Mark W. Sullivan

About Mark W. Sullivan

With 20+ years in pharmacy benefit management (PBM) and healthcare operations, I…

Experience

1. Senior Director, Regulated Markets Solutions Business Innovation

   Express Scripts Pharmacy Benefit Services

   Oct 2009 — Present · Richmond, VA, US

   EXPRESS SCRIPTS BY EVERNORTHSenior Director, Regulatory Support & Coordinated Services 2022-PresentAccountable for a team of individuals managing a diverse set of products and services that touch each one of our Health Plan and Commercial clients across the Express Scripts book of business (BoB). Regulatory intake of both Federal and State guidance, so reviews, cataloging and distributing the annual requests for information can be tracked and overseen via semi-automated workflow. Coordination of Benefit (COB) and Payment Integrity solutions that generated over $16M in revenue in 2024. Oversee the Medicare Plan Finder team that boasted a successful 2023PY BoB average 4.82/5.0 Stars. Commercial Regulatory engagement to ensure compliance of complex state guidance.Senior Director, Regulated Markets Solutions: Claims Processing & CMS Reporting 2015 – 2022Led 4 direct / 42 indirect reports and managed $125K budget, excluding labor, in addition to $5M IT spending in 2018. Cultivated team innovation and knowledge to accelerate attainment of organizational objectives in the U.S. Coached and developed team members and partnered with internal stakeholders including Product, Account Management, and IT. Built client relationships driving retention and new growth opportunities. Identified, developed, and launched innovative product solutions enabling differentiation to meet needs of all constituents. Monitored financial performance and regulatory compliance. Exceeded client-specific service level agreements and ensured quality, cost, and service targets.Director, Government Programs: Business Innovation (2009 – 2015) Led team of 4 directs through the acquisition/merger of Medco Health Solutions to Express Scripts to ensure best in class products and services from either organization would become the standard for implementation in combined organization.

Education

• Virginia Commonwealth University

  Bachelor of Science (BS)

Skills

• Business Requirements
• Sharepoint
• Business Intelligence
• Healthcare Information Technology
• Change Management
• Analysis
• Medicaid
• Sdlc
• Quality Assurance
• Medicare-Medicaid Plan
• Program Management
• Process Improvement
• Requirements Analysis
• Agile Methodologies
• Management
• Business Process Improvement
• Project Management
• Business Strategy
• Software Project Management
• Medicare
• Scrum
• Integration
• Project Portfolio Management
• Cross-Functional Team Leadership
• Pmo
• Pmp
• Leadership
• Business Process Management
• Project Planning
• Managed Care
• Requirements Gathering
• Enterprise Software
• Enterprise Architecture
• Healthcare Information Technology (Hit)
• IT Management
• IT Strategy
• Medicare Part D
• Process Engineering
• Business Analysis
• Mentoring