Pharmacy Benefit Managers (PBMs)

BluePeak supports Pharmacy Benefit Managers (PBMs) with operational and compliance services tailored for government-sponsored health plans. From formulary and benefit testing to claims monitoring, audit readiness, and PDE process reviews, we help ensure your Medicare services stay accurate, compliant, and audit-ready.

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PBM RFP Development, Review, and Contracting

BluePeak offers an industry-leading End-to-End PBM Procurement Process designed by former PBM Underwriters and Professionals. Our procurement process is designed around optimizing the final PBM service agreement and leads to better transparency and PBM partnerships. Plans can select the complete end-to-end process or we can customize a project to support any phase.

PBM Implementations/Transitions

BluePeak can assist with PBM implementations and transitions. Our team will work with your team, your existing PBM, and your incoming PBM to ensure a successful go-live. We offer a wide array of implementation and transition support services to help ensure that a vendor transition is smooth and successful.

PBM Audit

Comprehensive PBM audits to evaluate contract compliance, pricing accuracy, rebate pass-through, and overall performance against benchmarks.

Call Center Assessment & End-to-End Monitoring

While no longer a CMS requirement, CMS can audit Call Logs as part of CPE Audits. The BluePeak End-to-End Call Log Review can help you identify and correct misclassification issues that might be detected in a program audit, including Part C and/or Part D Call Log Review, Call Recording Monitoring, and Training and Process Improvement.

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