Description
The State of Tennessee seeks a single Pharmacy Benefits Manager (PBM) to deliver a comprehensive, end‑to‑end pharmacy‑benefits‑management solution for every plan under its Group Insurance Program. The selected PBM will be responsible for formulary design, network development, claims adjudication, utilization management, rebate negotiation, reporting, and member/provider support across all state‑sponsored health plans. The solicitation is open to full‑service PBMs that can demonstrate capability to manage large‐scale, multi‑plan pharmacy operations and meet stringent confidentiality and data‑destruction requirements.
• Provide a complete PBM solution covering all services listed in the pro‑forma contract (Attachment 6.6).
• Serve as the exclusive PBM for every SGIP health plan, handling formulary, network, claims, utilization review, rebate management, and analytics.
• Comply with a mandatory NDA that protects all Confidential State Data and requires destruction per NIST 800‑88 upon contract termination.