I help employers, health plans, and compliance teams understand what their drug coverage policies actually say — and where they create risk, inconsistency, or downstream cost.
Former PBM pharmacist. Independent coverage analyst focused on defensibility and operational reality.
Independent review of formulary and prior authorization criteria against clinical evidence, peer benchmarks, and regulatory exposure. You receive a tailored written analysis — not boilerplate slides.
The most contested coverage category today. I help teams navigate utilization controls, cost containment, and member experience tradeoffs without policy or adjudication blind spots.
For plans and PBMs: where criteria create appeals, friction, or compliance risk. I identify failure modes before they escalate.
Pricing reflects scope and value. Single-policy or single-drug audits start here. Broader reviews and ongoing advisory work are scoped after an initial conversation.