Strategic Pharmacy Benefit Consulting for Health Plans
Tier 1 Pharmacy Consulting specializes in Medicare Part D, while also supporting commercial and self-funded plans with leadership, pharmacy benefit oversight, and guidance to manage key pharmacy cost drivers.
Pharmacy Leadership That Fits Your Organization
Embedded Frational Pharmacy Leadership Services
We provide director-level pharmacy leadership delivered flexibly: fractional support for smaller health plans and interim coverage for organizations recruiting permanent staff.
Medicare Advantage-Prescription Drug Plan Application Support
We support health plans through the Medicare Advantage application process with expertise that ensures accuracy, compliance, and clarity on the implications of every response.
PBM Oversight & Monitoring
PBM oversight isn’t optional, and health plans can always be doing more. These arrangements are complex, spanning claims processing, service guarantees, delegation oversight, and compliance requirements. Too often, plans lack the internal pharmacy expertise to monitor these areas effectively, leaving them dependent on their PBM and uncertain whether issues are being identified and addressed. Without strong oversight, plans face compliance risks, member abrasion, and unnecessary drug spend. I guide health plans in managing their delegated functions, establish effective monitoring practices, and strengthen their PBM relationships. My role is to identify risk areas, evaluate contractual performance, and ensure your plan receives the services and value it is paying for.
Expertise in Medicare Part D and Beyond
With extensive experience in Medicare Part D, I help health plans navigate complex state and federal regulatory requirements while assessing rising drug spend and utilization trends. Beyond compliance, I partner with plans to strengthen clinical strategies and ensure the effective administration of pharmacy drug benefits.
Meet the Founder: Brent A. Hiley, PharmD, MBA
Dr. Brent Hiley is an expert in pharmacy benefit plan design and management. With more than 25 years of experience in healthcare and pharmacy benefit management, Dr. Hiley leads Tier 1 to help health plans reach their goals and improve patient care.
