Greg Miller, RPh, is a Senior Consultant at BluePeak Advisors where he focuses on CMS, PBM, pharmacy and oversight auditing in addition to Coverage Determinations, Appeals and Grievances (CDAG) operations.
In his previous management experience in the PBM industry, Greg developed, implemented and guided a team of associates dedicated to supporting the PBM clients through CMS operational audits. This included full CMS program, Transition Monitoring Program Analysis (TMPA), Formulary Administration Analysis (FAA), Mail Order and client initiated mock audits. He led his team in preparing clients’ audit universe files, quality assurance practices, mock audit preparation and also provided guidance on operational and audit best practices. He has also presented as a subject matter expert at industry conferences.
Also at the PBM, he led a team that developed, coded and implemented a robust Medicare Part D daily claim review reporting and analytic capability for the PBM’s clients. He was also involved in several management developmental training programs including being trained in six sigma black belt and process improvement methodologies.
Prior to his PBM experience, Greg held management positions in the retail pharmacy arena. While there, he gained experience in National Council for Prescription Drug Programs (NCPDP) claims adjudication, prescriber file database creation, maintenance and monitoring and claims editing for audit avoidance. In addition, he held positions where he gained experience in overall retail pharmacy management, operations and curriculum training and development.