HR Medical Plan Administration and Pharmacy Benefit Management Services

The government authority in Rhode Island is seeking a vendor to provide HR medical plan administration and pharmacy benefit management services. This engagement covers providing nationwide health plan coverage to eligible state employees, non-Medicare retirees, and their dependents. The selected vendor will be responsible for administering and supporting comprehensive wellness and health initiatives for the active enrolled population.

Key responsibilities include maintaining high accountability regarding member experience, especially in quality care and administrative processes; overseeing finances of the medical benefit program to ensure optimal cost and value; and driving improved health outcomes for state employees and their families. The vendor will also be expected to contribute to the state's health policy objectives, supporting care transformation and payment reform to enhance health care quality and reduce costs. The contract period for these services will be three years.