Ryan Davis

About Ryan Davis

An experienced health plan and PBM professional who has a focus on client/vendor relationships and Medicare lines of business. I have a history of providing results in the most compliant way possible. Healthcare costs are rising! Spending in the healthcare industry is rapidly reaching 20% of the United States gross domestic product. Medicare is following suit as the administration of Part D plans are increasingly becoming a huge piece of health plans’ budgets. Maintaining lean Medicare operations, viable PBM relationships, healthy contract terms, and effective staff processes allow organizations to remain profitable in this highly regulated marketplace. My vast experience in the Medicare field has touched on various operational functions such as coverage determinations, benefit implementation, claim adjudication, PDE review, standard procedure development, formulary adherence, beneficiary communications, grievances, audit readiness, and appeals.

Experience

1. Director, Market & Operations

   Centene Corporation

   Jun 2022 — Present

Education

• Western Governors University

  Bachelor of Science - BS, Health/Health Care Administration/Management

  2017 — 2019

Skills

• Siebel 7.x
• Process Improvement
• Management
• Team Building
• Medicare Part D
• Pharmacy Benefit Management
• Customer Service
• Call Centers
• Healthcare
• Strategic Planning
• Vendor Management
• Facets
• Claims Resolution
• U.s. Health Insurance Portability and Accountability Act (Hipaa)
• Microsoft Sql Server
• Cross-Functional Team Leadership
• Visio
• Data Reconciliation
• Project Management
• Healthcare Information Technology
• Data Analysis
• Pharmaceutical Industry
• Business Process Improvement
• Sharepoint
• Training
• Quality Assurance
• Healthcare Industry
• Health Insurance
• Managed Care
• Houston
• Genesys
• Insurance
• Edi
• Business Analysis
• Pharmacy
• Healthcare Management
• Medicaid
• Microsoft Office
• Hipaa
• Medicare