Dynamic Pharmacy Payer Relations Manager with extensive experience at Walmart Inc. Skilled in negotiation and contract management, fostering strategic partnerships to enhance operational efficiency across all channels.
Overview
5
5
years of professional experience
Work History
Pharmacy Payer Relations Manager 2
Walmart Inc.
11.2022 - Current
Oversaw 14 payer accounts, driving ~$105 million in annual net sales across commercial, Medicare, and Medicaid sectors.
Negotiated pricing for COVID-19 vaccines and therapeutics on behalf of Walmart, enhancing access to essential healthcare resources.
Established pharmacy agreements with commercial and Medicaid plans in Puerto Rico, expanding service capabilities in the region.
Negotiated Workers' Compensation plans, employing a "lesser of" logic to include state-mandated and jurisdictional fee schedules, ensuring compliance and cost-effectiveness.
Served as a Subject Matter Expert (SME) on specialty and mail order offerings, contractual obligations, procedures, and capabilities, providing guidance and expertise across departments.
Coordinated cross-functional teams to prioritize and resolve incoming requests, ensuring compliance with contractual deadlines and maintaining strong partnerships.
Developed a financial modeling tool currently utilized by the finance department to determine specialty drug pricing and total contract value based on member volumes, geographic locations, and drug utilization patterns.
Cannon Crewmember
Army National Guard
11.2019 - 03.2024
Served as primary driver and number one crewman for the M119 Howitzer, ensuring tactical precision and readiness.
Maintained military equipment, ensuring operational efficiency and adherence to readiness standards.
Awarded for exemplary performance during Joint Readiness Training Center (JRTC) exercises.
Maintained high physical fitness standards while demonstrating discipline and dedication.
Account and Implementation Manager
Walmart Inc.
08.2020 - 11.2022
Led the strategic implementation of six partnerships across Specialty, Mail Order, and Retail pharmacy domains, ensuring alignment with business objectives and operational excellence.
Developed comprehensive project timelines and orchestrated collaboration sessions to achieve seamless onboarding and integration processes within stipulated deadlines.
Formulated and codified Standard Operating Procedures (SOPs) to enhance process workflows, optimize performance metrics, and expand service offerings related to infusion therapies.
Spearheaded the creation of Walmart's RFP library, consolidating over 1,000 responses to streamline the proposal process, ensuring readiness for competitive bidding scenarios.
Established a robust annual review process for the RFP library, guaranteeing data integrity and facilitating optimal decision-making for future proposals.
Account Management
Designed and implemented workflows to guarantee compliance with contractual obligations while enhancing reporting efficiency and transparency.
Engaged with senior stakeholders from Walmart's top specialty and mail order partners to analyze performance metrics and drive continuous improvement initiatives.
Leveraged data analytics tools such as Tableau, Asembia1, and Connexus to generate in-depth performance reports for Performance Guarantees and Service Level Agreements, informing key strategic decisions.
Collaborated with DocuSign to innovate a patient consent form, significantly improving the member experience within Walmart's Mail Order Pharmacy.
Optimized incident management processes within Walmart's SOPs to ensure effective tracking and reporting of adverse events, dispensing inaccuracies, and shipping escalations.
Oversaw complex member escalations, implementing strategic solutions to resolve issues in specialty and mail order segments effectively.
Proactively communicated critical updates to partners regarding escalated incidents, system outages, and operational challenges, maintaining transparency and fostering collaboration.
Education
Master of Science - Management
Southern Illiinois University
Carbondale
2013
Skills
Key Skills
Pharmacy Payer Negotiation & Contract Management
Program Design & Assessment
Clinical Outcome Reporting
P&L Management & Data Analytics Reporting
Performance Guarantees and Quarterly Business Reviews