Navitus Health Solutions

• Maintain and enhance sales support mechanisms for prospective clients • Calculate risk of pricing metrics and value derived from the relationship with the client • Review, pro-actively identify, and support implementation of opportunities for rebate, pricing, and discount performance improvement via analysis • Research external and internal pricing trends and forecasts to contribute to overall pricing strategy • Maintain databases to support business decisions and inform responses to client or prospective client requests • Track and report client performance impacts of relevant programs (e.g. Savings Connect) • Monitoring of forecasted results as they compare to actuals • Identify opportunities for client savings or program enhancements • Perform analyses as requested by internal and external business owners, or in support of identified business objectives • Develop an understanding of contractual terms and performance to assist in development of program strategies, pricing decisions, and contract language • Perform quality assurance to ensure accuracy of pricing and processes

Title: Pharmacist, Clinical Retrospective Case Mgmt Archimedes Location: United States Category Archimedes Position Type Full-Time Remote Yes Job Description: Company Archimedes About Us Archimedes - Transforming the Specialty Drug Benefit - Archimedes is the industry leader in specialty drug management solutions. Founded with the goal of transforming the PBM industry to provide the necessary ingredients for the sustainability of the prescription drug benefit - alignment, value and transparency - Archimedes achieves superior results for clients by eliminating tightly held PBM conflicts of interest including drug spread, rebate retention and pharmacy ownership and delivering the most rigorous clinical management at the lowest net cost. We are committed to providing equal employment opportunity to all applicants and employees and comply with all applicable nondiscrimination regulations, including those related to protected veterans and individuals with disabilities. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, or handicap. Pay Range USD $0.00 - USD $0.00 /Yr. STAR Bonus % (At Risk Maximum) 0.00 - Ineligible Work Schedule Description (e.g. M-F 8am to 5pm) Our Core Business Hours- Remote or 3 Days in Office from our St. Louis, MO location Remote Work Notification ATTENTION: Archimedes is unable to offer remote work to residents of Alaska, Arizona, Arkansas, California, Connecticut, Delaware, Hawaii, Idaho, Louisiana, Maine, Massachusetts, Michigan, Mississippi, Montana, Nebraska, Nevada, New Mexico, New York, North Carolina, North Dakota, Oregon, Rhode Island, South Carolina, South Dakota, Utah, Vermont, Washington, West Virginia, And Wyoming. Overview The Pharmacist, Clinical Retrospective Case Management will be divided into two areas: external clinical outreach activities related to high-cost case management and prior authorization of specialty medications, across pharmacy and medical benefits and specialty and traditional drugs. In addition, this role will have the opportunity to evaluate the data to identify actionable opportunities for specialty management and create clinical policies. The Pharmacist, Clinical Retrospective Case Management is responsible for being the clinical expert for all specialty medications across both the pharmacy and the medical benefit. This role will be able to successfully communicate with physicians, nurses, pharmacists, and members related to high-cost case concerns, dose management, genetic testing, therapeutic substitutions and cost management related to specialty drugs. Clinical subject matter expert is required to conduct peer to peer consultations with physicians. Responsibilities How do I make an impact on my team? - Review and interpret client data to identify, develop, and manage high-cost clinical interventions and casework. - Evaluate clinical research and financial data to develop strategic medication management options and coverage recommendations. - Manage retrospective case requests in compliance with established clinical criteria. - Assist in the development of clinical policies and pharmacy benefit management programs. - Contribute to clinical program development for both medical and pharmacy benefits. - Complete claims editing and audits to ensure accuracy and compliance. - Develop and deliver clear, data-driven clinical messages to physicians, members and other clinicians. - Serve as a peer-to-peer consultant, effectively presenting complex clinical and cost-effectiveness information to various stakeholders. - Define, document, and present results of clinical interventions and programs to plan sponsors. - Participate in, adhere to and support compliance and diversity, equity, and inclusion program objectives. - Other duties as assigned. Qualifications What our team expects from you? - Education: Doctor of Pharmacy (PharmD) required. - Certification/Licenses: Current pharmacist license (RPh) in good standing with a State Board of Pharmacy required. Board of Pharmacy certification preferred for Pharmacotherapy, Ambulatory Care or Oncology Care. - Experience: - Pharmacy and Medical specialty benefit knowledge and experience required. - 3 years clinical or managed care experience or Clinical/Managed Care Pharmacy Residency preferred. - Proficient in Microsoft Excel, Power Point and Word. What can you expect from Archimedes? - Top of the industry benefits for Health, Dental, and Vision insurance - 20 days paid time off - 4 weeks paid parental leave - 9 paid holidays - 401K company match of up to 5% - No vesting requirement - Adoption Assistance Program - Flexible Spending Account - Educational Assistance Plan and Professional Membership assistance - Referral Bonus Program - up to $750! Location : Address 502 Earth City Expy STE 300 Location : City Earth City Location : State/Province MO Location : Postal Code 63045 Location : Country US

