PHARMACY BENEFIT SERVICES (PBS)

This solicitation seeks a qualified vendor to provide comprehensive Pharmacy Benefit Services (PBS) for the agency. The contractor will manage prescription drug benefit design, claims processing, formulary management, and compliance reporting. The work is expected to support the agency’s beneficiaries and ensure cost‑effective delivery of pharmacy services. • Design and maintain the pharmacy benefit plan, including formulary updates and tier structures. • Process prescription claims, adjudicate reimbursements, and resolve provider inquiries. • Provide regular performance analytics, cost‑containment reports, and regulatory compliance documentation. • Serve as the primary point of contact for beneficiaries, providers, and internal stakeholders regarding pharmacy benefits. • Maintain data security and privacy standards in accordance with applicable health regulations.