The Employer's Guide Blog for Overseeing PBMs

The Definition of Oversee: to watch over and direct (an undertaking, a group of workers, etc.) in order to ensure a satisfactory outcome or performance.

Every Health Care Plan Sponsor Must Have a System in Place to Make Sure Drugs Work [Tip of the Week]

There are three things I believe every health care plan sponsor should have in place (1) system to make sure members are taking the prescribed drugs (2) system to make sure the prescribed drugs work (3) system to make sure the prescribed drug is going to the right patient. As drugs get more expensive and complex so to must the services PBMs offer to keep pace. Watch the short video (1:30) to see what the Pharmacy and PBM Leader at Deloitte Consulting has to say about achieving optimal clinical and cost outcomes with specialty drugs.

Click to Watch

What is the Certified Pharmacy Benefits Specialist (CPBS®) training program designed for?

This educational offering includes knowledge that is critical to effective management of the pharmacy benefit. Each class concludes with a knowledge assessment test to help gauge student comprehension. Students are required to pass a comprehensive final exam with a score of 85% or better to qualify for the CPBS designation.

Employee Benefits 

  • Enhance your candidacy – one out of two hiring managers prefer job applicants with a certification 
  • Stay competitive in the workforce and raise your professional value 
  • Network with other employee benefits professionals
  • No or low out-of-pocket costs; employer may pick up portion of the costs 

Employer Benefits

  • Certified employees drive business goals through increased self-motivation and confidence
  • Uphold or gain competitive advantage in the marketplace because of the PBM mastery held by human capital 
  • Internal career advancement for certified staff which reduces hiring and onboarding costs 
  • Clients have more confidence in the results of certified staff
Pharmacy Benefit Managers will provide transparency and disclosure to a level demanded by the competitive market and generally rely on the demands of prospective clients for disclosure in negotiating their contracts. The best proponent of transparency is informed and sophisticated purchasers of PBM services. 

The purchaser needs to understand not only what they want to achieve in their relationship with their PBM but also the competitive market and their ability to drive disclosure of details on services important to them. Achieving optimal outcomes, cost and clinical, will be more effectively done by a trained eye with personal knowledge of the purchaser’s benefit and disclosure goals.

Tyrone Squires, MBA, CPBS

I am the proud founder and managing director of TransparentRx, a fiduciary-model PBM based in Las Vegas, Nevada. We help health plan sponsors reduce pharmacy spend, by as much as 50%, without cutting benefits or shifting costs to employees.

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