Skip to main content
search

Scott DunhamScott Dunham, Pharm.D

Senior Consultant

Scott is a clinical pharmacist and Senior Consultant with BluePeak Advisors (BPA) where he works with health plans and Pharmacy Benefit Management (PBM) companies on compliance and operational issues related Medicare Part D. His focus is on providing health plans with program support and vendor oversight for Coverage Determinations, Appeals and Grievances (CDAG), Formulary Administration (FA), Medication Therapy Management (MTM), Star Rating initiatives and Part D plan implementations. He spent the last twenty years in managed care, and the last ten years within Medicare.

Prior to joining BluePeak Advisors (BPA), Scott was Senior Director, Clinical Program Operations for one of the top 3 PBMs in the country. His team’s primary responsibilities were supporting the daily rejected claims review quality assurance program; development, implementation and maintenance of a CMS compliant Medicare Part D Transition Benefit program, including daily operational monitoring and audit support; and assisting in the design and development of Medicare Part D MTM program software as well as managing the MTM operational processes, HPMS reporting, and annual CMS submissions. He also oversaw the Concurrent Drug Utilization Review (cDUR) programs and retrospective Drug Utilization Review (rDUR) programs for Medication Adherence, Controlled Drug Over-utilization, Pharmacy Guideline Compliance, Retail to Mail, Mandatory Mail and Therapeutic Interchange/Generic Substitution programs. In addition, Scott has also developed medication adherence programs directly related to improvement in Medicare Part D star measures for health plans.

Scott has also worked for three other smaller PBMs in a variety of clinical and pharmacy administrative roles.

  • University of Arkansas for Medical Sciences, PharmD.
  • University of Pittsburgh, BSPharm.
  • Registered Pharmacist: Commonwealth of Pennsylvania, State of Georgia.

Back to Meet the Team

Close Menu