Senior Consultant, Pharmacy
Heidi is an expert in Medicare Part D benefit administration, including Part D readiness assessment, payment validation, formulary development, and CMS Formulary Administration (FA) and Coverage Determinations, Appeals, and Grievances (CDAG) audit readiness. She brings more than 35 years of pharmacy, operational, and benefits administration experience, focusing specifically on Medicare Part D for the last 15 years. Heidi’s business skillsets include problem solving, data mining and analysis, communication, quality assurance, and relationship building.
Heidi’s previous experience includes consulting to CMS’ Division of Payment Validation (DPV) as part of the team who develops the annual Part D payment error for Office of Management and Budget (OMB) and Congress. She also performed FA and CDAG audits and participated in a two-year review of federal agency pharmacy benefit formularies for CMS. Heidi was a benefit administration pharmacist for a large managed care organization before consulting to CMS. Additionally, she was part of the organization’s electronic health records implementation, from test scenario development through staff training and onsite support during roll-out.
Heidi received her MHA from the University of Maryland University College and her BS from the University of Connecticut School of Pharmacy. She is a member of Upsilon Phi Delta Honor Society for academic achievement in healthcare administration and Phi Kappa Phi Honor Society for academic excellence.