Challenge A large Pharmacy Benefits Management (PBM) was unable to keep up with the rapidly evolving regulatory and compliance requirements in Medicare, Medicaid, and Consumer Driven Healthcare due to systemic issues which resulted in substantial audit risk, member...
Challenges For both contractual and strategic reasons, a healthcare insurance company needed to jointly build out a new Pharmacy Benefit Manager (PBM). The company was looking for integrated medical and pharmacy benefits for members including billions of dollars of...
