Summary
Overview
Work History
Education
Skills
Websites
Timeline
Generic

Jamie Lynch

Orlando

Summary

Dynamic leader with a strategic mindset in health insurance and a forward-thinking small business entrepreneur. Renowned for expertise in product strategy, general management, and business development. Recognized as a subject matter expert in medical specialty drug and pharmacy benefit management. Proven track record of establishing a vision and guiding diverse, cross-functional teams to meet ambitious objectives. Focused on driving revenue growth and enhance profitability for health plans.

Results-driven leader with strong background in strategic management and organizational growth. Skilled in developing and implementing effective business strategies, optimizing processes, and driving team performance. Known for adaptability, effective collaboration, and delivering measurable outcomes in dynamic environments. Strong communication and problem-solving abilities, coupled with focus on fostering productive and positive team culture.

Overview

18
18
years of professional experience

Work History

DIRECTOR – Medical Product Strategy

CIGNA
03.2023 - Current
  • Lead and drive the go-to-market strategy for Cigna’s innovative medical specialty drug solutions to meet market and customer needs
  • Develop product roadmap and communicate progress against goals to executive leadership
  • Manage a group of skilled product development professionals responsible for delivering and maintaining a $65M enterprise project across 7.1 million enrolled commercial lives
  • Acknowledged as a subject matter expert, engaging with clients and brokers nationwide to support Sales teams in the U3K and O3K commercial segments
  • Achieved successful product adoption results through close collaboration with the sales teams.
  • Execute medical specialty drug monetization strategy to capture the market value generated and generate enterprise revenue.
  • Create effective marketing materials to attract new client enrollment
  • Launch a range of client reporting tools to showcase operational and financial performance
  • Collaborated with Sales, Marketing, Clinical, Underwriting, Finance, Actuary, Legal, Communications, IT, Networks, and Project Management teams to enhance solutions and launch new products in the market.
  • Drive RFP content as part of enterprise standards
  • Strengthen client and broker relationships by providing exceptional account management and support
  • Manage client benefit customization process for improved efficiency and retention

SR MANAGER – Pharmacy Product Strategy

CIGNA
01.2016 - 01.2023
  • Launch Commercial product solution roadmap that facilitates growth within our existing business and expansion thru new business
  • Developed innovative solutions for complex business challenges, enhancing operational efficiency.
  • Subject matter expert for Pharmacy benefit and network design defining concept, solution, and rollout strategy
  • Accomplishments include the industry leading Patient Assurance Program (PAP) for diabetes, Generic Optimization programs, and the Clinical Day Supply Program for specialty drugs
  • Strategically lead/ design enterprise thinking on medical and pharmacy solutions across current and future offerings
  • Provide the SME support, strategic guidance, and oversight to stand-up, often massively complex, net new product solutions
  • Govern client exception customizations, including specialized network solutions, with the end goal of driving more flexibility for our clients and customers, while also driving earnings for the enterprise
  • Identify trends in the market and make informed decisions on next product development or enhancement
  • Led cross-functional teams to achieve project milestones and deliver high-quality results.
  • Improved team performance by providing comprehensive training and fostering a collaborative work environment.
  • Promoted a culture of accountability and excellence to exceed performance targets.
  • Conducted performance evaluations to identify areas for improvement and professional development.

PRODUCT LEAD – Pharmacy Agile Delivery

CIGNA
01.2014 - 01.2016
  • Business/process consultation to key pharmacy business unit and IT stakeholders through all phases of work
  • Primary deliverable was create the foundational build for the Health Plan’s new product benefits book of record system
  • Document business requirements and translating them into a clearly defined project scope of work
  • Guide business stakeholders across Product organization to make key business decisions and prioritize work
  • Create program Epics and user stories based on defined capabilities, requirements and designs
  • Drive discussions around feasibility of solution to support scope/requirements within the project timeframe
  • Engage all stakeholders to prioritize epics for release planning with the input of Business SMEs / Product Owners

