menu
Thomas Kaye

Thomas Kaye

Director pharmacy services

location_on Louisville, Kentucky Area

Executive Director at K-Group Strategies LLC

Awards Earned:

1

1

0

0

0

Level: LEVEL 01 (12mo pts: 15 pts)

Rating: 5.00/5 stars (2 ratings)

Lifetime points: 177 pts View details

Thought Leadership:

% performance based on average of all engagements

Selected: % of applied

40%

Recognized: Contributions valued by peers

21%

Peer Support: Percentile of active participants

28%

Profile

Summary

Managed care pharmacy executive with insight and vision to deliver high performance pharmacy management with financial conservatism.
Has provided Innovative and dynamic leadership in pharmacy management for over 25 years using broad work experiences in State affiliated Medicaid, Medicare MA/PD/SNP programs,
Resource for state regulations & CMS regulations
Commercial self-insured, PPO and HMO plans with drug benefit programs.
Home infusion, rebate contracting, provider agreements, Specialty drug contracting pricing
Network development, claims processing and system analysis.
Strong analytical capacity for analysis of claims
Healthcare reimbursement process, contracting
Formulary development, pharmacy and therapeutics committee details
Strong analytical, strong reimbursement, strong financial understanding,
Presentation skills and ability to convey complex issues to audiences.
Possesses vision, excellent skills with people motivation, management, and mentoring and task team attainment of goals. A seasoned professional with business expertise to manage departments for efficient and accurate results. Competent and knowledgeable for attaining high service quality.
Organized and deliberate in execution of tasks to achieve desired goals, but aware of the value of human capital, work ethics and social challenges for effective team building. Astute with knowledge of pharmacy services deployment, supply and procedural environments that are complex to the nature of pharmacy management in a managed care setting. Savvy to medical business dynamics with experience with most area of managed care medical services. Strong negotiations skills with suppliers
Plans and executes clinical and non-clinical programs to deliver desired outcomes.
E-mail - tomkaye@rxman.com

Specialties: Operations - pharmacy - marketing- infusion

Experience

Executive Director

K-Group Strategies LLC

July 2017 - Present

Skills

Healthcare 33
Medicare 29
HMO 29
PPO 29
Pharmacy 4
Hospitals 2
Home Infusion 2
Inpatient 2
Medicine 2
Pharmacy Benefit Management
Medicaid
Managed Care
Utilization Management
Pharmacy Automation
Health Insurance
Pharmacists
HIPAA
Clinical Research
Medicare Part D
HEDIS
Healthcare Industry
Healthcare Information Technology
Disease Management
Oncology
Medicaid Managed Care
Healthcare Management
Health Policy
Clinical Pharmacology
Clinical Pharmacy
EMR
EHR
Formulary
Healthcare Consulting
Informatics
Healthcare Reimbursement
JCAHO
Long-term Care
Medication Adherence
Medication Therapy Management
Network Development
NCQA
Nursing
Outcomes Research
Patient Safety
Provider Relations
Pharmacoeconomics
Physicians
Quality Improvement
Revenue Cycle
Inpatient Care

Industries

Activities