Title: A TPA's Guide to Navigating High Cost Specialty Claims
When: Tuesday, January 17th at 2 p.m. EST
Speakers:
Robert Shelley, Founding Principal, Leaf Health, Warren Borders, Vice President of Client Engagement, Leaf Health, Hugh Gallagher, Vice President of Client Engagement, Leaf Health and Troy Lannoo, Vice President of Client Engagement, Leaf Health
Some of the most expensive drugs are in the hands of TPAs to process and not the PBMs because these are "j-code" type claims processed under the medical benefit.
Join industry experts as they review the market dynamics, latest trends, typical pitfalls encountered by TPAs today and more including:
- How to enhance your competitive position on managing very high specialty drugs
- Ways to leverage your strengths over the carriers
- How to proactively build protections for your customers against these very high-cost medications.
Speakers
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Robert Shelley Founding Principal, Leaf Health
Rob has been working as an executive in the Pharmaceutical, Pharmacy Benefits Management, and Pharmacy Benefit Consulting sector for more than 30 years. Rob’s passion is to advocate and help improve the overall competitive position of Leaf’s clients without sacrificing care, or access to services of members.
His expertise includes a broad understanding of the entire health care landscape with a specialization in in pharmaceutical benefit industry. Rob’s area of knowledge includes, drug manufacturer formulary rebate administration, specialty drug costs, utilization trends, PBM pricing evaluation and audit.
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Warren Borders Vice President of Client Engagement, Leaf Health
Warren joined the Leaf Health family in July 2020 as Vice President of Client Engagement. He has worked in the pharmacy benefit management industry since 2004 in the areas of sales and client management gaining valuable industry knowledge and experience with medium and large size PBMs.
Warren is dedicated to helping his clients navigate through various aspects of the pharmacy benefit including PBM pricing, contract negotiation, savings analyses, financial modeling, and pharmacy analytics.
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Hugh Gallagher Vice President of Client Engagement, Leaf Health
Hugh has been a member of the Leaf Health team since November 2021. As a proven pharmacy benefits industry leader, Hugh is on a mission to “change the PBM game.”
Leading the company’s national sales efforts, Gallagher demonstrates the effectiveness of Leaf Health’s ethical, transparent, and clinically driven business model – a model that stands out in the industry thanks to its full alignment with patient and plan sponsor interests. Gallagher’s consultative approach emphasizes the company’s core focus on clinical programs, incorporating clinical discussions into the selling process to ensure each client benefits from a program designed to meet their specific needs.
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Troy Lannoo Vice President of Client Engagement, Leaf Health
Troy joined Leaf in February 2022 as the Vice President of Client Engagement. He is responsible for partnering with senior leaders of his assigned accounts to navigate the various aspects of the pharmacy benefit including PBM pricing, contract negotiation, savings analyses, financial modeling, and pharmacy analytics. In addition, he is responsible for leading and coordinating the activities of multiple internal departments to deliver best-in-class service while promoting trend management solutions to help clients achieve lower overall costs, increase membership engagement, and provide positive health outcomes.
Troy has held various positions of increasing responsibility and has more than 17 years of experience in health services planning, strategy, and management.
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