PRODUCT MANAGER - Pharmacy PBM

INDEPENDENCE BLUE CROSS
01.2012 - 01.2014
  • Responsible for the overall program management of ancillary benefits for pharmacy across multiple Sales segments including individual consumer, small group, and large group markets
  • Oversight and coordination with cross-functional teams including Legal, Vendors, Sales, Product Development, and Finance in order to develop and execute health care compliant pharmacy benefit plans
  • Responsible for ensuring all plan designs comply with the most recent State Mandated and HealthCare Reform requirements, including the Affordable Care Act (ACA)
  • Business lead and subject matter expert for multiple projects including Preventive Care, Woman’s Preventive Health, Total Max out of Pocket, and Summary of Benefits (SBC)
  • Accountable for defining, developing, and executing plans for Retail and Private Exchange Platforms for Individual and Small Group plans
  • Successfully implemented 2014 Retail Exchange plans on Pennsylvania state marketplace; submitted 2015 Retail Exchange plans utilizing CMS tools, forms, and services
  • In-depth knowledge of CMS guidelines for plan design requirements and submissions
  • Pharmacy template owner responsible for completion and submission of plans to CMS via HIOS online tool
  • Successfully implemented 2014 Private Exchange plans for client with 50,000 plus lives
  • Vendor oversight to ensure timely and accurate execution of plan designs
  • Collaborative partner and business owner of all pharmacy product related collateral directed toward Brokers, Members, Consumers Brochures, and other external audience’s best suited to promote and sell the company products
  • Design and implement Marketplace Alerts to communicate changes and strategic product initiatives to Sales and Brokers
  • Create job aids and flyers to support Sales with obtaining new accounts and retaining key accounts
  • Business lead for major migration of corporate systems platform
  • Successfully transitioned 900 plus unique pharmacy benefit plans to new pharmacy claims adjudication environment
  • Managed efforts with Pharmacy Benefit Manager to ensure claims history and prior authorizations migrated with membership to ensure no disruption
  • Migration of 1 million plus pharmacy members to new corporate enrollment system
  • Serve as internal resources for sales and brokers for day-to-day handling and response to benefit issues including benefit design, enrollment, claims, and client specific benefit plans/programs
  • Pharmacy product liaison and vendor oversight manager

MANAGER - Implementations

INDEPENDENCE BLUE CROSS/FUTURESCRIPTS PBM
01.2007 - 01.2012
  • Manage benefit exception inquiries for all lines of business, including Commercial, TPA, and Med D plans and claims processing vendor
  • Led a diverse team of professionals in successfully completing complex implementations on time and within budget constraints.
  • Acted as the face out to the client while providing a direct high-level liaison to the PBM for FutureScripts’ largest commercial account
  • Implemented continuous improvement initiatives and best practives that resulted in increased efficiency across various stages of the implementation process.
  • Designed various client-friendly templates, including an Rx Plan Design Guide and custom pricing forms, which documented all aspects of the benefit plan to ensure documentation of client requirements
  • Managed internal project task force consisting of 10-20 Future Scripts employees of all levels as well representatives from external business support areas
  • Implemented HealthCare Reform Programs including the Affordable Care Act of 2010
  • Launched the PBM’s first Value Based benefit plan for large self-funded health plan clients and established the program protocols, processes and guidelines
  • Successfully transitioned pharmacy benefits for over 300,000 + members within 3 years
  • Successfully executed the implementation of Future Scripts’ first direct sale customer
  • Managed multiple simultaneous implementations with minimal supervision, demonstrating strong organizational skills and adaptability.
  • Presented project updates to senior leadership, highlighting successes and addressing challenges with proposed solutions, ensuring ongoing support for the implementation team''s efforts.
  • Established effective communication channels between internal teams and external clients to facilitate smooth project execution.

Education

Master’s Degree - Biomedical Science/Organizational Leadership & Development

Philadelphia College of Osteopathic Medicine (PCOM)
Philadelphia, PA
01.2005

Bachelor’s Degree - Biology/Psychology/Pre-Med

LaSalle University
Philadelphia, PA
01.2002

Skills

  • Medical Specialty Drugs
  • Product Strategy
  • Product Development
  • Medical Benefits & Coverage
  • Sales & Account Management
  • Vendor Management
  • Project Management
  • Public Speaking
  • Pharmacy Benefits Management
  • Process Improvement
  • Training and development
  • Compliance & State Filing
  • Microsoft Office
  • Excel
  • Word
  • PowerPoint
  • PBM
  • Claims processing systems
  • ARGUS
  • DST
  • ESI
  • Agile methodology
  • CMS HIOS system application
  • Strategic planning
  • Budget management
  • Team leadership
  • Project oversight

Timeline

DIRECTOR – Medical Product Strategy

CIGNA
03.2023 - Current

SR MANAGER – Pharmacy Product Strategy

CIGNA
01.2016 - 01.2023

PRODUCT LEAD – Pharmacy Agile Delivery

CIGNA
01.2014 - 01.2016

PRODUCT MANAGER - Pharmacy PBM

INDEPENDENCE BLUE CROSS
01.2012 - 01.2014

MANAGER - Implementations

INDEPENDENCE BLUE CROSS/FUTURESCRIPTS PBM
01.2007 - 01.2012

Bachelor’s Degree - Biology/Psychology/Pre-Med

LaSalle University

Master’s Degree - Biomedical Science/Organizational Leadership & Development

Philadelphia College of Osteopathic Medicine (PCOM)

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Jamie Lynch