Posted Date : October 04,2019
Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : MB-3518
Government Authority located in Arizona; USA based organization looking for expert vendor for employee benefits pharmacy management.
[A] Budget: Looking for Proposal
[B] Scope of Service:
(1) Vendor needs to provide employee benefits pharmacy management.
- Claims Adjudication
- Ability to Integrate services with other vendors e.g., disease management, care management, medical
- Eligibility maintenance
- Patient and provider education
- Systematic prospective, concurrent, and retrospective drug utilization review
- Network pharmacy management
- Formulary management and rebate sharing
- Member services, including quality and functionality of member website and mobile app
- Website with Membership Portal
- Medicare eligible retirees and retiree drug subsidy reporting and assistance in administration and reconciliation
- Intervention Claim any prescription presented to the mail order or specialty pharmacy that requires additional information from the member, provider, or before it can be sent to the member
- Paid Claims all transactions made on eligible members that result in a payment to pharmacies or members from member co-pays and does not include reversals, rejected claims and adjustments.
- Each unique prescription that results in payment shall be calculated separately as a paid claim
(2) A pre-offer conference will be held on October 15, 2019.
[C] Eligibility:
- Onshore (USA Only);
[D] Work Performance:
Performance of the work will be offsite. Vendor needs to carry work in their office location.
Budget :
Deadline to Submit Proposals: November 01,2019
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$
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Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : MB-3518
Government Authority located in Arizona; USA based organization looking for expert vendor for employee benefits pharmacy management.
[A] Budget: Looking for Proposal
[B] Scope of Service:
(1) Vendor needs to provide employee benefits pharmacy management.
- Claims Adjudication
- Ability to Integrate services with other vendors e.g., disease management, care management, medical
- Eligibility maintenance
- Patient and provider education
- Systematic prospective, concurrent, and retrospective drug utilization review
- Network pharmacy management
- Formulary management and rebate sharing
- Member services, including quality and functionality of member website and mobile app
- Website with Membership Portal
- Medicare eligible retirees and retiree drug subsidy reporting and assistance in administration and reconciliation
- Intervention Claim any prescription presented to the mail order or specialty pharmacy that requires additional information from the member, provider, or before it can be sent to the member
- Paid Claims all transactions made on eligible members that result in a payment to pharmacies or members from member co-pays and does not include reversals, rejected claims and adjustments.
- Each unique prescription that results in payment shall be calculated separately as a paid claim
(2) A pre-offer conference will be held on October 15, 2019.
[C] Eligibility:
- Onshore (USA Only);
[D] Work Performance:
Performance of the work will be offsite. Vendor needs to carry work in their office location.
Budget :
Deadline to Submit Proposals: November 01,2019
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$