Industry-leading expert with over 10 years of managed care experience in strategy, sales and account management, and program development and implementation with a focus on the commercial book of business.

Expert with broad and deep experience in drug benefit management for health plans at regional and national levels, providing a big-picture approach to payer strategy across a number of disciplines. Recognized leader across all lines of commercial and Medicare business, with particular focus in trend management, trade relations, specialty utilization, and formulary design.

Marketing maverick with B2B and B2C experience that has spanned start-ups and Fortune 25 companies, traditional, direct, and digital advertising agencies. Recognized throughout his career for producing award-winning work that delivers business results for pharmaceutical, healthcare, and consumer brands.

Former active-duty Army Pharmacy Officer with hands-on expertise in both commercial and government (Medicare Part D, Medicaid, and VA/DoD) pharmacy benefit management. Deep knowledge of pharmaceutical contracting, formulary economic modeling, and budget impact analysis. Assistant Clinical Professor at the University of Wisconsin School of Pharmacy.

Strategic visionary across managed markets, executing on planning and marketing for key payer channels. Expert in bringing new products to market with direct experience across more than 30 launches. Authority at contracting for managed care organizations, pharmacy benefits, providers, and institutions.

Veteran of pharmacy benefit management, spanning managed markets, health plans, and Medicare. Has established National Medicare Formulary offerings, and developed and managed ground-breaking strategies to enhance product offerings and increase client base. Prior leadership roles focused on PBM operations, account management, and clinical utilization management programs.

Longstanding thought leader in pharmacy program plan development for both the health plan and PBM industries. Expertise includes health technology assessment,  forecasting the impact of high-cost pharmaceuticals and developing utilization management programs to ensure clinically appropriate and cost-effective access. Member of AMCP, ISPOR, and contributor to ICER’s Unsupported Price Increase draft protocol.

Healthcare professional for 20+ years, holding a wealth of information on stakeholders across managed care, pharmaceutical managed markets, pharmacy provider organizations, and market access strategic consulting. Previous roles include President of Hobart Group Holdings, and executive positions at Humana and Merck, providing expert insight into various segments and channels of managed markets. 

Veteran rebate contract negotiator and implementer, working with both Medicare and commercial players. Expert in formulary maintenance, modifications, and annual development. Uses strategic assessments of pharmaceutical market landscape and key stakeholders to create impactful market solutions.

Leading authority in managed care, pharmaceutical markets, clinical quality management, healthcare provider performance-based delivery and reimbursement models, healthcare system migrations, community health alliances, organizational change, communications, and medical marketing. Health plan awards and recognitions include winner of the J.D. Powers Distinguished Health Plan Award for Preventive Care Services and US News & World Report/NCQA America’s Best Health Plans and Consumer Reports Best Health Plans. 

Esteemed faculty member at the Institute of Healthcare Improvement (IHI) and noted author. Previously Vice President of Operations and Quality for Kaiser Permanente Colorado, Colorado’s leading integrated health care provider and not-for-profit health plan, responsible for Behavioral Health, Call Center, Clintech, Lab, Labor Management Partnership, Medical Imaging, Medical Specialties, Nursing, Pharmacy, Population Care & Prevention Services, Primary Care, Quality & Risk Management, Surgical Specialties, Women's Health, visions essentials, and Business Operations Support Services.

Specialist delivering critical insight and guidance on all aspects of managed care, including formulary and utilization management, IDN-health plan collaboration, and medical drug management. Multi-pronged approach to specialty pharmacy strategy bridges clinical management, operational optimization, unit cost reduction, and member-centric wrap-around programs. Adjunct Professor at the University of Pittsburgh School of Pharmacy.

Healthcare industry executive with a focus on specialty pharma and home infusion. Expertise spans biopharmaceutical product launch, Rare/Orphan diseases, business development, federal and state healthcare lobbying, managed care payer strategy, sales, marketing and operations management, and profit and loss responsibility. Hetty has held executive-level healthcare positions at Baxter Healthcare, CVS/Caremark’s Specialty Pharmacy division, and Coram’s Hemophilia Services division, and Diplomat Specialty Pharmacy.

Innovator of novel promotional effectiveness measures, insight-driven analysis methodologies, and dynamic CRM-based tools and applications for account management and pull-through. Expert in solving market access challenges for pharma across market channels, therapeutic classes, and routes of administration.       

