Professional of the Year - Healthcare/Pharmacy Benefits Management

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Kim L. Daniel

Title: Director, Formulary Program
Industry: Healthcare/Pharmacy Benefits Management
Type of Organization: Pharmacy Benefits Management Company
Major Product/Service: Providing PBM services to the Commercial MCO, Medicare, Medicaid, self-insured, state/local government, 340B, and discount/retail pharmacy loyalty card market segments; Providing innovative solutions that optimize satisfaction, cost, service and quality in the healthcare industry
Expertise: Mrs. Daniel has over 20 years experience. She is a Pharmacist responsible for auditing compliance for the Medicare part D formulary administration. She oversees all the guidance from CMS ensuring that it gets operationalized so claims adjudicate correctly. Mrs. Daniel also oversees all formulation audits for CMS. She researches prescription claims and audits them, responds to CMS, identifies issues regarding what's not adjudicating correctly and works closely with applicable departments to ensure errors are not repeated. Mrs. Daniel manages client relationships relating to audits.
Geographic Area of Distribution: National
Affiliations: A.M.C.P.
University/Degree: Pharm.D., San Francisco, 1993
Hobbies/Sports: Travel, physical fitness, church activities
Spouse: Scott Daniel
Married: September 29, 2007
Work History: Previously, Mrs. Daniel served as a Clinical Analytics Manager, a manager of standard Pard D Formularie, a Director of Pharmaceutical Care outpatient clinics at Scripps (Cardinal Health), a Clinical Program Manager with MedImpact and a Clinical Ambulatory Care Pharmacist with NAMC of San Diego.
Career Accomplishments: Mrs. Daniel has participated in over 40 CMS formula administrative audits.