Mike Looney
MANAGING DIRECTOR
As an experienced healthcare leader and innovator, Mike has helped businesses grow, while transforming, for more than 30 years. He delivers profitable growth by leveraging best practices, market innovations, vendor relationships and technologies. Mike can bring perspectives and advancements that span the health ecosystem, from government programs, to managed care, pharmacy and pharmacy benefits.
His focus and experience on compliance-based products, member experience and operational excellence builds businesses that grow revenue and margin.
Experience
Mike is motivated to improve the health and experiences of patients and bend the curve on healthcare spending, all while improving business outcomes. Never has more investment been behind the American health care system. By leveraging business innovation, technologies and converting data into action, Mike established a verifiable track record of building and transforming health businesses.
Prior to joining Optimity Advisors, Mike consulted directly with PBMs and managed care organizations. He built system-driven transformation programs and multi-year Medicare Part D membership growth, retention and service strategies. Mike also has more than 12 years’ experience leading government programs for PBMs. While at Prime Therapeutics, Mike was responsible for the growth and profitability of the Medicare, Medicaid and federal programs. While at Express Scripts (Evernorth), Mike led the Medicare Part D business, building its membership from 500,000 to just over 2.2 million through a combination of merger integration (Medco), market expansion, government regulation changes and applied advanced analytics.
Mike also has more than a dozen years’ experience as a management consultant, primarily consulting to the managed care industry. Mike led a variety of transformative projects, including leading the Medicare practice for Ernst & Young, where he and his team helped multiple clients launch new Medicare Advantage and Part D products simultaneously across five states.
In addition to consulting, Mike has served in a variety of leadership roles in health plan organizations. He acted as CEO of the Express Scripts insurance company, where he also built the Medicare and Medicaid product offerings. Mike also served as the Vice President of new health plan implementations at Centene, and he began his career managing a Medicare Part B claims department for General American Life.
Mike holds an MBA from St. Louis University in Missouri and a B.S. in Communications from Bradley University in Peoria, IL. He also holds a U.S. Patent in Systems and Methods for Predictive Data Analytics.