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MB-5959 - USA (New Jersey) - Rx Drug Consultant Services - Deadline February 23,2022

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-5959

Government Authority located in New Jersey; USA based organization looking for expert vendor for Rx drug consultant services.

[A] Budget: Looking for Proposals

[B] Scope of Service:

Vendor needs to provide Rx drug consultant services
- Confirm, manage and maintain on-line eligibility for active employees, new hires, terminated employees, retired employees and dependents using the database provided.
- Confirm all co-payments are correct.
- Provide monthly reviews for all claims to ensure compliance with current Self-Insured Prescription Drug Program TPA contract with respect to discounts, co-payments and eligible drugs.
- Review all rebate statements to ensure rebates are being remitted in accordance with the Self Insured Prescription Drug Program TPA contract.
- Review all drugs purchased and from where the drugstore purchased the drugs
- Provide a monthly report to the Fund Administrator which shall contain but not be limited to information obtained from the claim review, rebate review and recommendations to reduce
costs.
- The successful vendor shall also send “Credible coverage Notices” to all eligible retirees as required by the Medicare Prescription Drug Benefit Program as set forth in Part D of the Medicare Prescription Drug Improvement and Modernization Act of 2003 and all amendments thereto. This shall be done annually.
- Establish a toll-free phone number to provide customer service assistance to Employees, provide 24/7-member access to service.
- Create employee communications literature as necessary or requested by the Fund Administrator.
- Provide assistance at open enrollment and/or when plan changes are introduced as required by the Fund Administrator.
- The successful vendor shall be required to contact the contracted Third-Party Administrator for the Self-Insured Prescription Plan in the event of an “exception” in which an employee needs to obtain and “override” on a prescription. This is a necessary function which is required in very specific instances
- Monitor Excluded Drug and Step Therapy Review Process with affected members and provide 24/7-member access to service. Prepare monthly reports and provide quarterly report at Professionals meeting.

[C] Eligibility:

Onshore (USA organization Only)

[D] Work Performance:

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

Expiry Date : Wednesday, 23 February, 2022

Category : Medical Billing and Coding, Professional, Consulting, Administrative or Management Support Services

Country : USA

State : New Jersey

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