Chief Compliance Officer
June 2010 to
January 2013
Accredo Health and Liberty Medical, divisions of Medco (Express Scripts) －
Memphis,
TN
Express Scripts is a pharmacy benefit management healthcare company serving the needs of more than 65 million people with active membership in S&P 500 and annual revenues exceeding $70 billion.
- Directed organization-wide compliance initiatives impacting the specialty pharmacy or medical supplies business by managing more than 50 staff as well as a $3 million budget.
- Coordinate and manage the compliance effort for specialty pharmacy services and diabetes care for private and public employers, health plans, government agencies, and individuals served by Medicare Part D prescription drug plans.
- Drive preparation for government and regulatory audits, ensuring operational standards meet current industry guidelines for Accredo Health and Liberty Medical as well as the Medco / Express Scripts corporate program.
- Developed and updated policies and staff training initiatives to stay within changing Medicaid regulations, such as Deficit Reduction Act of 2005.
- Oversaw billing processes and implemented strategic process improvements to streamline operations.
- Partner with HR, legal, internal audit and pharmacy regulatory teams to become fluent in various state board licensing requirements.
- Educated organizations and established monitoring plans to prove compliance within all areas of fraud, waste, and abuse regulations.
- Developed annual budget and work plans to accomplish organizational compliance.
- Performed annual risk assessment and review to develop focus of on-going work plan and proper priorities.
- Ensure accuracy of compliance documentation by leading writing and editing initiatives from a team creating compliance policy and procedure manuals.
- Implemented enhancements to system documentation for greater accuracy and data analytics enhancements.
- Conducted monthly communications calls to educate all organizational pharmacists, nurses, and general managers about regulatory matters.
- Drove support for third-party reviews by developing third-party relationships and agreements; provided pharmacy regulatory guidance to ensure overall compliance within pharmacy operations.
V.P. Clinical Operations and Operations Support
May 2002 to
May 2006
Accredo Health －
Memphis,
TN
A specialty pharmacy and related services company for patients with certain complex and chronic conditions with $1.7 billion in annual revenue.
- Spearheaded clinical and operational policies and procedures of Accredo Therapeutics, a specialty pharmacy company with more than 40 branch locations nationwide.
- Launched new specialty drugs available for limited distribution for home care therapy as well as revisions to clinical operations in collaboration with product management.
- Oversaw centralized distribution for drug and specialty programs.
Director of Clinical Operations (05/2002-09/2003)
- Oversaw clinical protocols and training for specialty drug therapies including licensure requirements for states to obtain Joint Commission accreditation.
- Established a culture for clinical excellence for company pharmacies and associated nursing programs.
Southeast Region Pharmacy Operations Specialist
October 1999 to
May 2002
Gentiva Health Services, Inc －
Atlanta,
Georgia
General Manager
April 1998 to
June 1999
National Medical Care －
Stone Mountain,
GA
General Manager
May 1997 to
April 1998
Home Care America －
Stone Mountain,
GA
President
May 1988 to
May 1997
Nutra-Care －
Stone Mountain,
GA
