Ken Goldberg is an innovative product and market strategy leader with keen business instincts and an entrepreneurial nature. He has a passion for developing & executing strategies to expand market opportunities and provide distinct value to shareholders, customers and patients. As an accomplished change agent, Ken is highly effective in building teams that meet customer needs and leading an organization that is accountable for results.
Ken has worked in the healthcare and PBM industry for his entire career. He has watched as the industry coped with the entrance of MCO’s, HMO’s, PHO’s, PPO’s, and PBM’s. He witnessed vertical integration at its best and at its worst; witnessing the industry cope and mature with these new pricing and valuation methodologies. He saw the entrance of capitation whereby physicians and hospitals were reimbursed not by the services they provided but rather by the number of patients which they agreed to own the responsibility of medical care. He began his formal career as a clinical social worker and was promoted through the healthcare arena numerous times over; always willing to accept new assignments and challenges.
At Cardinal Glennon Children’s Hospital, Ken was responsible for managing the PHO and the creation of the primary care operation; recruiting referring physicians to sell their practices and hiring residents out of training to assume responsibility for those practices whereby creating a patient flow into the hospital.
At Express Scripts, Ken held numerous responsibilities as he assisted the company in growing into the world’s largest Pharmacy Benefit Manager (PBM). He guided teams of Account Directors as they cross-sold and upsold various pharmacy products and benefit services. He was recruited to implement the Medicare Part D product and to establish the company’s first mail order product, which entailed implementing a direct-mail promotional campaign that achieved significantly above-industry average (9%) response rates. He was hand-selected to turn around a failing multi-million dollar workers compensation acquisition whereby he integrated the entity into the ESI book of business and established a new sales manager function within the ESI organization. He held P&L accountability for a business unit comprising of approximately 150 corporate clients and $38 million in EBIT. Ken operated in the player-coach model as he provided strategic and tactical leadership to his team who were managing day-to-day operations, selling/upselling new products, and assuring PBM contract compliance.
Currently Ken is a Partner with Experience on Demand Consulting company. He understands trends and topics relating to the healthcare and PBM industry, including: Market Strategy Development, Product Development, & Subject Matter Expertise in the field of Pharmacy, Medical and Health Benefit Management areas. He can discuss the implications of employer public and private exchanges, growth of employers leveraging self-funding (as premiums are on the rise) with the advent of specific disease state stop loss coverage, and overall expertise in healthcare benefit programs. His knowledge spans the presence of specialty pharmaceuticals, compounding pharmacies, retail pharmacy, and M&A activity in the PBM industry. He truly understands the PBM sales cycles and is comfortable explaining the various value propositions of the key PBM’s in the marketplace.