Paragon Healthcare, Inc.

VP, Payer Relations and Strategy

Kroger Health

Lead third party contracting strategies for Kroger specialty pharmacy, infusion pharmacy, ambulatory infusion suite, 340b program, Kroger clinics, retail and mail order.  With over 2,300 pharmacies and 9 specialty pharmacies nationwide and 200 clinics our team of 22,000 healthcare professionals from pharmacists, nurse practitioners, dietitians and technicians serve over 13 million customers.

Responsible for gaining opportunities through lead generation, relationship building, capture, contract signature, initial oversight, implementation and transitioning to operations.

Inform third party, pharmaceutical companies, hospital systems, consultants, brokers, TPAs, states and other municipalities on the value proposition of Kroger Health while building rapport and solution to meet their needs. 

Work on RFPs, bids, pricing, business submission for completeness, accuracy and market competitiveness to maximize revenue, gross profit and margin. 

Consult with PBMs on benefit designs by adding medical specialty as an offering to their business model.    

Strategize the identification, recommendation and execution of product and service enhancements that would create opportunities, market disruption and drive sales to maximize profit.

Vice President Contracting and Market Access

Kroger Specialty Pharmacy

Lead strategy for Kroger Specialty Infusion including operations, clinical, sales, pharma-trade relationships, procurement, compliance, quality, training, business development and implementation.  

Serve as the subject matter expert in pharmacy enterprise, providing information, recommendations based on evidence-based literature, compliance, regulations, data analysis and leading practice within specialty pharmacy.    

Build a national specialty infusion pharmacy post M&A to achieve operating and clinical excellence in medication therapy management

Full P&L responsibility including forecast and budget for multiple sites across the country.      

Responsible for the oversight, direction, and relationship with pharmaceutical manufacturer and GPOs for market access and LDD opportunities.

SVP, Kroger Specialty Infusion

Walgreens

Led and managed all areas of a 1.6-billion-dollar Specialty Pharmacy business.  Responsible for clinical programs, centers of excellence and service standards to meet the goals established by Walgreens, URAC, ACHC, VIPPS and regulations governing the Healthcare industry.  Exceeded quarterly and annual established revenue growth, cash flow and profit contribution goals while delivering a high degree of customer/patient satisfaction.  Participated in Managed Market Access Meetings in the development of Care plans and Programs while managing Performance Guarantees.  Exceeded goals for access to Limited Distribution Drugs (LDD) while participating in Quarterly Business Reviews with Pharmaceutical companies.  Onboarded and launched ‘BCBS  FEP' (Federal Employee Program) consisting of an annual 500K annual specialty prescriptions.  Performed Business Process Improvement while launching BCBS of TX, OK and NM.  Worked closely with executive leadership between Walgreens Boots Alliance and Prime Therapeutics to form ‘Alliance Rx Walgreens + Prime’.  Provided Growth and Development to a team of 325 team members with 8 Direct Reports while creating a team environment of care, trust, respect, empathy and accessibility.

General Manager -Walgreens Specialty Pharmacy

Option Care Health

Responsible for leading and executing all financial services, operational excellence and clinical programs designed to improve key quality measurements for Walgreens/Option Care Specialty Home Infusion Pharmacy.  Responsible for total annual budget, including forecasting of sales volume, expenses, annual payroll and SG&A budget.  Increase EBIDTA from 1.9% to ~10% and reduce Bad Debt from 5% to <1% for total book of business.  Work closely with internal and external teams to excel in all areas with accountability to clinical services, sales, performance, customer satisfaction and financial performance.  Work with marketing and managed care team to bring products and programs to C-Suite including Makena, IVIG, Factor, Gattex, TPN, inotropic therapies, transplant services and 340B Program.  Presented to C-Suite to upsell our offering and available therapies to hospital systems, VA and long-term care to decrease length of stay and prevent readmissions.  Create a strategic partnership within Walgreens Retail Pharmacies and Walgreens Specialty Pharmacies to drive access and market share to Walgreens Infusion Services.  Experience negotiating with outside vendors, including negotiating contracts, prices, resolving service issues and reconciling differences.  Maintain ACHC, URAC standards while adhering to Walgreens Policies and Procedures.

General Manager

Elevance Health

Provide management of Anthem’s clinical product offerings to support operational initiatives.  Act as the interface between Anthem/Amerigroup and CVS Caremark our PBM to manage and deliver pharmacy information, cost/trend detail and strategies.  Assist in the expansion of Prior Authorizations and clinical activities within Anthem/Amerigroup while reducing costs and increasing the provision of quality care to members.  Perform monthly pharmaceutical cost analysis to identify savings opportunities based on formulary management.  Establish collaborative relationships with external and internal stakeholders to gather accurate requirements and evaluate product performance.  Support the development of market and sales strategies and value proposition.  Navigate multiple cross functional teams in a complex, matrix work environment within Anthem/Amerigroup business units.

