Overview
Centene moved its Pharmacy Benefits Manager from CVS to Express Scripts (ESI). That was not a vendor swap behind the scenes. It forced a full redesign of pharmacy experiences and integration patterns inside the member portal.
I led design for the programs most members feel directly: Drug Cost Lookup (DCLU) and pharmacy claims. The work exposed gaps in the legacy experience (limited design system adoption, accessibility, and analytics instrumentation) and became the pattern library Ambetter used to bring pharmacy UX into the portal instead of sending members out to ESI.
Ambetter pharmacy home: coverage, claims, and plan details (Express Scripts) inside the portal before any SSO handoff
Core change
The business migrated the PBM from CVS to Express Scripts. That shift directly impacted Drug Cost Lookup and pharmacy claims experiences in the member portal.
Technical impact
Required new data integrations for pharmacy pricing and claims. Introduced SSO-based access to the ESI portal for prescription management and mail-order services instead of CVS.
Experience gaps exposed
Legacy flows were not built on Fondue, had limited accessibility, and lacked consistent analytics instrumentation. Modernization had to happen while members still relied on these tools daily.
The ESI migration was not just a backend change. It required new UX patterns, research, integration models, and a clear bridge between what lives in the portal and what still depends on ESI.
- New pharmacy pricing and claims data integrations
- SSO handoff to ESI for prescription management and mail order
- Functional parity with legacy tools during transition
- Improved usability, accessibility standards, and analytics coverage
What my team delivered
We rebuilt Drug Cost Lookup and the prescription claims experience with functional parity to legacy tools, then improved how members understand cost, coverage, and claim status.
- Drug Cost Lookup (DCLU)Rebuilt pricing experience with clearer cost communication and improved accessibility.
- Prescription claimsRedesigned claims visibility, including yearly spend summaries and improved claim detail.
- First-time user flowsOnboarding for pharmacy tools during a provider transition members feel directly.
- Pharmacy selectionNew UX handling where ESI did not natively support multi-pharmacy selection.
- SSO bridge patternsStructured handoffs to ESI for prescription management without making the external site feel like the whole experience.
Manage Your Pharmacy Needs: structured SSO bridge to Express Scripts for prescriptions, pricing, and pharmacy search
How this work powered Ambetter
Ambetter initially relied on simple SSO links to ESI in primary navigation. Pharmacy was mostly a collection of outbound links, not an experience owned inside the portal.
The ESI migration produced foundational research, flows, and integration assumptions that Ambetter reused as the first downstream application of the work. We shifted from "ESI is the experience" to "Ambetter owns the experience, ESI is a dependency."
From link-out to guided experience
Replaced direct ESI nav links with a structured pharmacy landing page that guides members through coverage, claims, spending, and prescriptions before handoff when needed.
In-portal capabilities
Centralized pharmacy inside the portal: manage medications, estimate drug costs, and understand claims and spend. Enhancements still depend on ESI APIs, but the funnel is owned by Ambetter UX.
Moving away from raw ESI links to a guided landing page produced measurable engagement: +25% higher retention in month 2 and +17% higher retention in month 3 on the Ambetter pharmacy landing work informed by this migration.
Full Ambetter pharmacy landing: portal-owned funnel from coverage and claims through guided Express Scripts handoffs (+25% month-2, +17% month-3 retention)
Outcome
- Portal-owned pharmacyRebuilt DCLU and prescription claims inside the member portal with parity, accessibility improvements, and analytics instrumentation.
- Integration modelEstablished SSO and data patterns for pharmacy pricing, claims, and external prescription management.
- Pattern foundationESI migration artifacts became the starting system of flows and assumptions reused on Ambetter.
- Engagement liftGuided Ambetter pharmacy experiences showed +25% month-2 and +17% month-3 retention versus link-out behavior.
- Systems alignmentAccelerated adoption of Fondue and accessibility standards in high-traffic pharmacy flows.
Related: Centene design leadership · Fondue design system