Michael Zucarelli

Michael Zucarelli is a practicing pharmacist and leads CBIZ’s National Pharmacy Practice, a specialty practice within CBIZ’s Benefits and Insurance Group.  He serves as the lead pharmacy consultant for clients, providing financial and clinical guidance to optimize a group’s pharmacy program and overall benefit strategy that is cost-effective, compliant and sustainable.  Michael’s approach focuses on client satisfaction with the pharmacy benefit value and PBM relationship.  He assists clients with financial models, pharmacy program analysis, and clinical evaluation.  Upon completion of this analysis, he presents these results concisely and offers strategic recommendations.  He is a graduate of the University of Arizona and joined CBIZ in 2013.

Service Specialties:

• Lead clients through pharmacy benefit plan evaluation including procurement, contract review, and implementation of pharmacy benefit management for self-insured plan sponsors
• Lead planning and strategy meetings with clients to produce and maintain a cost-effective and sustainable pharmacy benefit for their employees and dependents
• Leverage PBM and carrier relationships to advocate vendor accountability and best practices on the client’s behalf
  Employ and update proprietary modeling tools to determine pricing benchmarks consistent with the marketplace environment
• Proactively advise the core CBIZ account services teams on relevant State and Federal pharmacy issues
• Foster an environment of continuous learning by leading regular, topical pharmacy discussions with CBIZ associates
• Serve as a resource for clients and CBIZ associates specific to pharmacy benefit  operations, clinical programs, and member experience

Bachelor of Science in Chemistry and Doctor of Pharmacy degree from the University of Arizona

Licensed pharmacist in Arizona, Missouri and North Carolina

Member, Academy of Managed Care

Prior to joining CBIZ, Michael was a pharmacist member of Mercer’s Managed Pharmacy Practice serving large and jumbo self-insured clients. He was responsible for evaluating pharmacy strategies and programs with respect to their alignment with his client’s corporate culture and financial goals. Michael also collaborated with actuarial teams responsible for the capitated rate setting of Managed Medicaid plans. He provided pharmacy consulting around financial and clinical parameters used in the actuarial modeling of prospective capitation rates.

• Lead clients through procurement, contract review, and implementation of pharmacy benefit management for self-insured plan sponsors
• Provide oversight for client’s pharmacy benefit pertaining to operations, clinical programs, and member experience
• Lead planning and strategy meetings with clients to produce and maintain a reasonable, and sustainable pharmacy benefit for their employees
• Assist with drug pipeline and trend reporting to various clients
• Evaluate new drugs for formulary placement and develop the clinical programs for the appropriate and efficient use of each agent
• Create client deliverables promoting generic utilization and therapeutic interchanging in the effort to augment cost savings, improved compliance and disease management
• Collaborate with actuarial teams to provide strategic consulting and recommendations specific to State and Federal law including healthcare reform
• Create clinically sound parameters used to assess claims data for inefficiencies
• Perform financial modeling and savings projections based on various pharmacy pricing benchmarks
• Process,  verify and evaluate for appropriateness, new prescription orders in the outpatient pharmacy setting
• Evaluate patients’ medication regimen for therapy optimization while monitoring disease progression. Ensure each disease state is appropriately recognized and treated while minimizing duplicative therapies

Contributed to the development of a whitepaper on best practices for Medicaid pharmacy that was published and presented to the State of New York (http://www.uhfnyc.org/publications/880758)

Created reporting models used by State Medicaid departments and health plans to benchmark plan performance

• Risk Advisory Services
• Health Care Reform
• Benefits Consulting