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sherry pound

Sherry Pound

Sherry Pound is Area Senior Vice President, BluePeak Advisors, a division of Gallagher Benefit Services, Inc.   Sherry has been in the managed care industry for 25 years and advises health plans, pharmacy benefit management companies and information technology companies on Medicare strategies, operational and compliance issues.

Sherry brings a strong mix of business, regulatory and information technology knowledge with Medicare Part D and PBM operations. Her areas of expertise are focused in the operational areas of Medicare Part D including claim processing, data management, reporting and PDE. She has extensive knowledge of the regulatory requirements of Medicare and how to implement accurate and compliant programs. Sherry has conducted and supported numerous audits with her primary expertise in Part D Formulary Administration (FA).

Sherry formed her own Medicare consulting firm in early 2010 in response to a need for consultants with hands on operational experience in Medicare especially related to the downstream vendors that perform much of the work for the health plans contracted with CMS. During this time, she has had experience with a large variety of small and large health plans, PBM’s, software companies, print and enrollment vendors all working on making their programs and offerings CMS compliant by understanding regulations and industry best practice. This broad knowledge of the Medicare industry offers BluePeak’s clients a unique insight into the latest in the CMS expectations and best practices.

Prior to consulting, Sherry was the Director of Government Programs at a leading PBM. She was responsible for the implementation and support of the Medicare Part D programs and services. This included leadership responsibility for understanding all CMS requirements and implementing the business and system services required of the MA-PD and PDP customers.

Her background prior to Medicare was in assisting businesses to understand requirements, evaluate and implement solutions to their most complex projects. Sherry has over 20 years of experience in designing and implementing IT driven solutions to complex multi-year projects to meet client and regulated requirements.

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Experienced Medicare staff: Ready when you are!

BluePeak knows how difficult it can be for Medicare Advantage plans and TPAs to find knowledgeable resources with experience in Medicare, especially when demands increase sharply given the Medicare annual cycle. BluePeak maintains a wide variety of experienced Medicare personnel to help you with seasonal projects, operational backlogs, compliance monitoring, remediation activities, and more.

Examples of projects that BluePeak has assisted plans in 2022 include:

  • Clinical chart review by licensed clinicians
  • Call center oversight, including listening to calls for accurate classification and calibration
  • Operational support to resolve grievance backlogs and provider directory compliance
  • Pharmacy support to resolve coverage determination backlogs
  • Program area specific operational and administrative responses to a corrective action (initiated internally or externally)
  • Compliance resources to support compliance program initiatives

Whether you need one resource or many, BluePeak can quickly staff any project, train resources, track results, and deliver success.

Contact us today!