hardware replacement. Recognized, documented, and proved cases of customer induced damage that voided warranties - completed repairs if the customer approved payment.Mentored new technicians in proper troubleshooting and part replacement procedures.* Maintained quality rate at 95%* Completed 100% of my repairs within the expected turn-around time. -
Assistant ManagerSubway Sep 2004 - Sep 2006Clyde, OhioAchieved high productivity and low food cost. Ran daily reports and balanced a daily cash sheet. Made safe deposits. Maintained inventory and placed weekly orders. Trained new team members.* Improved the productivity of my location to become the best regionally and competitive nationally.
Thomas Leiter Education Details
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Health Informatics -
Computer Science -
Computer Science -
Chs
Frequently Asked Questions about Thomas Leiter
What company does Thomas Leiter work for?
Thomas Leiter works for Holmes Murphy
What is Thomas Leiter's role at the current company?
Thomas Leiter's current role is Pharmacy benefit management and payer SME with 10+ years experience | Excel and Access guru | Java SE 17 Developer Certification in progress.
What schools did Thomas Leiter attend?
Thomas Leiter attended Western Governors University, Kent State University, Terra State Community College, Chs.
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