Director of Clinical Operations

Magellan Health Services

Drive clinical performance and strategic operations of a $400-million business unit of Magellan Rx       Specialty Pharmacy Services.  Work with C-Suite, executives, national/regional account managers, managed care liaisons, MSLs, wholesalers and suppliers to drive contracts, penetrate new business opportunities, GPO enrollment, lower price negotiations, formulary access and rebate management.  Partner with pharmaceutical companies and managed care to maximize revenue and drive market share  while managing the complexity of specialty prescriptions, REMS programs and Medical Pharmacy.  Work on RFPs and RFIs to add value and reduce cost to Magellan Health Service and stakeholders.  Work on inventory conversion from Cardinal to Amerisource Bergen and software synchronization to   CPR+ Specialty Pharmacy Software.  Work with PBMs on Drug Utilization Reviews (DUR), claims adjudication/processing, audits and data integration while ensuring financial and clinical goals are met or exceeded.  Work on the development and execution of a Prior Authorization Program used to issue PAs for managed care companies to enhance their clinical outcome and drive cost savings.  Work with Medical Directors and KOLs to promote the education of clinical therapeutics and Medication Therapy Management (MTM) regarding specialty medications.  Work with commercial plans, Medicare Part B, Medicare Part D, PBMs and Medicaid to evaluate and analyze pharmacy cost of care, trend management and recommend improvements.  Develop and implement standard operating/clinical policies and procedures to acquire and maintain U.R.A C. accreditation.

Director, Pharmacy Operations, Pharm.D

Promoted to Director of Pharmacy Operations.  Perform client facing and site visits to enhance Magellan’s clinical portfolio while understanding customer’s processes to drive business collaboration.  Partner with customers P&T team to interpret clinical data from a P&T perspective to drive operational partnership within Magellan.  Provide leadership in the management of clinical products while working with Pharmaceutical partners, KOL, MDs, MSLs, NPs, RNs to create therapeutic simulation to drive clinical outcomes.  Supervise tasks of Clinical Team which consists of Pharmacists, Nurses, Pharmacy Technicians and Medical Assistants.  Work directly across multiple departments and cross functional teams to design, develop and drive successful deployment of new and enhanced programs and services.  Improve efficiency by establishing company’s guidelines, developing standard clinical operating procedures and workflow for team members.  Experience conducting clinical research and market competitive intelligence analysis.  Clinically research information and provide timely feedback to requests for drug information.

Manager, Pharmacy Clinical Operations

Review and verify patients’ oncology and specialty medication orders and documents.
Compound chemotherapy, specialty and supportive medications in a USP 797 compliant IV room
Process and check medications and supplies prior to compounding and dispensing from the pharmacy.  Communicate with physician’s office, clinics and hospitals as related to prescription orders, DUR and MTM.

Specialty Oncology Pharmacist

Montefiore Medical Center

Work in various settings of a 726-bed hospital including oncology, pediatrics, geriatrics, respiratory, neurology, family medicine, transplant, intensive/critical care units, emergency room, compounding area and IV Room.  Work in various settings of a 106 bed children’s hospital including oncology, neurology, epilepsy, cardiovascular, family medicine, transplant, NICU and IV Room.  Work with the administrative team to follow all applicable guidelines and formulary set by the department and hospital P&T Committee.  Participate in Risk Management consultation and analysis with appropriate administrative personnel and Medical Directors.  Work with D.O.P and management team to prepare and exceed JCHAO and regulatory standards.  Compounded various extemporaneous and IV medications and prepare sterile admixtures that are not commercially available for pediatric and adult patients in a USP 797 compliant room.

Clinical Pharmacist

CVS Caremark Corporation

Responsible for all aspects of Pharmacy Operations including inventory, personnel and an emphasis on patient/customer satisfaction.  Consult with physicians and healthcare team members on medical dosage, drug interactions and duplicate therapy.  Prepare prescriptions to meet diverse needs of patients and customers.  Counsel and communicate with customers/patients while following HIPAA guidelines.

Supervising Pharmacist

Filled prescriptions for pharmacist to check and counseled patients under pharmacist supervision

Pharmacy Intern/Technician

Experienced and passionate leader within the healthcare industry.  Skilled in leading enterprise strategy, business development, market access, growth opportunities, profitability, clinical programs, value-based care with managed care, PBMs, brokers, Medicare, Medicaid, government payers, pharma manufacturers, GPOs, KOLs through relationships, negotiations, contracting and implementation.   

I’m adept at leading enterprise multisite operations with P&L responsibilities while developing highly skilled cross functional teams, collaborating with internal and external stakeholders to exceed business, customer, and client expectations.

Doctor of Pharmacy (Pharm.D.) from The University of Kansas and a Bachelors of Pharmacy from St. John's University

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