payer contracting services for specialty pharmacies

 

BACKGROUND

With over 30 years in the field of managed care and pharmaceutical services Steve has extensive knowledge of the evolving health care industry. Employment with two large payers covering over 40 million lives afforded Steve with a unique inside view of payer owned specialty pharmacies as well as the health plan decision process. Steve has been extremely successful within the following areas: Specialty Pharmacy Network Contracting, health care benefit designs, pharmaceutical relationships and physician marketing models. Steve’s keen understanding of the payer market has allowed him to take companies struggling for existence and turn them around producing revenues over $100 million including a Philadelphia Specialty Pharmacy.

As Vice President working with Prime Therapeutics, Inc. Steve’s experience included working with all the stakeholders for numerous health plans. Steve’s professional interaction with Medical and Pharmacy Directors, Legal Counsel, Analytics and regulatory departments provided an in-depth understanding of specialty pharmacy benefit designs. Steve implemented a specialty program with a BlueCross Plan yielding over $75 million in revenue.

As Regional Director with Anthem/Wellpoint Steve successfully implemented a specialty pharmacy program which produced over $100 million in revenue in the first year. His specialty pharmacy implementation model was utilized in subsequent payer conversions across the country.

Steve founded Keystone Healthcare Advisors in 2007 and has been actively helping entrepreneurs build out best in class specialty pharmacy services and offerings.

 Who we are - Stephen steinmetz

Stephen Steinmetz

Principal

contact: ssteinmetz@khafirm.com


AREAS OF EXPERTISE

•  Payer/PBM Contracting
•  Executive Management
•  Pharmacy Operations
•  Physician marketing
•  Clinical Program Development
•  P&L Oversight
•  Strategic Planning
•  Client Relations
•  Business  Development
•  URAC/ACHC Accreditation
•  Pharma Relations
•  Market Analysis
•  Program Redesigns
•  Continuous Quality Improvement
•  Personnel Supervision