Our Pharmacy team members are experienced professionals with hands-on experience, specialized training, and in-depth industry knowledge to navigate the complexities in today’s healthcare environment. Our team includes subject matter experts within each area of pharmacy management: financial, clinical, operational, contracting, reporting, and analytics.
Our pharmacy management services include:
- RFP / Vendor Selection - Selecting the right vendors can be a daunting task; we know the questions to ask and can manage the process from the start of the request for proposal (RFP) through implementation.
- Contract Review and Negotiation - The review includes negotiating terms and conditions, definitions, pricing, performance standards and guarantees, audit rights, and other key components. We make sure the contract protects your interests.
- Market Check Analysis - We compare your current pricing against industry benchmarks to ensure market competitiveness with the PBM. We identify opportunities to improve the terms of the contract to enhance performance.
- Custom PBM and Clinical Programs - We have negotiated custom agreements that allow plan sponsors to get the most from the carrier and realize significant cost savings. Our Pharmacy Coalition is a prescription drug purchasing pool that offers access to deeply discounted pricing and rigorous financial and service performance guarantees for self-funded groups. Our partnership with EmpiRx Health provides a fully aligned PBM model that manages drug spend by utilizing evidence-based care, proactive engagement and concierge service.
Our Clinical Care Management program, developed with industry-leading pharmacists and medical health experts, integrates with your PBM. This program provides an independent, unbiased layer of clinical management by engaging physicians and members directly to ensure that the best possible drug therapies are chosen based on their clinical effectiveness and overall cost to patients and the plan.
- Implementation & Account Management - Once the right PBM is selected, we make sure the benefits are set up according to the contract and plan design. Dedicated resources support your members 24/7 providing an enhanced level of customer service, account management, and clinical support.
- Auditing - We back up the contract by providing ongoing audits and clinical reviews. Our audit and compliance experience provides clients with the comfort of knowing that their benefit plans are set up according to the contract and producing the financial results they expect.