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MB-4279 - USA (New York) - Prescription Drug Claims Administration Services - Deadline July 17,2020

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-4279

Government Authority located in New York; USA based organization looking for expert vendor for prescription drug claims administration services.

[A] Budget: Looking for proposal

[B] Scope of Service:

Vendor needs to provide comprehensive pharmacy benefit management solution for their approximately 680 employees and 1790 members (includes employees) including Medical, Disease Management and Data Aggregation vendors. The chosen administrator will be expected to bear the cost of preparation and installation of appropriate administrative systems, contract preparation, billing, network enhancements, related administrative manuals, enrollment forms, and communication with employees and providers.
a) Discount guarantees with per-unit price stability
b) Administrative fee structure
c) Maximizing generic utilization
d) Percentage of earned rebates to the Client with minimum floor guaranteed rebates, without overutilization of brand drugs
e) Performance Guarantees
f) Stable and decreasing PMPM (per member per month) spending trend
g) Stable formulary, focused on lowest net cost drugs
h) Drug monitoring and utilization review programs
i) Innovative programs, such as therapeutic mac, disease management, therapeutic interchange programs, limited network strategies, retail pharmacy partnerships, etc.
j) Periodic reviews – financial, clinical, market, strategic
k) Effective customer, client, and consultant communications and messaging.
l) Mail cost savings opportunities with incentives programs
m) Organizational stability and experience
n) Customer service representative and account manager capabilities.
o) Ability to work with the selected third-party claims administrators, data aggregators, consultant and other entities that may be involved with the administration of the health plan to provide up to daily electronic exchanges of eligibility, and claims information
p) Online member information resources, including mobile applications
q) EGWP program management experience
- For more information describe in documents.

[C] Eligibility:

- Onshore (USA Organization Only);

[D] Work Performance:

Performance of the work will be Offsite. Vendor needs to carry work in their office location.

Expiry Date : Friday, 17 July, 2020

Category : Medical Billing and Coding, Pharmaceutical, Pharmacy & Related Services, Software, System and Application

Country : USA

State : New York

Cost to Download This RFP Document : $ 5

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