Senior Benefit Consultant – Health Plans
Caron Wingerchuk has more than 25 years of experience in healthcare, pharmacy, and pharmacy benefit consulting, with key skills in regulatory compliance, auditing, pharmacy operations, and clinical program development.
Prior to joining PSG, Caron has held senior consulting roles, where she has served as a subject matter expert related to Medicare Part D formulary administration, coverage determinations, and appeals. She also supported PBM implementation to ensure accuracy of benefit setup. As Senior Director for Pharmacy Solutions with Gorman Health Group, Caron provided consultative guidance on CMS audit and remediation activities and quality initiatives, including Stars and Medication Therapy Management (MTM) programs. She managed the relationship with PBMs as well as assisting health plans with Part D compliance readiness reviews.
For CVS Health, Caron held several roles with increasing responsibility. As Manager Medicare Part D Operations, Quality Monitoring, for CVS, she developed a Medicare quality monitoring program and supported claims auditing for CMS Formulary Administration and Transition Monitoring. As Lead Clinical Pharmacist, Pharmacy and Therapeutic (P&T)/Formulary, Caron performed new drug and therapeutic class reviews for formulary recommendations.
Caron earned a Bachelor of Arts and Bachelor of Science, Pharmacy, from University of Saskatchewan, and a Doctor of Pharmacy (summa cum laude) from University of Minnesota. She completed post-graduate programs in internal medicine, nephrology, and renal transplantation.