Rebecca Hohensee
Merrill,USA
Summary
Results-driven Sr Director at RxBenefits with a strong focus on PBM pricing models and optimizing client profitability. Successfully led cross-functional teams to implement technology-driven solutions, significantly improving pharmacy benefits and increasing client satisfaction. Demonstrated expertise in consultative engagements and strategic financial insights, contributing to substantial wallet share growth. Proficient in leading discussions with C-suite executives and delivering compelling presentations.
Overview
20
20
years of professional experience
Work History
Sr Director, Account Management
RxBenefits
Birmingham, AL
03.2019 - Current
- Leads and support 3 regional teams (135 employees, SAEs, AMs, Managers, Directors) to help direct our client's decision to choose the right PBM based on technology-enabled pharmacy consulting solutions
- Work with executive leadership to manage the annual budget, staffing, and operational needs for the organization
- Support key clients to optimize the value of pharmacy benefits through transparency, accountability, and advanced data analytics, paired with deep insider expertise
- Focused on helping to minimize drug spending while maximizing patient health outcomes and satisfaction
- Support and manage multiple high-profile team clients, including National, Regional, Hospital and Strategic Market
- Support as Executive Sponsor to key client success strategy through client success plan, and client quarterly business review process
- Work collaboratively with all departments to develop, implement, and execute the Customer Service framework
- Directed the design of data analytics solutions for complex business challenges
Director of Account Management and Sales
HDI Solutions, LLC
Auburn, AL
06.2014 - 03.2019
- Responsible for the management of State, Commercial, TPA, Medicare, and Medicaid client accounts
- Proficient in contract management (proposals, statements of work, programming documentation)
- Manage expectations internally and externally to represent client requests for product development enhancements, as well as custom needs by individual client solutions.
- Upsell, cross-sell, and promote new product enhancements to current and future customers
- High-profile client base of 30,000 to 1.8 million member lives
- Implemented and upsold letter print and mail service.
- Grew wallet share to $900k from 2015 to 2018
- Successfully implemented and upsold business process outsourced services to software-as-a-service (SaaS) clients
- Grew wallet share to $6.4 million from 2015 to 2017
- Successfully upsold a product enhancement opportunity
- Grew wallet share to $2.2 million from 2015 to 2018
- Secured new business through marketing, and effective product and service expansion
- Grew the company size of 113 call center staff and clinical staff to support new business growth
- Successfully manage state and government regulatory audits, NCQA, CMS, and URAC accreditation standards
- Develop and monitor client financial performance, including renewal planning, negotiation, and profitability levels
Client Relationship Manager
OptumRx
Wausau, WI
04.2011 - 06.2014
- Responsible for the overall management of a book of national accounts
- Directly work with clients, brokers, and consultants, providing extensive operational and client-sensitive support to ensure pharmacy claims are adjudicated according to the plan's intent
- Complete data analysis to improve benefits or initiate an upsell on a better product or service
- Maintain a high level of healthcare industry knowledge, as well as the customer's industry
- Successfully implemented multiple new Direct-to-PBM clients
- Identified new business opportunities through research and analysis of client needs
- Maintained accurate records of client interactions and transactions
Client Service Consultant
UMR (United Healthcare)
Wausau, WI
06.2008 - 04.2011
- Primary point of contact for day-to-day operational needs for multiple large employer groups
- Responsibilities include a strong knowledge of the CPS Claim System, implementation, and assisting clients in all aspects of problem-solving to fully support the company's decision to pay medical claims and provide excellent customer service based on the client's intent
- Responsible for the successful implementation of multiple new clients
- Responsible for planning, building strategy for on-site medical facilities ‘minute clinics’ for employer/employee health and wellness
- Engaged with clinical to build out successful care management employer plan strategies for diabetes, prenatal, mental health and preventative care
Medical Claim Supervisor
UMR (United Healthcare)
Wausau, WI
03.2005 - 06.2008
- Lead a group of 36 individuals, providing support in all aspects of claim processing, plan benefit training, and customer service, as well as providing performance appraisals for each employee
- Assist with the workflow of the Claims Department, successfully implementing six new process improvements, testing through pilots within my team
- Update payroll time records for the Claims Department
- Prepare Claims Production Analysis Reports
- Review all written referrals from the Claims Examiners
- Participate in the hiring and interviewing process
- Review and adjudication of medical claims based on policy provisions
- Supervised and monitored daily activities of the medical claims department staff to ensure accurate and timely processing of all claims
- Analyzed, reviewed, and processed complex medical insurance claims according to established policies and procedures
- Investigated discrepancies in patient accounts, identified errors or omissions, and took corrective action to resolve issues
- Train new staff on medical claim processing systems, policies, and procedures
Education
Bachelor of Science - Healthcare Management
Rasmussen College
Skills
- C-Suite relationship management and the ability to lead innovative, forward-thinking discussions
- Experienced and highly competent in understanding PBM pricing and contracting models
- Experienced and demonstrated success in owning and managing client profitability profiles
- Extensive consultative client engagement with high-profile health plan clients
- Experienced in working with sales teams and support areas to complete Requests for Proposals (RFPs) and finalist presentations
- Strategic Financial Recommendations
- Contract Interpretation Expertise
- Extensive experience developing and delivering formal presentations to message and position information for maximum customer impact and influence
Timeline
Sr Director, Account Management
RxBenefits
03.2019 - Current
Director of Account Management and Sales
HDI Solutions, LLC
06.2014 - 03.2019
Client Relationship Manager
OptumRx
04.2011 - 06.2014
Client Service Consultant
UMR (United Healthcare)
06.2008 - 04.2011
Medical Claim Supervisor
UMR (United Healthcare)
03.2005 - 06.2008
Bachelor of Science - Healthcare Management
Rasmussen College
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