Stephen O'loughlin, JD Chc
About Stephen O'loughlin, JD Chc
Legally trained healthcare professional (licensed in MA and CT) with a wide range of experiences in healthcare operations and regulatory compliance. Over the past several years, I have developed a strong track record in the healthcare space including: Team and Project Management, Operational Process Design and Improvement, Building and Auditing Compliance Programs, Medicare Part D, Third Party Risk Management and organizational restructuring. As a legal compliance analyst at Wolters Kluwer I worked extensively in all facets of health care regulation; including the Affordable Care Act, HIPAA, HITECH, Medicare & Medicaid and the OIG Work Plan. I was responsible for developing Compliance based risk assessments for various health care organizations including hospitals, insurers and PBMs. I routinely conferred with clients regarding their organizational risk according to the latest regulatory updates. I later transitioned into consulting as a PwC Associate, and specialized in their national healthcare practice, where I worked with a number of large payor organizations to improve operations, streamline reporting structures, decrease audit scores and further embed compliance within the business. We held a number of responsibilities our health care clients including advising C Suite members on Compliance related issues, revising Compliance departments, rewriting Policies and Procedures, auditing Compliance program effectiveness and even conducting mock CMS audits. As a Manager in the Process Innovation space with CVS, I worked extensively across the organization to improve efficiency in some of our key PBM systems and programs. In my first year I led a team of PI professionals to improve our Med D enrollment platform, which executed in several different phases and projects. In my second year I partnered with various aspects of the organization to redesign and improve a popular $8M benefit program.