Health Plan Services Consultant
Jill Pepe is a Health Plan Services Consultant with BluePeak Advisors, a division of Gallagher Benefit Services, Inc. Jill is a healthcare professional with over 13 years’ experience in Medicare Advantage with expertise in customer service, product development, marketing, regulations, Part D formulary administration, and coverage determinations. Throughout her tenure, Jill has supported and participated in an array of projects including operational assessments, marketing material review, call center organization, and project management. She has also participated in numerous audits with her primary expertise in Formulary Administration (FA) and Part D Coverage Determinations, Appeals and Grievances (CDAG) and Online Provider Directory reviews for Medicare Advantage (MA-PD) plans.
Prior to BluePeak Advisors, Jill worked for a large health insurance company as a Program Manager which integrated her into the clinical business operations where she gained insight into Utilization Management process. In addition, Jill worked to plan, develop and implement business critical programs and projects.
Jill has also served as Manager of Government Pharmacy Programs where she was responsible for Pharmacy Benefit Manager (PBM) oversight and compliance, audit readiness, and quality monitoring. Using CMS methodology, her team developed a quality assurance program to monitor daily rejected claims, transition, and coverage determinations. Jill supported formulary submissions and bid filling deadlines to ensure CMS acceptance.
Jill received her Master of Arts in Organizational Leadership from Medaille College and holds a B.S. degree in Business. She is a certified Project Management Professional (PMP).