• Run and review volume forecasts, shrinkage analysis reports, headcount requirements, new hire/modified shift requirements, and average handle time analysis to ensure accurate scheduling. • Conduct and document routine data validation of WFM systems and reports. • Collaborate with department leadership to understand all possible impacts to volume and staffing. • Measures accuracy of those forecasts on both short term and long-term basis. • Meet established forecast accuracy goals. • Review staffing forecasts on a daily, weekly, etc. basis and proactively address staffing concerns. • Monitors volume demand throughout the day in real time and flexes workforce accordingly. • Schedules activities around forecasted contact patterns and ensures activities are current in the WFM system. • Notifies affected parties when off-line activities need to be rescheduled. • Schedules off-phone activities when contact volumes are down. • Adjusts call routing as directed when unusual call patterns exist in order to ensure service levels are met; manages multiple queues and skill groups. • Identify need for departmental reports for individual and unit performance metrics and submit requests for enhancements; see through to production. • Create agent schedules to support contact volume demands and optimize contact center performance. • Prepare standard and ad-hoc reports as required for internal and external customers with high level of accuracy and professionalism. • Documents and assembles requirements to generate reports, charts, scorecards, dashboards, forecasts for business use. • Responsible for development of training materials and documentation of policies and procedures. • Other duties as assigned.

• Support the network contracting management division by preparing contracting and strategy analytics, including new contracts and contract renewals • Assist with preparation and attend meetings with strategic pharmacy partners • Plan, design, and deploy appropriate reports, tools, and/or applications • Provide support with pharmacy data and topic preparation for industry conferences, including scheduling • Prepare analyses covering provider agreements, 340B opportunities, mail order, discount card, specialty, and any related needs • Collaborate with Contract Managers, Finance, Pharmacy Informatics, Legal and other internal business divisions to make recommendations to financial models and assist with the development of financial contract solutions • Prepare forward-looking network analytics, ensuring alignment of planned actions and targets in the forecast • Support network management leaders in the development and analytical review of quarterly forecasting, annual planning, and multi-year contracting development and multi-year financial modeling • Advise internal stakeholders on strategic fiscal matters related to pharmacy financial management throughout the organization. • Participate in regular meetings with leadership to review financial results and act as an internal consultant on interpreting financial results, analyzing variances and improving contracting performance. • Support pharmacy contract negotiations by monitoring and delivering impact analysis of suggested pricing revisions • Other duties as assigned

• Manage the clinical relationships with clients • Attends and leads client meetings and actively participates as necessary • Develop and implement a clinical plan that meets the goals and objectives of the client and is in alignment with corporate business strategy • Identifies expansion opportunities and incorporates into strategic plan • Analyze client’s financial and utilization data to identify opportunities for improving health care and/or controlling drug and overall health care costs • Recommend and oversee implementation of select clinical programs • Effectively communicate client needs and process/product development opportunities to the organization • Actively participate in developing the clinical strategy for client • Participate in developing overall client/account strategy • Consultant on Plan/Benefit design recommendations • Participate in development and delivery of annual reviews to client • Establish and maintain client relationships at the appropriate levels, including medical and pharmacy directors, CEO’s, benefit managers and consultants • Provide Drug information and act as the clinical consultant/expert on the account team • Support and participate in P & T Committees for select clients • Consultant for formulary management and administration • Provide ongoing evaluation of clinical programs and services • Lead/Facilitate in multi-disciplinary team to discuss the ongoing needs of the clients • May require up to 20% travel

• Responsible for ongoing monitoring of claims activity for accuracy and successful submission • Responsible for ensuring that patient billing information is set up appropriately in the pharmacy software • Participate, as necessary, in conferences and meetings related to reimbursement/billing • Responds to employee/patient/client questions or complaints regarding reimbursement and/or billing • Works with internal teams to review and resolve claim issues • Maintains accurate reference information relating to reimbursement and copay assistance • Responsible for accurate and thorough documentation of information, insurance and prescriptions/orders within the patient profile • Act in accordance with all applicable federal and state laws and with the highest ethical standards

