A large segment of our business is focused on pharmacy benefit management (PBM) companies and assisting you with compliance, operations and interim staffing solutions. We have extensive experience in the PBM world, both on the clinical and operational side, with many operations experts and both founders of BluePeak being from the PBM industry. BluePeak understands the pressures of having many different health plans wanting different things from the PBM, as well as CMS actions that all hit at once, like the transition audits, and how hard that is to manage.
Pharmacy Benefit Management
BluePeak staff has worked on both sides of the CMS world- as PBM business owners and CMS auditors and regulators. This gives BluePeak the edge of being able to support PBMs, understanding the business challenges that you face, as well as how CMS will audit you and your customers and their processes. This allows for better preparation and maintenance of your compliance programs.
BluePeak staff has worked in the trenches at PBMs and health plans and understand the challenges that businesses face with limited resources and increasing CMS demands. Our team can provide subject matter expertise across all operational areas of your business to enhance your business processes, fill in compliance gaps, provide interim staffing and train your staff to enhance their efficiency and effectiveness.
BluePeak has seasoned experts who are proficient at product strategy and development. Whether it is assisting plans to go into new markets with new products, providing direction on starting an EGWP or PDP, or providing CMS benefit design and bid assistance, BluePeak can support new and existing plans to help grow their businesses.