About Tier 1 Pharmacy Consulting
After spending more than a decade at a PBM working directly with health plans, I launched Tier 1 Pharmacy Consulting in 2018 to fill a gap I saw repeatedly in the industry. Many plans did not have a full-time pharmacist on staff, often because of their size, budget, or difficulty finding candidates with true managed care experience. As a result, they leaned heavily on their PBM, without always having the internal expertise to evaluate decisions, monitor performance, or fully understand the regulatory requirements tied to their pharmacy benefit. I knew I could help health plans navigate this complexity and bring the leadership needed to manage such a highly regulated and delegated function.
Today, health plans often partner with me to serve as their Director of Pharmacy in a fractional capacity, providing the strategic leadership and regulatory expertise that ensures compliance while supporting existing pharmacy staff. I work with teams that may not have deep experience in PBM oversight, regulatory change management, or connecting operational details to broader regulatory requirements. My role is to bring an executive-level perspective, strengthen oversight, and provide the guidance plans need to operate with confidence.
Another area where I often engage with health plans is during the Medicare Advantage application process, which requires long lead times and careful planning before a plan enrolls its first member. For many health plans, it isn’t practical to hire a full-time pharmacy leader this early, but having the right expertise is essential. I’ve supported multiple plans through this process, facilitating PBM discussions, guiding pharmacy benefit design, and ensuring every detail is addressed for a successful launch.
In addition to Medicare Advantage, I partner with commercial, marketplace, and self-funded health plans that need to focus on the financial performance of their pharmacy benefit. This includes analyzing key cost drivers, monitoring drug spend, and evaluating utilization patterns to ensure plans are maximizing the value of their pharmacy benefit. I help organizations strengthen their clinical strategies, manage emerging drug trends, and build processes that balance cost containment with quality outcomes. My goal is always the same: to give health plans the pharmacy leadership they need to manage complexity, improve oversight, and deliver greater value to their members.
Why Work With Me?
Health plans choose Tier 1 Pharmacy Consulting because they gain access to senior-level pharmacy leadership without the cost or commitment of a full-time hire.
- Director-Level Expertise: I’ve been in the managed care space since 2008, working with health plans and PBMs, with deep knowledge of Medicare Part D and broader pharmacy benefit management.
- Flexible Engagement: Available as a fractional partner, interim leader, or project-based consultant, tailored to fit your organization’s size and needs.
- Stronger Oversight: Hands-on support for PBM monitoring, compliance, and regulatory change management to give your plan clarity, accountability, and confidence in your PBM delegation.
- Cost & Performance Insight: Guidance to identify key cost drivers, evaluate clinical strategies, and improve the value of your pharmacy benefit.
Mission
To provide high-quality pharmacy consulting services that ensure compliance with regulatory guidance while maximizing pharmacy benefits through proper oversight and intervention. Tier 1 will do this with a commitment to our partners to improve overall plan performance and value to the member.
Brent A. Hiley, PharmD, MBA
Dr. Brent Hiley has built a career that spans clinical practice, pharmacy benefit management, and senior leadership, bringing a unique perspective shaped by experience across multiple areas of healthcare. Prior to founding Tier 1 Pharmacy Consulting, he spent more than a decade at an independent, middle-market PBM, ultimately serving as Vice President of Account and Product Management. In that role, he gained comprehensive experience across the pharmacy benefit landscape, including prior authorization management, regulatory compliance, formulary design, clinical program development, account management, contract negotiation, trade relations, and audit coordination. This broad foundation now enables him to provide health plans with PBM-level insight and leadership to strengthen oversight, ensure compliance, and improve pharmacy benefit performance.
Brent launched Tier 1 Pharmacy Consulting after recognizing a common challenge: many smaller and growing health plans lacked the senior pharmacy leadership needed to navigate complex delegated relationships with PBMs, regulatory requirements, and drug benefit administration. By offering executive-level expertise on a fractional or interim basis, he helps plans bridge this gap, providing leadership, compliance support, and strategic insight without the cost of a full-time hire.
Earlier in his career, Brent practiced in both retail and health-system settings, including serving as a clinical pharmacist in critical care and emergency medicine at the University of Nebraska Medical Center (UNMC). At UNMC, he helped expand full clinical pharmacy services into what remains one of the largest emergency departments in the Midwest.
Brent earned his Doctor of Pharmacy from the University of Iowa and completed his residency in pharmacy practice at UNMC. He earned board certification in pharmacotherapy (BCPS) and holds an MBA in Finance.