Sr. Vice President, Operations/Payor Strategy
Marie Anderson is an experienced executive with an extensive background in a broad scope of health care dimensions. She has held leadership roles in Specialty Pharmacy, PBM, Home Health, Contracting, Operations, Product Development, 340b, Community Health and Billing and Reimbursement.
Marie is a subject matter expert in all things Payor, including Medicare and Medicaid and has worked to develop innovations in widely recognized managed care programs. Marie’s initial industry expertise positioned her working directly with major payors in member services and claims for Prudential and Cigna.
While at Prudential, Marie was part of the team that developed TennCare – one of the first leaders in Managed Medicaid in 1992 for Prudential’s MCO. Marie then shifted to the provider world and was part of the start up management team at Accredo Health Group. She was integral in establishing many of the programs that capitulated Accredo to the success it knows today, including joint ventures with 340b, hemophilia treatment centers and pediatric endocrinology.
Marie then assisted WellPoint with the build out of Precision Rx Specialty Solutions, leading Contracts, PBM Networks and pricing. She was responsible for all of the pricing schedules for WellPoint’s Specialty Networks, contracting for Medicare/Medicaid throughout the continental USA. Marie also handled all of the provider contracts, including Nursing and Home Health- across both Pharmacy and Medical Benefit.
She has led Product Development at Express Scripts and was an executive at Presbyterian Medical Services, serving the underserved in Community Health Care in New Mexico. While at Presbyterian, Marie led revenue cycle management for 50 programs in 30 locations spanning Family Practice, Behavioral Health, Dental, Homecare, Hospice, Pharmacy and Inpatient adolescent treatment centers.
She also played a key role with the insourcing of Triessent Specialty which was the Prime Therapeutics specialty brand. Marie was responsible for development of Specialty operations and processes at Prime, building Specialty Rx from the ground up. Under her direction, in just one year, Prime’s Specialty Pharmacy grew to over $1 Billion dollars annually, with an average DSO <20 days! Clearly an exception to the industry norm.
During the course of Marie’s career, she has also spearheaded projects including IT conversions, process improvement & developed and trained professional at summits on industry trends. Marie has a Bachelor of Science in Business Administration and is a Certified Six Sigma Process Improvement Manager.