Presentation #1

Enhancing Member Engagement and Reducing Confusion in Self-Funded Health Plans through Integrated Solutions

In today’s self-funded health plans, improving member engagement and reducing confusion surrounding point solutions is critical for ensuring better health outcomes and cost-efficiency, especially with members at risk either episodically or with chronic conditions and emerging risk. As union health plans increasingly adopt multiple point solutions—such as telemedicine, mental health services, and targeted health solutions – high risk members often face challenges navigating these disparate offerings, leading to confusion, underutilization of resources, and missed opportunities for improved care. To address these challenges, health plans must streamline communication, integrate services more effectively, and provide members with clear, personalized guidance, thereby driving better health outcomes and maximizing the effectiveness of the self-funded health plan.

Presented by: David Lauritzen
Regional VP Business Development
Conifer Health

David Lauritzen is a seasoned healthcare consultant with 34 years of experience in national business development and account management within the Employee Benefits industry, specializing in self-funding and medical management. As the Regional Vice President of Business Development for Conifer Health Solutions, David is responsible for expanding market exposure in the Eastern region, and his leadership has been instrumental in forging strategic partnerships with unions, employers, consultants, strategic partners, and payers, positioning Conifer Health as a leader in population health management and value-based care. Through his efforts, David has helped unions and self-funded employers streamline their medical management processes, ensuring high-risk members are identified early and provided with the right interventions, ultimately improving care quality and reducing unnecessary costs. 

With a deep understanding of the critical role that medical management plays in self-funded health plans, David is passionate about helping organizations better identify and engage high-risk members to improve health outcomes and reduce overall costs. When medical management is not properly executed, it can result in costly consequences for the health plan, making effective management of at-risk populations a key priority. Today, Conifer Health services over 1 million union members nationwide ensuring that both the needs of the member and health plan are met for the best outcomes. 

His career includes leadership roles at renowned organizations such as The Difference Card, Healthcare Strategies, Kaiser Permanente and CareFirst Blue Cross Blue Shield, where he developed successful distribution channels, managed large portfolios, and led initiatives that resulted in significant client growth and retention. His expertise in self-funding, data analytics, and risk management has made him a trusted advisor to clients, partners, and consultants alike, empowering them to make informed decisions and achieve long-term financial sustainability.

David holds a Bachelor’s Degree in Business Management from Notre Dame of Maryland University in Baltimore and proudly served in the United States Marine Corps. His distinguished military service, combined with his professional achievements, reflects his dedication to excellence, leadership, and commitment to delivering impactful results. Known for his strategic vision, work ethic, and collaborative approach, David continues to drive success in the healthcare industry by helping organizations navigate complex challenges and achieve improved outcomes in their self-funded health plans.

Presentation #2

US-Rx Care PBM: Clinical Update – Controversial Thoughts

The presentation will cover general health and cost of medications; the controversy of prior authorizations and views from the different stakeholders of PA; autoimmune disease; treatment without drugs; guidelines are tainted and influenced by drug manufacturers; highest cost therapies and what should we be doing; biosimilar market; weight loss and GLP-1s; and what therapies are unnecessary or overused.

Presented by: Taeho Oh
Co-Founder and Chief Pharmacy Officer
US RX Care

Taeho is a founder and Chief Pharmacy Officer of US Rx Care, a fiduciary PBM and clinical pharmacy management company.
 
Taeho earned a B.S and M.S. in Pharmacy from Ohio State University and Residency from The Ohio State University Hospitals and Clinics. He has published twenty-six peer-reviewed articles and has been a faculty appointment as an Assistant Professor in Pharmaceutical Sciences at Nova-Southeastern University for 9 years (part time). 
 
Taeho has over thirty years’ experience managing pharmacy risk within hospitals (early years of DRGs) and managing discharge, physician groups, Medicare, Medicaid, and self-funded plans. He has worked for several pharmaceutical companies and has own and operated a specialty, home infusion pharmacy and infusion suites to assist payors manage site of care for both for Part D and B drugs. Taeho has experience in HEDIS, STAR, MTM, prior authorization and drug cost savings programs.
 
He started doing prior authorizations for SSHP, a Centene Plan, other health plans both as a provider and working directly for the plan using medical policies, guidelines, criteria (NCCN, national plan, medical society, ICER and ASCO). Using prior authorization process as both science and art, he helped WellCare and Universal Health Plan save millions of dollars.

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Contact Karleen at 201-507-0334
email: koneill@smw25.org