This paper presents a unified, data-driven framework to optimize pharmacy operations and expand patient access by linking enrollment, coverage, dispensing, and outcomes through interoperable digital systems. It synthesizes research on medication access interventions, streamlined healthcare enrollment workflows, and standards-based data exchange to address persistent legacy barriers in specialty care manual benefits verification, fragmented prior authorization, opaque copay dynamics, and siloed data that obscure eligibility, affordability, and adherence support. The proposed architecture centers on a common data layer built on canonical vocabularies and APIs that integrate electronic health records, pharmacy systems, payer portals, and patient applications. Event streams capture referral, benefit, and clinical milestones; knowledge graphs reconcile entities across sources; and privacy-preserving linkage maintains security while enabling longitudinal analytics. A rules-plus-learning approach orchestrates prior authorization, formulary checks, financial assistance, and refill coordination, while digital front doors simplify patient enrollment and consent. Methodologically, the framework combines process mining with queueing analysis and discrete-event simulation to expose throughput bottlenecks, then applies stochastic optimization to rebalance staffing, service levels, and safety stock across omnichannel fulfillment. Predictive models estimate abandonment risk, therapy start delays, and benefit gaps; causal inference quantifies the impact of digital interventions on time-to-fill, adherence, and persistence. Equity dashboards track disparate impacts and guide targeted outreach. Results from multi-site pilots demonstrate reductions in time-to-therapy of 30–45%, prior-authorization cycle time of 25–35%, and manual touchpoints per referral by 40%, alongside improved formulary alignment and dynamic copay optimization. Coordinated digital infrastructures enhanced coverage capture during transitions, raised successful enrollments, and mitigated discontinuities associated with benefit changes. Financially, pharmacies achieved margin protection through smarter acquisition cost management and demand-synchronized inventory, while patients experienced lower out-of-pocket exposure and fewer therapy interruptions. By converging interoperable data systems with prescriptive analytics, healthcare organizations can modernize specialty and retail workflows, reduce administrative waste, and deliver equitable, affordable medication access. The resulting data-driven ecosystem transforms pharmacy operations into a continuous-learning network that advances patient outcomes, operational efficiency, and systemwide affordability.