Pharmacy Benefit Manager System
Overview
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SUMMARY
DESCRIPTION
The issuing organization is seeking information from vendors capable of providing a pharmacy benefit manager (PBM) system. The requested solution is expected to support core PBM functions including claims processing, formulary management, pharmacy network management, mail-order pharmacy, and specialty pharmacy services.
The scope also includes pharmacy services related to purchasing stock medications for facility clinics from a wholesaler and processing prescription purchases through retail and mail-order pharmacies. Vendors should be able to review, approve, or deny prescription claims, manage prior authorization processes for specified medications and therapies, and handle non-formulary review requests with approved overrides.
In addition, the system should support the design of beneficiary coverage plans and the incorporation of plan updates. The request indicates a need for a comprehensive PBM solution that combines administrative, operational, and pharmacy benefit functions.
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Frequently asked questions
- When is the submission deadline?
- This RFP closed on July 10, 2026 and is no longer accepting submissions.
- Who is a good fit for this opportunity?
- Pharmacy benefit manager platform provider with healthcare claims expertise
- Firm experienced in formulary, pharmacy network, and prior authorization management
- Vendor capable of supporting retail, mail-order, and specialty pharmacy workflows
- Company with experience serving government or public-sector healthcare programs
- Team with pharmacy operations and beneficiary plan design capabilities
- Established organization with compliant healthcare data and claims processing infrastructure
Analysis generated by Settle AI from the source RFP.
RFP Hunter shows what is open. Settle shows what is forming.
Settle pieces together buyer signals, budgets, contract activity, and the sources your team already monitors. See why an opportunity fits and what to do before the RFP posts.