Pharmacy Benefit Manager

Transforming Pharmacy Benefits: Simplifying Access, Empowering Health.

Portfolio Hero Image

The Challenge

The legacy desktop interface for the Pharmacy Benefit Manager (PBM) was outdated, heavily reliant on keyboard commands, and difficult to navigate. Users struggled with managing complex pharmacy benefit structures, including varying pricing models based on drug tiers, insurance carriers, and specific benefit plans. This inefficient interface led to user frustration, increased errors, and longer processing times.

User Pain Points

  • Complex Navigation: The interface relied too much on keyboard commands, making it tricky and time-consuming to use.
  • Data Overload: Users faced difficulty managing large datasets and understanding benefit structures.
  • Error-Prone Processes: Manual inputs increased the risk of errors.
  • Inefficient Workflows: Outdated systems slowed down benefit management.

Project Role

Lead UX/UI Designer – Led ideation, visual design, prototyping, and creative exploration. Oversaw junior designer and collaborated closely with cross-functional teams.

Team Structure

  • Junior UX/UI Designer
  • Business Analyst
  • Project Manager & Scrum Master
  • Front-end and Back-end Leads
  • QA Lead
Junior UX/UI Designer, Business Analyst, Project Manager, Scrum Master, Front-end Lead, Back-end Lead, QA Lead

Tools

Figma, Axure RP, Figjam, Miro, Photoshop, Illustrator

1Empathize: Discovery & Research

Creative Discovery & User Research

Despite initial stakeholder resistance, I successfully demonstrated the value of research, leading to a Creative Discovery Phase.

Through workshops and interviews, we identified key insights that reshaped our approach:

Persona Interviews

  • Configuration Solution Architect (Main Persona)
  • Account Manager
  • Carrier Configuration
  • Implementation Manager
  • Test & Validation Analyst
  • Configuration Analyst
user Personas

Primary Persona: Kristin

Among the multiple personas identified, we focused on Kristin, the primary persona, as she handled most of the workload.

  • Demographic: Experienced benefits manager at a large insurance company.
  • Needs: Fast, accurate benefit configuration with minimal errors.
  • Motivations: Reduce processing time, improve accuracy, and streamline workflows.
Primary Persona

Discovery & Workshop Facilitation

I initiated and led a series of collaborative workshops designed to uncover both user and stakeholder perspectives on the existing challenges within the Pharmacy Benefit Manager (PBM) system. My objectives were to:

Understand User Pain Points: Gain insights into the difficulties users faced, particularly regarding complex navigation, data overload, and error-prone processes.

Clarify Business Needs: Engage stakeholders to identify organizational goals and requirements, ensuring alignment between user experience improvements and business objectives.

Foster Collaborative Understanding: Create a shared comprehension of the problem space among cross-functional teams, facilitating a user-centered approach to solution development.

Through structured activities such as affinity mapping, journey mapping, and open discussions, I collected qualitative data that informed the subsequent design phases. This approach ensured that the redesign was grounded in real user experiences and aligned with business goals.

workshops
workshop 1

What We Learned

Through stakeholder workshops, we discovered that the primary business goal was to reduce the time required to onboard new clients. A significant bottleneck was the phase where benefit features, structures, and preferences were collected manually via documents. Our goal was to gain a deep understanding of the user workflow, the onboarding process, and how benefit structures and plans were being created—so we could identify opportunities to streamline and improve efficiency.

Flow Timeline
Process Flow

KPIs and measuring success

To drive meaningful design decisions, it was crucial to identify key performance indicators (KPIs) that aligned both business objectives and user needs. We conducted a focused workshop with key stakeholders to outline the KPIs that would measure the program’s success and directly inform design strategies.

  • Task Completion Time: Reduction in time spent configuring benefits.
  • Error Rate: Decrease in user-generated errors.
  • User Satisfaction: Improved user feedback post-launch.
  • Adoption Rate: Increased use of the new interface over the legacy system.
  • Support Tickets: Reduction in user-reported issues.

Information Architecture

We redesigned the Information Architecture (IA) to simplify navigation across benefit tiers, carriers, and pricing models.

Information Architecture

Journey Map

I developed a user journey map to visualize the end-to-end experience of key personas as they interact with the system. This journey map highlighted user emotions, key touchpoints, and pain points at each stage of the workflow—from initial login and benefit configuration to testing, approval, and claims validation. By mapping out these interactions, we identified areas where users faced friction and optimized workflows to create a more seamless and efficient experience.

