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MB-6632 - USA (New York) - Pharmacy Benefit Management Services - Deadline August 17,2022

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-6632

Government Authority located in New York; USA based organization looking for expert vendor for pharmacy benefit management services.

[A] Budget: Looking for Proposals

[B] Scope of Service:

(1) Vendor needs to provide pharmacy benefit management services
- Comprehensive pharmacy benefit management solution for their approximately 1404 employees and 3226 members (includes employees).
- The self-funded prescription plan currently includes active employees, and all retirees including those over age 65 eligible for Medicare. There are currently 644 over age 65 retirees eligible for Medicare (194 retirees) covered under the self-funded Plan.
- PBM will need to take into account the required integration with other benefit providers including but not limited to 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
- PBM performs in the following areas:
- Discount guarantees with per-unit price stability
- Administrative fee structure
- Maximizing generic utilization
- Percentage of earned rebates to the Client with minimum floor guaranteed rebates, without overutilization of brand drugs
- Performance Guarantees
- Stable and decreasing PMPM (per member per month) spending trend
- Stable formulary, focused on lowest net cost drugs
- Drug monitoring and utilization review programs
- Innovative programs, such as therapeutic mac, disease management, therapeutic interchange programs, limited network strategies, retail pharmacy partnerships, etc.
- Periodic reviews – financial, clinical, market, strategic
- Effective customer, client, and consultant communications and messaging.
- Mail cost savings opportunities with incentives programs
- Organizational stability and experience
- Customer service representative and account manager capabilities.
- 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
- Online member information resources, including mobile applications
- program management experience for over age 65 retired members.
(2) All the questions must be submitted no later than August 3, 2022.

[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, 17 August, 2022

Question Answer Deadline : Wednesday, 3 August, 2022

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

Country : USA

State : New York

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