Senior Pharmacy Benefits Consultant - Health Plans
Madelena (Maddy) Lieu is a registered pharmacist with more than 24 years of experience in pharmacy, Medicare, and health plan pharmacy benefits. Maddy became a well-respected authority on Medicare Part D during her tenure at several roles before joining PSG.
Maddy served as Senior Pharmacy Consultant for Gorman Health Group, where she provided consultative expertise and promoted compliance with CMS Medicare Part D. She provided guidance on formulary requirements, MTM (medication therapy management), under- and over-utilization, B versus D categorization, coverage determinations, appeals, and other Part D program requirements.
As Director of Pharmacy Service, Formulary Development, and UM (utilization management) for Aetna, she created and maintained Aetna’s Medicare Part D formularies, managed and trained the Medicare Part D formulary and UM pharmacists, all while serving as the clinical lead for therapeutic class strategy deep dives and guidelines.
For EmblemHealth as Director of Clinical Pharmacy Programs, Maddy managed and trained the clinical department pharmacists, analysts, and assistants while also implementing and managing the in-house MTM program. Also, for EmblemHealth as Director of Medicare Pharmacy Program, Maddy developed Medicare Part D policies and procedures and managed internal and client audits. She started with EmblemHealth as Medicare Pharmacy Manager, developing and maintaining Part D formularies and developing clinical coverage determination criteria. Serving as Medicare Product Specialist for MMC20/20, Maddy developed PDE (prescription drug event) edit logic and demonstrated expertise in PDE data analysis, in addition to auditing PBM-administered Medicare Part D claims.
Early in her career, she was Staff Pharmacist and then Pharmacy Manager for Rite Aid, supervising daily pharmacy operations and providing medication information and counseling to customers.
Maddy earned a Bachelor of Science in Pharmacy from Rutgers University, College of Pharmacy, and a Master of Public Health, concentration in Health Policy and Management, from Columbia University.