Jim Clark

Jim Clark

Senior Consultant

Jim Clark brings Gorman Health Group clients over 30 years’ experience in aligning people, processes, and technology with business objectives™.
 
Jim leverages his extensive knowledge in information technology and organizational leadership to deliver exceptional technology, back-office operations, and re-engineering solutions to Medicare Advantage Prescription Drug (MA-PD) plans across the United States and Puerto Rico.
 
Jim has worked with more than two dozen Medicare Advantage and Part D plans to improve enrollment reconciliation, reduce Prescription Drug Event (PDE) rejections, oversee Pharmacy Benefit Manager (PBM) processing, and re-engineer business processes to increase member-centric, cross-functional workflow to streamline business processes and mitigate compliance risk. Jim has broad Medicare operations expertise but can also drill down to complex business processes like Other Health Insurance (OHI)/Medicare Secondary Payer (MSP)/Coordination of Benefits (COB) and Late Enrollment Penalty (LEP).
 
Mr. Clark serves as Project Manager for GHG’s largest projects. His Medicare operations and technology experience has been applied to a number of recent projects including technology readiness assessments, designing shared services environments,  providing systems integration strategies, best practice business process improvements, training, and knowledge transfer to Medicare Advantage plans. 
 
Jim founded Interim CIOs, a company that offers interim IT leadership and strategic planning services to companies in transition.  He also co-founded cranespharmacy.com with the objective of bringing back the neighborhood drugstore by designing, building, and hosting e-pharmacy websites.
 
Prior to GHG, Jim held a number of senior management positions with UnitedHealthcare, including COO of the Allina/Medica contract and Regional CIO of UHG.
 
Jim serves on advisory boards for Benchmark QA and Capella University and is also a member of the Health Information and Management Systems Society (HIMSS), America’s Health Insurance Plans (AHIP), and the Minnesota High Tech Association (MHTA).