DAVID BISSER
Phoenix,AZ
Summary
Senior healthcare services leader with 27 years of experience in pharmacy benefit management (PBM), health plan operations, and government programs (Medicare Part D, Medicaid, ACA/Exchange). Proven leader of large teams and complex operations with deep expertise in compliance, client engagement, and strategic growth. Recognized for building strong partnerships, driving operational excellence, and delivering innovative solutions that meet regulatory requirements and enhance Health Plan client results.
Overview
31
31
years of professional experience
Work History
Senior Director, Government Programs
Navitus Health Solutions
04.2023 - Current
- Managed Medicare, Medicaid, and ACA regulatory compliance operations, leading team of 50+ associates and supervising six direct reports.
- Support compliance with federal and state regulations via oversight and monitoring; audit support and readiness (e.g., CMS program audits, Medicaid state and client oversight audits).
- Spearheaded implementation of Inflation Reduction Act (IRA) Medicare Part D and M3P provisions, executing end-to-end testing for strategic clients.
- Partnered with sales team to develop RFP positioning, execute competitive analysis, and shape finalist strategy for new business growth.
- Collaborate with internal subject matter experts to optimize existing processes, resolve client issue escalations, and execute new client implementations effectively.
- Managed department budget, staffing, and annual training curriculum while mentoring and developing future leaders.
Director, Government Pharmacy Operations – Regulatory Support
Cigna Corporation
11.2018 - 04.2023
- Directed a team of 19 colleagues supporting government pharmacy operations with focus on compliance, reliability, and audit performance.
- Led all PBM-related audits, including CMS Program Audits, EGWP client audits, and Sarbanes-Oxley financial reviews.
- Built compliance programs by improving cross-functional processes, managing issues/risks, and driving corrective action plans.
- Oversaw grievance resolution, drug recall notifications, and emergency member access to benefits.
- Negotiated PBM Service Level Agreements and represented Pharmacy Ops across corporate compliance forums and initiatives.
Director, Government Services & Operations Excellence
CVS Health Corporation
01.2003 - 01.2018
- Directed teams of subject matter experts supporting Medicare and Medicaid client implementations, compliance, and issue resolution.
- Partnered with large health plan clients to ensure operational compliance and high-quality service delivery.
- Managed end-to-end product implementations for PBM innovations, including diabetes program rollouts and network transitions.
- Resolved high-risk Medicare and Medicaid claims issues; led remediation projects to maintain CMS compliance.
- Earlier roles: Executive Advisor, Business Advisor (Client Operations & Account Management), Senior Implementation Analyst, Credit Supervisor.
Regional Credit Manager
Cardinal Health
01.1998 - 01.2003
- Managed credit/collections team overseeing $25M A/R portfolio for hospitals and pharmacies across multiple regions.
Assistant Collection Manager / Management Trainee
Associates First Capital (now Citi)
01.1996 - 01.1998
Education
Bachelor of Science - Finance
Bradley University
Peoria, IL05.1996
Skills
- PBM & Health Plan Operations Government Program Compliance
- Regulatory Oversight & Audit Readiness (CMS, Medicaid, ACA)
- Client Engagement & RFP Strategy
- Issue & Risk Management
- Financial & Project Management Large-Scale Implementations
- Executive Leadership & Staff Development Cross-Functional Collaboration
Timeline
Senior Director, Government Programs
Navitus Health Solutions
04.2023 - Current
Director, Government Pharmacy Operations – Regulatory Support
Cigna Corporation
11.2018 - 04.2023
Director, Government Services & Operations Excellence
CVS Health Corporation
01.2003 - 01.2018
Regional Credit Manager
Cardinal Health
01.1998 - 01.2003
Assistant Collection Manager / Management Trainee
Associates First Capital (now Citi)
01.1996 - 01.1998
Bachelor of Science - Finance
Bradley University