Pharmacy strategy for managed care leaders.

TLS Rx Advisory Group is an independent pharmacy advisory firm for Medicaid, Medicare, and Marketplace health plans, managed care organizations, and PBMs. We turn pharmacy data, contracts, and compliance requirements into clear decisions, with the perspective of operators who have run pharmacy programs from the inside.

What TLS Stands For

Transparency. Leadership. Strategy.

Transparency
Clarity on PBM contracts, pricing, and performance.
Leadership
Operator perspective for decisions leaders can stand behind.
Strategy
Practical plans that improve performance and reduce risk.

Core Services

Pharmacy Program Assessment
End-to-end review of pharmacy operations, workflows, and controls.
PBM Performance Review
Independent review of PBM contract terms, pricing, and delivery.
Medicaid Pharmacy Strategy Advisory
Ongoing advisory support for Medicaid pharmacy leaders.
Utilization Management and Formulary Strategy
Prior authorization, step therapy, and formulary decisions that balance cost and access.
Specialty Drug Performance
Visibility into specialty spend, channel management, and trend levers.
Regulatory Readiness and Audit Support
Preparation for state Medicaid and CMS Medicare reviews.
Medicare Part D Advisory
Formulary, utilization management, Star Ratings measures, and CMS compliance readiness.
Pharmacy Benefit Design
Benefit and network design that balances cost, access, and member experience.

Who We Serve

Medicaid Health Plans
Medicare Advantage and Part D Plans
Managed Care Organizations
Pharmacy Benefit Managers
Health Systems and Healthcare Organizations

Our Approach

1
Discover
Understand your goals, constraints, contracts, and data.
2
Assess
Analyze operations, performance, and risk against requirements.
3
Recommend
Deliver clear, prioritized findings and a practical path forward.
4
Support Implementation
Stay engaged as your team puts the plan into action.

Flat-fee engagements with clearly defined scope and deliverables.