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Pharmacy Benefit Managers

A new era for pharmacies and pharmacy benefit managers is here and it’s far from business as usual.

As competition encroaches on the traditional healthcare sector and online giants, Cognizant helps retail, specialty and mail order pharmacies and pharmacy benefit managers (PBMs) rethink their business models. We can help you deliver targeted, personalized services in innovative ways, to gain a new competitive advantage in a changed world.
BenefitServ improves user experience

Healthcare plan drives significant savings and improves CX through an end-to-end QA approach.

Our capabilities

Simplifying a complex regulatory environment

Cognizant helps healthcare organizations evaluate the impact of regulatory requirements and implement solutions that help ensure compliance. Our services include:

  • ICD-10
  • Medicare Part D compliance
  • NCPDP D.0 compliance
  • Controlled substance dispensing
  • Patient compliance

Driving better health outcomes

The ability to access and leverage data is changing the way business decisions are made, with rich insights enabling evidence-based decision-making and proactive planning. Cognizant provides expertise on data collection across a wide range of attributes affecting pharmacy and PBM businesses, helping them make well-informed decisions in:

  • Analytics strategy
  • Process innovations

From detection to prevention

Enabling organizations to identify and resolve intentional and unintentional errors or verify the absence of both is critical. With significant capital lost to fraud and abuse each year, investigation and recovery efforts are key to an organization’s overall financial health.

Invest in the digital future

We help healthcare organizations drive cost reduction and revenue enhancement through improved efficiency, effectiveness and process transformation by offering:

  • Best-in-class services (claims, enrollment and medical management)
  • Requirements definition
  • Product evaluation and selection
  • Operational readiness

Empower consumers with digital tools

New consumer-focused operating models in healthcare demand a shift in thinking, requiring many companies to go from a B2B to a B2C focus. Cognizant helps healthcare organizations manage the patient and member experience with solutions that drive engagement and help build effective strategies for member identification and retention. Our services span these areas:

  • Customer engagement
  • Customer experience
  • Customer retention

Deliver digital health services at scale

We offer complete project and IT implementation and support services, including:

  • Legacy systems modernization
  • Administrative, claims management, clinical and electronic health record implementations
  • Custom development and maintenance
  • Systems integration and program management
  • ERP and CRM systems
  • Data warehouses
  • E-health, self-service applications and portal development

Latest thinking

Winning with digital in the post-COVID-19 healthcare industry

The pandemic’s impact validated the industry’s initial digital investment priorities; now is the time to fine-tune them—or play catch-up—to align with shifting COVID-influenced trends.

Take the first step

Serving customers by looking forward as well as back is a big promise, but the power of today’s new digital capabilities is vast and growing.

Let’s talk about how digital can work for your business.