PHAR-0335 - USA (Houston, Texas) - Pharmacy Benefit Manager Services - Deadline January 16,2020

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: PHAR-0335

Government Authority located in Houston, Texas; USA based organization looking for expert vendor for pharmacy benefit manager services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide pharmacy benefit manager services to manage a comprehensive pharmacy network which includes retail participating pharmacies, mail service pharmacies, specialty products and ancillary supplies, equipment, and services, eligibility set-up and ongoing eligibility maintenance, deliver flexible savings account (FSA) eligibility feeds to the applicable vendors, offer website services including employer admin website; member portal, mobile app for members; chat and/or texts, ongoing member communications including implementation packages, performance guarantees (including member services, account management, claims adjudication and clinical outcome-based preferred), data reporting, offer a pharmacy discount plan, integration of pharmacy third party claims data to support benefit accumulators as well as predictive modelling to the government authority located in Houston, TX.
- Claims Adjudication including, appeals services, utilization management of clinical rules (prior authorization, quantity and day supply limits, step therapy, dispense as written, etc.), systematic prospective, concurrent, and retrospective drug utilization review and external review services.
- Member Services Call Center Support. Supplier will provide 24-hours a day, 7-days a week toll-free telephone (preferred), IVR and internet support to assist agency, agency agents and members with member eligibility and benefits verification, location of participating pharmacies or other related member concerns. Multilingual call center support is preferred.
(2) A pre-proposal conference will be held on December 10, 2019.
(3) All question must be submitted no later than January 09, 2020.

[C] Eligibility:

- Onshore (USA Only);

[D] Work Performance:

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

Expiry Date : Thursday, 16 January, 2020

Pre-proposal Conference Date : Tuesday, 10 December, 2019

Question Answer Deadline : Thursday, 9 January, 2020

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

Country : USA

State : Texas

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