Upcoming Webinar
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Please join the Central Indiana Chapter on December 1st for a webinar "Unmasking the Co-Conspirators and Factors Contributing to Your High Cost Pharmacy Claims". Our speaker is Susan Hayes, Principal and Founder of Pharmacy Investigators and Consultants (PIC). A short chapter meeting will be held before the presentation.
In this webinar some important questions about pharmacy benefit costs and pharmacy benefit managers (PBMs) will be answered. Participants will be introduced to the pharmacy world, behind the scenes, to include definitions of valuable terms for a health plan. Top Takeaways
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DATE:
Tuesday, December 1, 2020 TIME: 11:30 am - 12:30 pm Eastern (A short chapter meeting will be held before the presentation.) COST: FREE! REGISTRATION: Please click here to register via Zoom. 
This program qualifies for one (1) CEBS Compliance credit. Visit www.cebs.org/compliance for more information. |
SPEAKER
Susan Hayes
Principal
Susan has over 38 years’ experience in the health care consulting and management industry. As a founder of Pharmacy Investigators and Consultants (PIC, and its predecessor firm, Pharmacy Outcomes Specialists), Susan has been responsible for the last 23 years for the strategic direction of the firm and specific sales, proposal, product pricing and development. Susan is a lead project manager for the firm's clients, which include Meridian Health Plan, Connecticut Coalition of Taft Hartley Health Plans and McKee Foods and many other government, union, employer and managed care organizations. In her many years in the pharmacy benefits industry, Susan has developed a broad understanding of the market place, services offered by the pharmacy benefit managers and pricing terms that are currently available in the industry. Susan provides expert witness testimony on key prescription drug industry litigation.
Susan is the inventor and patent holder for technology solutions in the employee benefits field. COPs™ assists managed health care clients detect fraud in pharmacy and medical plans and CARs™ assists PBM and managed care auditors/investigators in fraud resolution and recovery. P3™, to be released in Q1 2020, assists brokers, consultants and employers in procurement of pharmacy benefit programs.
Prior to PIC, Susan was Vice President of Marketing for Systemed Pharmacy, Inc. and Vice President, Marketing of Walgreens Healthcare Plus. In both positions, she was responsible for the strategic development of the target market and product mix for PBMs, growing retail and mail service revenues and enhancing overall client retention. For five years prior to Walgreen Co., Susan was the National Practice Leader for William M. Mercer, Inc., specializing in prescription drug auditing and bid procurement amounting for Fortune 500 employers.
She has published several articles in Business Insurance and Employee Benefit News and was recently quoted in Fortune Magazine and the Wall Street Journal regarding pharmacy benefit practices. Susan was a co-producer of the Pharmacy Benefits Academy and was part of their distinguished faculty. Susan has testified to the Committee on Oversight and Government Reform, Subcommittee on Federal Workforce, Postal Service and the District of Columbia on Transparency in the PBM Industry.
Susan has a B.S. in Criminal Justice from Northeastern Illinois University and a Master’s Degree in Criminology from Boston University and is a Doctoral Candidate in Criminology at the University of Portsmouth, UK with a defense scheduled for April 2020. Her thesis focuses on the integrity of pharmacists. She is a Certified Registered Pharmacy Technician and a Licensed Private Detective (Lic # 115.002527) in the State of Illinois. Susan is a member of the Professional Council for Roosevelt University, School of Pharmacy. In 2012, Susan earned her Accredited Healthcare Fraud Investigator (AFHI) designation from the National Healthcare Anti-Fraud Association.
Principal
Susan has over 38 years’ experience in the health care consulting and management industry. As a founder of Pharmacy Investigators and Consultants (PIC, and its predecessor firm, Pharmacy Outcomes Specialists), Susan has been responsible for the last 23 years for the strategic direction of the firm and specific sales, proposal, product pricing and development. Susan is a lead project manager for the firm's clients, which include Meridian Health Plan, Connecticut Coalition of Taft Hartley Health Plans and McKee Foods and many other government, union, employer and managed care organizations. In her many years in the pharmacy benefits industry, Susan has developed a broad understanding of the market place, services offered by the pharmacy benefit managers and pricing terms that are currently available in the industry. Susan provides expert witness testimony on key prescription drug industry litigation.
Susan is the inventor and patent holder for technology solutions in the employee benefits field. COPs™ assists managed health care clients detect fraud in pharmacy and medical plans and CARs™ assists PBM and managed care auditors/investigators in fraud resolution and recovery. P3™, to be released in Q1 2020, assists brokers, consultants and employers in procurement of pharmacy benefit programs.
Prior to PIC, Susan was Vice President of Marketing for Systemed Pharmacy, Inc. and Vice President, Marketing of Walgreens Healthcare Plus. In both positions, she was responsible for the strategic development of the target market and product mix for PBMs, growing retail and mail service revenues and enhancing overall client retention. For five years prior to Walgreen Co., Susan was the National Practice Leader for William M. Mercer, Inc., specializing in prescription drug auditing and bid procurement amounting for Fortune 500 employers.
She has published several articles in Business Insurance and Employee Benefit News and was recently quoted in Fortune Magazine and the Wall Street Journal regarding pharmacy benefit practices. Susan was a co-producer of the Pharmacy Benefits Academy and was part of their distinguished faculty. Susan has testified to the Committee on Oversight and Government Reform, Subcommittee on Federal Workforce, Postal Service and the District of Columbia on Transparency in the PBM Industry.
Susan has a B.S. in Criminal Justice from Northeastern Illinois University and a Master’s Degree in Criminology from Boston University and is a Doctoral Candidate in Criminology at the University of Portsmouth, UK with a defense scheduled for April 2020. Her thesis focuses on the integrity of pharmacists. She is a Certified Registered Pharmacy Technician and a Licensed Private Detective (Lic # 115.002527) in the State of Illinois. Susan is a member of the Professional Council for Roosevelt University, School of Pharmacy. In 2012, Susan earned her Accredited Healthcare Fraud Investigator (AFHI) designation from the National Healthcare Anti-Fraud Association.