I worked in healthcare B2B for a while and had this same problem. We ended up going with a more minimal approach and focused on using type and color (we had to use images for a lot of our brand fonts with the healthcare audience) over graphics. Sometimes adding a little bit of line-height and keeping the width of the body copy tighter makes a big difference visually.
We use JIRA. We treat our process more like a software development team so everything is tracked by stages. Got the idea from how Atlassian is using JIRA for their email processes: http://blogs.atlassian.com/2013/06/how-atlassian-uses-jira-email-marketing/