Medical Benefits Medication Management
An AMCP and Milliman Corporate Training Program
Brand and payer marketers, account executives, field and HQ-based HEOR leads, and payer medical leads
Join leading managed care and health plan experts for an interactive training that translates medical benefit management into new opportunities for you and your customers. With AMCP faculty and Milliman professionals, you will receive:
An interactive self-paced e-Learning training program designed to fit into your busy schedule and deliver the basics with eight 40-minute modules. This program is designed to deliver the fundamental knowledge on the basics of medical benefits medication management. The program includes an overview of today’s key trends and challenges and provides insights and solutions.
One day remote learning training from experts in managed care and health plans to gain knowledge and actionable insights in medical benefits medication management.
At the completion of this program, participants should be able to:
- Describe the foundational components of medical and pharmacy benefits and market trends impacting medical and pharmacy benefits.
- Identify employer benefit design and coverage processes and discuss health plan versus PBM medical and pharmacy coverage.
Describe medical benefit medication contracting and integration and payer rules of engagement.
Discuss medical policies and utilization management techniques.
Describe pre-certification versus prior authorization and other medical benefit utilization management techniques and approval and denial management.
Identify buy and bill methodology, and medication distribution models.
Discuss medical benefit reimbursement and claims, including reimbursement billing overview and coding for medical benefit billing.
Provide overview of patient support services, HUB services, patient assistance, and provider reimbursement support services.
Discuss field team support roles and review case studies.
Susan Silseth, FSA, MAAA – Consulting Actuary, Milliman
Susan is a consulting actuary with Milliman’s Milwaukee office. She joined the firm in 2011 and possesses a mix of consulting and industry practice over her fifteen-year tenure. Today, she leads teams to complete strategic analyses in the areas of Medicare Part D and Pharmaceutical Manufacturer Consulting. Her clients look to her to formulate and implement solutions for complex challenges due to regulatory changes or when they are seeking improved financial results.
- eLearning Modules
Accountable Health, LLC
John. D. Bower School of Population Health
University of Mississippi Medical Center
One-Day Remote Learning Session
Chris Ford, Prime Therapeutics
Chris Ford is the Senior Director of Innovation Solutions at Prime Therapeutics. He has been with Prime Therapeutics since 2016 and has spent the bulk of his tenure developing medical benefit drug strategies on behalf of Prime’s Blue Cross Blue Shields owner plans. He holds a Bachelor’s Degree and MBA with an emphasis in strategy from The Carlson School of Management of the University of Minnesota.
Christina Link, Blue Cross Blue Shield of Michigan
Christina Link, PharmD, is the Clinical Program Manager for the Medical Drug Utilization Management (UM) commercial team at Blue Cross Blue Shield of Michigan. She is responsible for the implementation and oversight of clinical programs, including but not limited to Prior Authorization, and management of the clinical UM team for medical benefit drugs. Her role also includes the identification and development of innovative programs and solutions in the medical pharmacy environment.
Dr. Link joined Blue Cross in 2014 as a utilization management pharmacist. She received her Bachelor's in Human Physiology from Michigan State University, her Doctor of Pharmacy degree from Ferris State University, and went on to complete a PGY-1 Pharmacy Practice residency at Beaumont Hospital in Troy, MI.
Jeremy Kush, FSA, CERA, MAAA, – Consulting Actuary, Milliman
Jeremy Kush joined the Chicago-Milwaukee Health Practice in 2010. Prior to joining the Milliman, Jeremy worked in the strategic development area of Assurant Health. He consults to multiple clients in various sectors of the industry, focusing his efforts on valued growth within the ever-changing commercial healthcare market.
For more than 70 years, Milliman has pioneered strategies, tools, and solutions worldwide. As one of the largest consulting and actuarial firms in the world, we are recognized leaders in the markets we serve. Milliman offers specialized consulting services in healthcare, with Milliman consultants serving a wide range of current and emerging markets. Clients know they can depend on us as industry experts, trusted advisors, and creative problem solvers. For further information, visit milliman.com.
About AMCP Corporate Training
AMCP is the professional association leading the way to help patients get the medications they need at a cost they can afford. Creating real-world, relevant training for life science companies, we build your health care business acumen so you can step out in confidence, equipped for customer engagements that drive positive patient outcomes. We’ve shaped our learning forums to connect you with thought leaders and experts. This, plus AMCP tools and resources, fast-tracks you to what’s relevant and keeps you informed about the newest insights. We’ll help you learn about the health care reforms that are most meaningful to you, your account teams and your clients – guiding you to customer-targeted solutions.
For questions on the corporate training program, please email firstname.lastname@example.org.