Francis Ayson

Francis has previously worked for a major pharmacy benefit manager (PBM) and health insurance organization. He has experience with underwriting, data analysis and reporting, configuration, performance guarantee tracking, and Part D compliance. In addition, Francis held positions in internal audit, contracts, and configuration services.

Francis’ specialties are in pharmacy claims auditing, rebate audits, performance guarantees, and Part D compliance. He worked with configuration services for Part D compliance and designed a process for Part D compliance notification and issue reporting. He has supported a wide range of clients, including Medicare Part D plans, state Medicaid plans, health plans, self-insured employer groups, and third-party administrators.

Francis’ experience includes:

• Account management
• Benefit plan design
• Contracting
• Copay programs and financial assistance
• Data analysis and reporting
• Insurance and health reimbursement
• Medicare Part D compliance
• Medicare Part D Employer Group Waiver Plans (EGWP)
• Medicare Part D Retiree Drug Subsidy (RDS)
• Medicare Part D star ratings
• Performance guarantees
• Pharmacy benefit manager audits
• Pharmacy claims processing
• Proposals
• Rebate audits