Matthew Pluimer

Experience

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  InnerCity Tennis

  Jul 2001 - Aug 2004

  Tennis Instructor

  Taught tennis to local children ages 4-18 for 6 weeks during summer vacation.

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  The JET Progamme

  Aug 2006 - Aug 2009

  Assistant Language Teacher | English Department | Japanese High School Students

  Full time teacher at 兵庫県立三田祥雲館高校 (Hyogo Prefecture Sanda Shounkan High School). Spearheaded international pen-pal program, created new English curricula for several classes, and re-initiated High School versus University student debates in English.Prepared high school students for EIKEN tests for the central college examination.First credit based school in Hyogo Prefecture, where student could select their own courses. Many students went on enroll international universities.

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  Queens Education

  Jan 2010 - Jan 2011

  Head Instructor | TOEIC Instructor | Japanese Language Specialist

  In charge of teacher training, business and student curriculum development, translations, business development, TOEIC training and language testing while maintaining a full time teaching schedule. Instructed business people on English language and culture in preparation for working in English speaking countries.

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  Mie YMCA

  May 2012 - Mar 2014

  English Instructor | Early Childhood Teacher | Business English

  Teaching English students ranging from kindergarten to business professionals (ages 2 to 75). Focusing on early development education, business English and translation classes, this job offers a wide range of responsibility, challenge and reward.

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  Reinsurance Group of America, Incorporated

  Apr 2014 - Jun 2017

  Actuary Analyst

  Responsibilities include the production and execution of pricing models, conducting experience studies, preparing pricing memos, modifying bases for new product specifications and performing technical reviews of models by other pricing actuaries. The pricing work varies greatly; it can move from traditional products to products that are new/becoming common place in the Japanese insurance market to consulting with our GFS team in Singapore on co-insurance deals from week to week. The variety of work poses not only challenges but also learning opportunities and keeps work fresh and interesting. Show less

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  Prime Therapeutics

  Jun 2017 - Dec 2023

  Responsibilities include the weekly maintenance of pricing algorithms to ensure optimum performance and meet our GER (Generic Effective Rate) Contracts with pharmacy networks as well as determining new price points when our performance gets off track. The streamlining of our weekly manual processes is a top priority as the number of price points we track increases weekly. We are automating more processes which will standardize our pricing methodology across all MAC (Maximum Allowable Cost) Lists as well as free up more resources for researching drug trends. Future projects will include forecasting utilization of drugs into our pricing algorithms to improve ours savings forecasts. Show less Responsibilities include the updating of pricing algorithms for weekly price changes and maintenance of targets in order to meet our GER (Generic Effective Rate) Contracts with pharmacy networks. The current weekly pricing process is being reinvigorated by utilizing automation which will both standardize our pricing methodology across all MAC (Maximum Allowable Cost) Lists as well as make our pricing more accurate. This will in turn allow us to become proactive in our pricing methodology. Client and potential clients requests also require analytic and predictive skills as required by the situation. Show less

  • Manager Financial Modelling

    May 2020 - Dec 2023

  • Senior Pricing Analyst

    Apr 2018 - May 2020

  • Pricing Analyst

    Jun 2017 - Apr 2018
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  Capital Rx

  Dec 2023 - Aug 2024

  Manager, Financial Performance - Pharmacy Network Pricing

  Responsibilities include the review and update of client specialty lists, monitoring the changes in NADAC pricing/performance after the CMS methodology changes, review of changes to standard SQL and Python code, updating of team resources/guides for new comers, perform reconciliations with various pharmacy chains, perform surveillance of claims and updating the surveillance code based on new contract terms, create pharmacy performance metrics and dashboards for senior management, automation of current processes and report creation to gain efficiencies, review of network set-ups to ensure compliance with contract terms and state laws and ad hoc analyses for other teams as needed. Show less

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  Gateway Health Partners

  Aug 2024 - now

  Director, Finance - Margin Analytics