Leading expert in reimbursement dynamics of “buy and bill” drugs, from fee-for-service to miscellaneous J codes to evolving value-based reimbursement methodologies. Authority in hospital/health system integrations, site-of-care shifts and payer strategies to direct care delivery settings, and payer’s utilization management tools.

Veteran of managed care and pharmacy segments, spanning product implementation and launch, client relationship management and strategy development, P&T Committee leadership and formulary development, utilization management, and contracting.

Veteran leader of the insurance and managed care industries, recognized for his innovation in clinical-cost-of-care strategies, product development and healthcare technology, as well as his deep expertise in clinical informatics and the application of lean methodologies to improve operations. Ongoing research explores value transformation, digital therapeutics, changes in the healthcare landscape, and legislative impacts on healthcare cost and access.

Specialist delivering critical insight on employer/commercial markets, benefit design, and population management. Developer of workforce/consumer engagement strategies in the rapidly changing US healthcare insurance environment, leveraging key opinion leaders as strong third-party voices on issues of client interest. Creator of numerous collaborations between clients and national organizations, such as the National Committee for Quality Assurance and numerous national and regional business coalitions

Long-standing authority in specialty pharmacy, formulary development, the clinical drug review process, and specialty drug utilization management and reimbursement strategies.

An expert in integrated market access, specializing in managed markets strategy, value demonstration, and organizational leadership. Deep experience with oncology products and a keen understanding of payers, plan sponsors, and the increasing complexity in the reimbursement marketplace.

Industry leader in market insights, medication management, and access strategy for pharmaceuticals. Combines deep payer experience and insights across the market access landscape to drive strategic planning and guide execution.

Seasoned values-based and patient-focused healthcare executive; visionary leader with extensive experience in a variety of patient care populations, including pediatrics, geriatrics, acute care and oncology. Pacesetter in reducing variation in care and improving the safety, reliability, and cost of care in hospitals, IDNS and ACOs. Skilled in strategic assessment of clinical drug development programs and product life cycles. Highly effective in securing critical physician engagement and alignment while establishing networks of healthcare and business clients, decision-makers, and key opinion leaders to achieve common goals.

Lead strategist helping clients engage with payers to support both branded and unbranded quality initiatives. Deeply grounded in the areas of quality improvement and reporting, care management, behavioral health, and end-of-life care.

Innovator with deep expertise in redesigning clinical programs to improve quality and utilization through patient centricity and aligning pharmaceutical clients with payers and key stakeholders. Has led teams in developing award-winning preventative health programs with plans, health systems, and IDNs, garnering recognition from the National Business Coalition on Health. Appointed to the National Quality Forum Medicaid Innovation Accelerator Project.

Seasoned healthcare executive with a focus on innovation, payer-provider collaboration, and optimizing the patient experience. As a Chief Medical Officer, developed specific expertise in P & T, credentialing, quality, and network development and optimization, while leading clinical efforts for Medicare, Medicaid, Commercial, Exchange and self-funded populations.

Global expert in health services and outcomes research, health economics, health system design, health policy, and market access, with deep knowledge of HEOR for cardiovascular, metabolic and immunology products and medical affairs within a biopharma setting. Contributor to more than 70 articles appearing in peer-reviewed journals such as Archives of Internal Medicine, The American Journal of Managed Care, Journal of Medical Economics, and Health Affairs

Deep expertise in specialty drug strategy for managed care, leading initiatives to maximize utilization and reimbursement for high-cost specialty medications. Worked closely with pharmaceutical manufacturers on establishing benchmarks for risk-based contracts. Specialist in asthma, diabetes, hemophilia, oncology, and optimizing site of service for injectable medications.

Long-standing expert in sales and account management, clinical program customization, and strategic initiatives. Creator of leading sales training for health plan sales and account management teams, and programs to manage complex patient, formulary, and specialty management for patient-centered medical homes.

Extensive experience in specialty pharmacy as a long-standing advisor to manufacturers, payers, and plan sponsors in designing and executing utilization management, patient education, and clinically based adherence programs that promote the optimum utilization of specialty products.  

Long-standing expertise in pharmacy benefit management for both small molecule and specialty products. Has directly negotiated rebate contracts with the pharmaceutical industry, developed and implemented exclusion formularies, and led rebate programs for both commercial and Part D offerings. Conducts financial analysis, develops benefit design recommendations, and assists pricing groups with the development of rebate guarantees.