UNITAS

• Responsible for the clinical evaluation and determination of client UM requests. • Accountable for direct consultation with health care providers concerning non-formulary and clinical product coverage issues. • Collaborate with team members to promote consistency of clinical decisions across the pharmacist team. • Other duties as assigned.

• Support company's non-dispensing pharmacy operations by providing clinical oversight. • Ensure employer-supported cash-pay pharmacy model delivers accurate clinical review and maintains patient safety. • Collaborate with Product, Operations, and Compliance teams to build scalable pharmacy workflows. • Review and clinically validate prescription information for accuracy. • Partner with Product to design automated criteria and compliant workflows.

• Oversee the development and maintenance of custom formularies for all non-Medicare lines of business including Commercial, Medicaid, and Health Information Marketplace/Exchange • Monitor and analyze regulatory and legislative requirements, develop project plans to meet requirements, and lead cross functional teams to implement programs to meet requirements • Oversee the implementation and maintenance of custom and standard formularies • Supports relationship with external partners/vendors (P&T, rebate aggregator, formulary management tool, etc.) • Facilitate communication to and education of clients, members, and internal staff regarding clinical issues and objectives • Supervise and coach direct reports in the performance of their duties including performance reviews and feedback to direct reports • Develop clinical criteria for review of non-formulary or non-preferred drug lists and communicate recommendations to clients • Evaluate drugs/drug classes and make formulary positioning and utilization management recommendations and formulary management strategies • Provide support to operational teams and clients during implementation • Analyze and interpret prescription claims data to identify opportunities to improve existing formulary management strategies • Supports quality improvement and clinical value projects, as required • Support Pharmacy and Therapeutics (P&T) committee items, as required • Support RFI and RFP submissions, as required • Support general business needs and operations, as required • Responsible for adherence to the company Code of Conduct including reporting of noncompliance.

• Responsible for the clinical evaluation and determination of client UM requests, which includes consideration of the denial language, as well as the appropriateness of the decision as it pertains to the clinical intent of the individual program criteria. • Accountable for direct consultation with health care providers concerning non-formulary and clinical product coverage issues. • Collaborate with team members to promote consistency of clinical decisions across the pharmacist team. • Other duties as assigned.