Chris J. Turoff

Director of Pharmacy @Medigold

Columbus, OH, US

Joined this not-for-profit Medicare Advantage plan as their first pharmacist and pharmacy director, and leveraged past PBM experience to drive the efficient and effective operation of the health plan—with $125M+ annual drug spend—for its 50K+ members. Deployed a Therapeutic Intervention Program—increasing generic dispensing rate to 91.5% and decreasing drug spend by $5M over 2 years—and engaged physicians to migrate patients to a more affordable drug option, playing an instrumental role in the ability to mitigate a significant increase in specialty drug costs and maintain flat ratios. Engaged with the Mount Carmel leadership team during quarterly strategy setting, vision planning, yearly CMS Bid process, and hindsight analysis meetings, working cross-functionally to support diverse stakeholders from Compliance, Marketing, Communications, Member Services, Sales, Finance, Fraud Waste and Abuse, and Quality Departments. Applied expertise to negotiate a highly competitive 3-year PBM renewal contract, optimizing KPIs including Average Wholesale Price (AWP) discounts, Maximum Allowable Cost (MAC) pricing, delegated service fees, and rebates. Nurtured a high-value relationship while also capturing a 70% increase in rebates and $50M+ in plan savings. Made the decision to divest Medication Therapy Management Program to a new partner—increasing Star rating to a 4 and 5 across 2 plans for 2019—and better aligning business goals with medical program strategies. Elevated ratings by also increasing medication adherence, eliminating therapeutic gaps, and earning a Part D rating of 4 of higher. Served as an early adopter of Part D opioid overutilization initiatives, not only implementing 2019 requirements, but also educating members and prescribers and prompting DUR and UM edits as well as retrospective reviews. Passed all Part D CMS audits with zero findings and observations, ensuring on-time submission of data to CMS.