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Jeff Low
Managing Director @Ankura
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WORK HISTORY
Managing Director @Ankura
EDUCATION
University of Washington
MHA
Oregon State University
RPh
SKILLS
ABOUT JEFF LOW
Jeffrey Low is a Managing Director who brings over 25 years of diverse healthcare experience. Jeff brings over a decade of Pharmacy Benefit Management (PBM) experience with a focus on Medicare and Medicaid payer marketplace. Working in various clinical and operational roles he has led and created programs surrounding the delivery of formulary development/utilization management, sales and account management, contracting between PBMs and pharmacies/health plans, directed Pharmacy and Therapeutics Committee, pharmacoeconomic evaluations, claims adjudication, Coverage Determinations and Appeals, coordination of benefits between Medicare Part B and D, grievance oversight, Medication Therapy Management, and oversight of data analytics. He has served as a pharmacy expert and testifying witness, a subject matter expert on behalf of Independent Review Organizations, the opioid epidemic, engaged in pharmacy audits, claims and rebate analysis, and pharmacy delivery methods. Outside of pharmacy, he works in a Compliance capacity assisting organizations with implementing policies and procedures, training, Compliance Program development, risk assessments, and process improvement initiatives to health plans. Additionally, he has practiced in direct patient care roles working with patients and providers serving as a Pharmacist in Charge in Retail and Long-Term Care pharmacy settings and a manager within health plans (Managed Medicaid and Medicare) facilitating multidisciplinary efforts through nursing, pharmacy, mental health, physician, and network capacities.Areas of ExpertiseCompliance and Regulatory Control: Leader in initiatives related to corporate compliance programs and establishing monitoring and auditing in highly regulated programs such as Qualified Health Plans, Medicare, Medicaid, and state boards of pharmacy.Health Care and Life Sciences: In-depth knowledge of regulatory and legal requirements related to Health Plan Payers and Pharmacy Benefits Managers. Review of pharmacy claims for clinical and operational aspects to validate the accuracy of payments by PBM, insurers, and pharmacies.Data Analytics: Lead the creation of analytic relational data base environments to create queries of large pharmacy and medical claims data sets. Focus on pharmacy datasets such as Medi-Span, First Data Bank, and National Council for Prescription Drugs Programs (NCPDP).
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