EXL PBM Solutions

EXL addresses your entire value chain to identify strengths, weaknesses, gaps, and opportunities, so you can achieve healthy operations, end-toend, quickly and efficiently.

Choose a partner who understands pharmacy benefits and can meet your needs with a variety of purpose-built solutions

Scale to meet client needs, reduce effort, and realize proactive patient care

Pharmacy benefits management (PBM) is a time-consuming investment of resources that cannot be avoided yet can rarely be tamed. Data generated across disparate systems and the availability and integration of medical with pharmacy claims and Social Determinants of Health (SDOH) are difficult, yet valuable. Call center agents tasked with communicating information with members are challenged to provide timely information, even as long wait times frustrate callers and create member abrasion.

What’s more, the daily grind of processing claims, managing networks, and managing utilization have caused business and IT leaders to seek new ways of achieving efficiencies. Digital and data-led solutions might work, but false starts can be expensive, and few remedies exist with partners that truly understand the industry.

With the call for transparency continuing to rise and regulations tightening, time is of the essence. Where can PBMs turn to find the technology and talent necessary to streamline operations, elevate member experience, and improve outcomes? EXL leads the way.

EXL solutions start with you

EXL addresses your entire value chain to identify strengths, weaknesses, gaps, and opportunities, so you can achieve healthy operations, end-to-end, quickly and efficiently. Before we recommend any solutions, our experienced consultants help you assess your people, operating environment, technical infrastructure, processes and, most important, business objectives, to ensure your investment pays off.

As your transformation partner, we promise to accelerate your path to ROI in a sustainable, nimble, and resilient way. Nobody else brings the depth and breadth of experience, along with the full scope of purpose-built offerings you need to lower cost, reduce friction, and embrace proactive, quality patient care. Ensure your success from the start. Take a closer look at EXL.

EXL PBM solution at-a-glance

EXL improves PBM operational efficiency and member experience through:

  • Technology infrastructure and data management improvement
  • Advanced analytics for real-world insights
  • Next-generation digital and AI technologies
  • Contact center modernization
  • Member-centered clinical programs
  • Improved population health and member engagement
  • Optimized financial performance
  • Accelerated efficiencies

As your transformation partner, we promise to accelerate your path to ROI in a sustainable, nimble, and resilient way.

Pinpoint your greatest area of need and scale to full digital operations with EXL

Contact center modernization

One area many PBMs struggle to enhance is member experience. EXL understands the integrated nature of technology and processes and applies this knowledge to effectively improve communications across your various customer journeys.

Our combined focus on capabilities such as natural language processing (NLP), conversational AI, smart agent desktops, work-from-home support, and omni-channel system integrations serve to improve member self-service, agent productivity, and customer satisfaction. Collapse your time to value with contact center modernization orchestrated by EXL.

Digital analytics

PBMs who can successfully proactively manage utilization and population health for their clients have an advantage. EXL releases the flow of information across the organization to help you identify and predict at-risk populations using advanced analytics and infusion of data for enhancement to drive outcomes.

Let us help you integrate data stores, train digital technologies to spot emerging trends, and access information using intuitive dashboard displays, so you can make better decisions, improve outcomes, and increase your bottom line.

EXL offers practical answers now

As your strategic partner, we are fully equipped to help you immediately improve any number of areas across your value chain, leading to total modernization at the highest level of performance. Consider just a few of the following use cases as a starting point, and let us take you from there:

  • Disease management programs: Integrate data sources, benchmark care, support clinicians, and prioritize outreach based on 360° member views.
  • Trade negotiations and network contracting: Enable advanced analytics to predictively manage contracts and generate reports.
  • Network audits: Proactively identify potential FWA through onsite, desk, and compliance audits.
  • Client reporting: Integrate data sources, summarize spend and trends, and automate client reports for quality health management.

Case study: Established mid-market PBM


Broken member self-service journeys, lag in member data presented to agents, and unsatisfactory member experience led the client to EXL for help.


EXL partnered with ALTTRAX, a healthcare consulting firm, to perform a rapid assessment of the client’s contact center, digital assets, tech stack, and outbound communications, leading to a documented roadmap for transformation. Based on plan priorities, EXL helped the client create a single data source with system integrations across the tech stack. This enabled omni-channel communications over a unified desktop for improved agent productivity and member experience.


EXL PBM Solutions

Take your PBM to the next level with EXL

Let EXL help you align business and technology concerns for improved user experience, scalability, and growth at the speed of business. Move to the next level by applying innovative, practical solutions that preserve margins, control costs, and differentiate your brand with EXL. To start your journey, contact us now.