Jim DiGuiseppe

Principal

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Jim is a Principal of Evolution Benefits Consulting (Evolution Benefits Consulting) and has over 20 years experience as a health care and group benefit consultant to large employers and trusts for their active and retiree populations. Jim has worked for a two leading benefit consulting firms and joined Evolution Benefits Consulting after identifying a need in the market place for cost effective and high quality services.

He specializes in helping large employers design, implement, and control the cost of their health care and group benefit programs. He has an in-depth knowledge of health care market variables, vendor processes and systems and customer demands. Jim assembled and created the Ernst & Young Rx Value Approach (RVA) and has worked on other Rx coalitions while at William M. Mercer, Incorporated.

Jim is considered a thought leader in the area of prescription drug management, health promotion and wellness and has considerable experience in the area of Rx process analysis and improvement. He has assisted employers with documentation and procedural improvement suggestions on many areas of their Human Resource financial controls.

Jim has an MBA and M.A. in Mathematics from Villanova University and B.S. in Engineering from The Pennsylvania State University. In addition, Jim has completed Six-sigma green belt training from Drexel University.

Areas of Specialization

• Expertise in process mapping and designing, developing, and implementing best solutions, in terms of cost and quality
• Created purchasing groups for medical, Rx and worksite wellness programs
• Design, development, and implementation of both active and retiree benefit strategies
• Advanced knowledge of Pharmacy Benefit Manager (PBM) marketplace and contract intricacies
• Management, supervision, and participation in project teams and communication of analytic results to client’s management in both oral and written forms
• Review and analysis of HMO rate filings to determine rate adequacy
• Use of actuarial and MBA background to determine pricing and employee contribution methodologies
• Manual and experience rating renewals and prospects for medical, dental, life, AD&D, and disability coverages
• Extensive knowledge of health care cost drivers and disease management/predictive modeling opportunities
• Benchmarking design and cost to peer groups

Education & Certification

• M.B.A., Villanova University, Villanova, PA
• M.A., Mathematics, Villanova University, Villanova, PA
• B.S., Aerospace Engineering, Pennsylvania State
• Six-sigma Green Belt Course, Drexel University, Philadelphia, PA
• Actuarial Exam Credits