by Alec Dusheck | Nov 25, 2019
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...
by Alec Dusheck | Nov 25, 2019
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...
by Alec Dusheck | Nov 25, 2019
Challenge Coordinate the consolidation of six claims systems, middleware architecture, and customer facing system portfolios and ensure seamless transitions for millions of members as they move from legacy claims & customer facing systems to strategic platforms...
