7 Health Plan Relationships
Relationship builder leading total cost of care and cost-offset model discussions across seven major health plans, with practice-side formulary education and prior authorization redesign.
$2M+ Pharmacy Utilization Management Program
Drove contract negotiations for GLP-1 prescription reduction goal. Achieved goal of 5% reduction in utilization with $2M+ saved in drug costs and improvements in payer-studied A1C cohort.
$236K Saved in Polypharmacy Outreach
Remaining 44% of Opportunity Addressed with Policy Change
Validated $236,152 in combined savings from October 2023 to March 2024 across 40 provider interventions, representing 56% of the total opportunity. Recognizing the remaining 44% was slipping through, I advocated upstream to embed the fix at the prior authorization level, addressing the gap before prescriptions are ever filled. The proactive process now captures what manual outreach could not.
Operational Oversight of 60+ Clinics
500K+ Members
Clinical protocols and educational resources deployed across 60+ Florida clinics, adopted as standard onboarding materials for all new providers and cross-functional teams across a 500,000+ member population, with continued expansion into the UnitedHealthcare market in Texas.