Journey map

Phase 1 Digitizing the Questionnaire

2Definition

Mockup Phase: Digitizing the Implementation Questionnaire

Discovery & Planning

We began by identifying the core challenge: the current paper or manual method of completing the Implementation Questionnaire was time-consuming, inconsistent, and prone to error. From research with stakeholders, it was clear we needed a more guided, digitized, and user-friendly approach.

Initial Concepts & Flows

Before designing, we mapped out a user journey inspired by TurboTax. Our goals were to:

  • Break content into logical sections (Client Info, Carrier Configuration, Formulary, etc.)
  • Design a linear, low-friction flow with simple navigation
  • Reduce cognitive load by focusing on one topic per screen

Low-Fidelity Wireframes

The mockups illustrated in the image capture the early layout of the experience:

  • Landing Screen: Introduces users to the process and its purpose
  • Sidebar Navigation: Displays high-level sections while guiding users step by step
  • Form Screens: Collects structured inputs with clean, focused layouts
  • Decision Screens: Presents choices (e.g., Custom vs Standard) with helpful context
IQ Wireframes

Design Principles

  • Progressive Disclosure: Show only what’s needed per step
  • Guided Flow: Simplify decision-making through a structured path
  • Reusable Components: Build modular question groups for scalability
  • Future-State Ready: Structured for smart validations and future enhancements

Next Steps

  • Test and validate with users (internal and external)
  • Iterate based on usability feedback
  • Add visual design and branding elements
  • Create interactive prototypes for smoother handoff
  • Collaborate closely with developers for implementation

Final High-Fidelity Mockups & Results

After multiple rounds of wireframes, testing, and stakeholder feedback, we arrived at a set of high-fidelity mockups that brought the Implementation Questionnaire (IQ) to life. These designs reflect a clear, modern UI with a guided, TurboTax-inspired flow that simplifies the complex process of setting up a Pharmacy Benefit Plan.

High Fidelity Mockups of Implementation Questionnaire

Key Improvements

  • Onboarding Screen: Provides a warm, welcoming introduction with visual storytelling
  • Progressive Navigation: Clear steps and sidebar navigation reduce uncertainty
  • Form Simplicity: One question group per screen to avoid overwhelming the user
  • Smart Defaults: Common options are pre-selected or surfaced based on earlier inputs
  • User-Friendly Modals: For actions like adding contacts or custom configurations

Results & Impact

  • 80% reduction in time-to-complete compared to the previous manual method
  • Improved data accuracy due to structured inputs and built-in validations
  • Positive stakeholder feedback on clarity, efficiency, and user confidence
  • Future scalability: Easily extendable to accommodate evolving plan requirements

Phase 2 Creation of the Benefit Plan Interface

2Definition

After completing the digitization of the Implementation Questionnaire, we moved into Phase 2: designing the Benefit Plan Interface. This part of the project focused on enabling users—primarily admins and benefit specialists—to create, edit, and manage benefit plans through a centralized dashboard and supporting screens.

The goal was to provide visibility and control over the structure of the benefit offerings, including coverage tiers, cost-sharing rules, eligibility groups, and reporting options.

Wireframes & Iteration

We explored low-fidelity sketches and wireframes that emphasized clarity, modularity, and quick access to key actions. Iterative testing helped us refine the layout and reduce cognitive load.

High Fidelity Mockups of Benefit Mocks

Design Goals

  • Modular structure to manage complex data
  • Action-oriented dashboard for quick updates
  • Smart guidance and validation to reduce errors
  • Visual consistency with the Implementation Questionnaire

Final High-Fidelity Designs

Benefit Plan High-Fidelity Designs

Interactive Prototype

Key Takeaways

1. MVP Success with Measurable Impact

  • 80% faster questionnaire completion time
  • Improved data accuracy via smart defaults and validations
  • 40% reduction in task time for benefit plan management
  • Positive stakeholder feedback and higher user confidence

2. Design System Foundations

Modular, reusable components were created to support consistency across the two phases, establishing a strong foundation for future scalability and maintainability.

3. Research-Driven Decisions

Despite initial resistance, user and stakeholder research became a critical part of the process—shaping workflows, layout, and IA based on real user pain points and business goals.

4. TurboTax-Inspired Flow

A step-by-step guided flow reduced cognitive load and made a complex, high-stakes process feel approachable and intuitive for users.

5. Collaboration Was Key

Cross-functional collaboration with engineering, QA, and product stakeholders ensured alignment from research through final handoff—helping the MVP launch on time with minimal rework.

Future Opportunities

  • Build out the remaining pages of the application
  • Define user profiles and set up role-based permissions
  • Develop the project tracking functionality
  • Design and implement reusable report templates