Pharmacy Benefit Management Service

A government authority located in Colorado is seeking a vendor to provide comprehensive pharmacy benefit management services. This agency needs to optimize its clinical program management, pharmacy network access, and financial performance while ensuring high-quality customer service and account management. The primary problems to solve involve managing high-cost drugs like gene and cell therapies, monitoring the drug pipeline, and minimizing pharmacy network disruption for plan members. The scope of work covers clinical program management, including custom formulary development, clinical review committee governance, and evidence-based policy updates. The selected partner must manage retail, mail order, and specialty pharmacy networks, while coordinating closely with the agency's in-house pharmacy. Financial management requirements include real-time claims adjudication, coordination of benefits, and administering manufacturer rebates with a one hundred percent pass-through to the agency. Bidders must be onshore organizations based in the United States to be eligible for this opportunity. The performance of the work will take place through a combination of onsite and offsite services. The agency accepts digital proposal submissions sent via email or through their online portal. The evaluation criteria will focus on pricing, pharmacy network access, formulary management, contractual compliance, and account management services. The agency will also assess reporting capabilities, financial stability, performance guarantees, flexibility, references, clinical programs, and customer service. While the agency is openly looking for proposals to define the budget, bidders must provide clear definitions and treatment of all revenue streams. The agency has scheduled a pre-bid meeting for June 9, 2026. Bidders must submit all questions regarding this opportunity no later than June 12, 2026.