Ashley Manfredo

Responsible for leading company strategy to increase sales and exceed revenue and gross profit goals. This is achieved by maintaining and expanding existing payor accounts, while cultivating new payor opportunities and building partnerships. Providing direction in end to end process of negotiations, implementation and client management by analyzing financial models by payor by medication and identifying risk. Continue payor management by scheduling, creating and leading quarterly business reviews. Lead Payor Solution team to be motivated and productive producing high quality outcomes. Develop high-performing Payor Solution Team by providing mentorship, guidance, and opportunities for professional growth. Assist Payor Solution Team in resolving billing, operational and network issues with individual payors. Manage payor requirements of ongoing credentialing responsibilities and record retention. Oversee continued development of CRM tool for easy organization of contracts and payors PDL.

Assisted sales team in reviewing and delegating responsibilities for RFP/RFIs, as well as updating sales presentations as needed. Provided sales team with communication of new drugs launches to key payer partners, as well as manages medication access inquires. Lead meetings with Leadership and Finance to review financial models regarding medication pricing requests, new/existing medications, and client opportunities. Ensured signed executed client contracts are communicated to necessary internal and external personnel. Assisted with completion and maintenance of clients preferred drug list (PDL) and distribute to appropriate internal parties. Sent required reporting to clients in designated timing per contraction requirements, including creation of QBRs.

Assisted with operation management of end-to-end procedures that support both existing and new payer contracts for CareMed. Cross-functional project management: work with all collaborating Pharmacy Operations, Sales, Marketing and Billing teams to ensure seamless execution for new contract launches and support post-launch. Lead and conduct ongoing team meetings with cross-functional team leads as they pertain to assigned projects and contract rollouts. Served as account manager for contracted managed care plans: adhere to key support requirements of programs such as issue resolution with 24 hours and hosting and participating in meetings as needed. Supported payer sales team with RFP response, sales presentations, contract performance guarantees and customer troubleshooting. Facilitated pricing negotiations for new to market medications, as well as assist in re-negotiations of currently contracted medications.

Lead, support, and mentor Contracting Payer Relations team members in all their duties & responsibilities. Responsible for development, negotiating and maintaining of contracting strategy for organization in conjunction with sales. In conjunction with sales, establish, own & maintain relationships with PBMs/payers and health plans for purposes of pre-launch contracting & various levels of access. Assisted in creation of product and patient agreements for direct contracting with all major PBMs/health plans nationwide. Facilitated network development in support of strategic goals and directives from Executive Leadership. Analyzed and executed contracts with various business partners including payer & pharmaceutical/biotech organizations. Assisted in training team to utilize contract databases/listings/spreadsheets and ensure up to date correspondence/amendments are loaded to files. Reviewed and support execution of contracting process by reviewing contracts and addendums, compare payment/fee schedules, partner follow-ups, and obtain required signatures. Assisted with payor team with resolution of operational, billing, and credentialing issues.