Mike Cardamone

About Mike Cardamone

Mike is a passionate, outcomes-focused health care, managed-care, and pharmacy leader. He is a conceptual thinker and problem solver with excellent utilization management, financial, clinical, and operations acumen, accompanied with a desire to lead. In his current endeavor with Optum, Mike is focused on medical drug spend - owning, maintaining, and growing the industry-best editing suite for high cost medical drug claims, ensuring the stewardship of the healthcare dollar for his clients. Leveraging over 15 years of experience in managed care pharmacy, Mike\'s diverse background in this unique niche has allowed him to become an expert in UM policies & procedures, operations execution, benefit/formulary design, drug contracting, pricing, & negotiation, and genuine relationship development - cultivating a robust professional network. Along with effective communication skills, as well as a consistent level of exceptional performance, Mike’s track record of success is a testament to his unwavering work ethic and inherent drive to be a top performer & leader.Additionally, Mike holds certifications as a Pharmacy Regulatory Specialist (PRS) & Pain Management Specialty Pharmacist (PMSP) and is always seeking to grow both not only professionally, but personally as well. In his free time, Mike enjoys being outdoors with his daughters, strength training, Buffalo sports, fishing, playing his trombone, and mentoring the next generation of pharmacists.\"You just can\'t beat the person who never gives up\"- George Herman \"Babe\" Ruth

Experience

1. Director of Specialty Pharmacy, Payment Integrity - Optum Insight

   Optum

   Aug 2021 — Present · Buffalo, NY, US

   Oversee the ideation function that identifies specialty drug related medical cost savings opportunities using data and clinical perspective and manage the related portfolio of solutions to maximize client value delivery- Participate in analytical, investigative, and other fact-finding work in support of new concept development - Establish strong client and matrix partner relationships to define, align, and deliver payment integrity solutions for clients- Provide executive level program updates and manage Optum team escalations- Influence client leadership to adopt new ideas, approaches, and/or products- Influence specialty drug product strategy and recommend changes to current product development procedures based on market research and new trends- Support specialty drug related sales efforts with prospective clients- Operate as an industry thought leader and Payment Integrity SME- Partner with Optum leadership groups to develop and execute on cutting-edge product offerings to mitigate patient/physician barriers regarding specialty medication- Grew the program in 2022 to achieve 7M$ in savings and >16M$ & 20M$ in \'23/\'24

Education

• University at Buffalo

  Bachelor of Science - BS, Pharmacology

  2003 — 2007

• University at Buffalo

  Doctor of Pharmacy - PharmD

  2007 — 2011