- Graduate of the schools of pharmacy and master program in business at Southwestern Oklahoma state university and Oklahoma City school of business
- Maintains licensees in pharmacy for the states of Oklahoma, Kansas, Kentucky and Arkansas
- Serves as strategic pharmacy consultant for several national and regional managed care plans with efforts to improve operations, efficiencies and patient outcomes by the deployment of technology, benefit structure, payer relations and data analytics.
- Past assignments have been with national and regions payer plans, MCO’s and healthcare providers in various models including directorship of pharmacy departments.
- Strategic consults of manufacturers
- Regulatory compliance – State- Federal (Medicaid – Medicare)
- Technology review/ assessment and emerging markets
- Pharmacy pricing, costing and rebating
- PBM (pharmacy benefit manager) details
- Specialty pharmacy deployment
- Pharmacy and health care benefits design
- Provider incentives for improvement in plans quality achievements
With more than 25 years experience as a clinician and operations expert in the healthcare space, Mary brings critical insights for clients working on health home and MLTSS programs. She has a strong industry knowledge of health insurance, managed care, Medicare, and Medicaid. She helps clients develop strategies to increase quality, improve operational efficiencies and optimize revenue opportunities.
Pam has over 30 years of experience in executive leadership roles in healthcare operations, program development and support in the public and private sectors. Her accomplishments include restructuring and establishing clinical and non-clinical programs, writing and evaluating proposals, strategic planning, compliance and program integrity. For clients and former employers, she has developed strategic partnerships in various arenas. Specializing in clinical and government compliance, individual case and situational analysis, her expertise has contributed to the operational success of many government, for-profit, and not-for-profit entities nationwide.
Pam currently serves on the Delaware Board of Nursing as a Board member, formerly as President and chairs the Limited Lay Administration of Medications Committee (formerly AWSAM). She served on the National Council of State Boards of Nursing (NCSBN) Committee on Long Term Care, and as the Delaware Delegate and on the Delegate Assembly Resolutions Committee. Pam donates her knowledge and time to various community and charitable agencies, and served as a healthcare advisor to Delaware Legislators.
Clay has advised CMS administrators, state Medicaid Directors, health plan CEOs, technology COOs and a wide range of other clients in the healthcare industry. His unique blend of management consulting, project management, policy making and analytics help deliver on-time, actionable results for a wide array of business challenges. His Weekly Medicaid Roundup is read and loved by more than 10,000 professionals in the Medicaid industry.
His experience includes policy making at both the federal (CMS) and state levels (State of Georgia), management consulting for large organizational change initiatives, big data solution sales and implementation and cutting-edge analytics.
He currently leads key project components related to consultation design, Medicaid subject matter expertise and project management. He has a masters in Health Policy from the Johns Hopkins Bloomberg of School of Public Health and is also a Certified Internal Auditor.