Rebecca Smith

Rebecca has a broad background in commercial payer operations, clinical policy, and coverage decision making, as well as health outcomes analysis. She specializes in using real-world administrative claims data to conduct health economics research and health policy evaluations. She also focuses on market access strategy development, including value-based contracting and broader patient and trade advocacy work.

Rebecca has extensive knowledge of care management, utilization management, and preauthorization operations within the payer space. She has tested the viability of novel alternative payment arrangements for biosimilar drugs, developed claims-based machine learning algorithms for cancer identification, and evaluated the feasibility of health product offerings and value-based payment arrangements in the commercial and Medicare spaces. Rebecca has significant experience in the oncology, diabetes, kidney, and respiratory care spaces.

Prior to joining Milliman, Rebecca held a senior management role in the Medical Affairs division at Aetna and CVS Health, where she was responsible for identifying opportunities to drive medical cost savings and quality improvement for the enterprise. Rebecca was also involved in assessing clinical policy and coverage decisions and developing new clinical products and services. She covered several medical cost categories, including endocrinology, gastroenterology, preventive health, and complex and critical care. In this role, she also created and implemented clinical programs in the retail clinic setting and served as Aetna and CVS Health's liaison to the FDA's Payor Communication Taskforce.