• Lead negotiation of pharmacy participation agreements across all provider segments, including chains, grocers, PSAOs, and independent pharmacy networks. • Own reimbursement structures, contract terms, and financial outcomes of pharmacy provider agreements. • Establish negotiation strategies that balance market competitiveness with enterprise financial and network performance goals. • Serve as the decision-maker for contract structure, rate positioning, and escalated negotiation decisions. •Approve contract exceptions and ensure alignment to broader network strategy and pricing objectives. • Provide strategic leadership over pharmacy participation agreements, network addenda, and contract standards, ensuring consistency with enterprise pricing, access, and compliance objectives. • Develop and maintain contracting playbooks, standards, and governance frameworks to support scalable and consistent negotiation practices. • Guide contract structure decisions to support evolving pricing strategies, regulatory changes, and market dynamics. • Recommend enhancements to contract language and structure to improve clarity, enforceability, and long-term sustainability. • Lead provider engagement strategy to support successful contract negotiations, alignment to contract intent, and long-term network stability. • Serve as a senior point of contact for complex and strategic provider discussions, including reimbursement changes, contract interpretation, and structural alignment. • Maintain strong relationships with key pharmacy partners to support transparency, issue prevention, and alignment on contract expectations. • Drive resolution of high-impact or systemic provider issues, ensuring alignment to contract terms and enterprise objectives. • Ensure negotiated contract terms are clearly defined, documented, and positioned for accurate downstream implementation. • Partner with Network Operations and Performance teams to support effective handoff, implementation, and validation of contract terms. • Provide strategic guidance on contract interpretation to support claims configuration, pricing application, and network governance. • Support enterprise initiatives related to network strategy, growth, and regulatory readiness. • Accountable for financial performance of pharmacy network contracts, ensuring negotiated reimbursement terms align with enterprise pricing strategy and expected outcomes. • Partner with Network Performance and Reconciliation leadership to ensure contracted terms are operationalized and achieved through effective execution and monitoring. • Incorporate performance insights and market feedback into future negotiation strategies and contract design decisions. • Act as escalation point for complex, high-risk, or systemic contract issues requiring higher-level leadership intervention. • Analyze trends in provider inquiries, disputes, and operational friction to identify opportunities for structural contract improvement. • Drive continuous improvement initiatives to enhance contract clarity, reduce administrative burden, and improve provider experience. • Provide leadership and direction to contract managers and/or senior contracting staff. • Set expectations for negotiation discipline, contract quality, documentation, and escalation standards. • Foster a high-performing team environment focused on accountability, consistency, and execution excellence.

• Own and manage a portfolio of complex, high-value clients, serving as the primary strategic point of contact and ensuring alignment with organizational goals. • Lead the execution, and ongoing management of long-term account strategies, including Strategic Business Plans, Quarterly Business Review (QBR) Summaries, and performance reporting. • Partner with internal subject matter experts to identify opportunities for cost savings, service enhancements, clinical improvements, and program expansion. • Support and lead contract renewals, negotiations, and new business implementations, ensuring client commitments and performance guarantees are met. • Proactively identify, communicate, and execute up-sell and expansion opportunities across both personal and team-managed books of business. • Provide day-to-day leadership, coaching, and strategic guidance to ensure consistent client management practices and high service standards. • Translate strategy from the Sr. Director into clear priorities, expectations, and execution plans for the team. • Conduct performance management activities, including goal setting, performance reviews, feedback, development planning, and corrective action when necessary. • Oversee hiring, onboarding, training, and workforce planning for the team to ensure appropriate coverage and capability. • Foster a culture of accountability, collaboration, continuous improvement, and client-centric thinking. • Monitor and report on team and client performance metrics, ensuring achievement of service levels, performance guarantees, and financial targets. • Provide guidance and leadership when performance guarantees are at risk or not met, including development of corrective action plans and client communication strategies. • Assist with budget planning and management, including staffing, travel, and operational expenses. • Participate in Sales finalist meetings, client presentations, and new business pursuits as needed. • Travel to client sites and internal meetings as required.

• Provides client audit administration support and coordination for audit activities. • Serves as point of contact to account management when client audit requests are received. • Accountable for coordination and/or facilitation of deliverables including schedules, identifying client demographics and IDs for data gathering, preparing templates, updating policy and procedures, and internal communications. • Administer all Service Requests and serve as initial point of contact for inquiries by analytics for all data extractions. • Accountable for validating accuracy of data criteria and reporting formats, per audit requirements. • Prepares audit deliverables and performs initial quality review ensuring deliverables comply with audit criteria. • Accountable for administering the SharePoint site used for inventory, tracking, and recording audit related activities. • Supports Manager, Client Audits, account management, and organizational SMEs with coordination of schedules, deliverables, communications, inventory, and reporting. • Serve as a SME to support and/or respond to client inquiries. • Must be able to interact with clients and/or auditors as directed by the Manager, Client Services. • Develops knowledge in Navitus audit practices to better understand upstream and downstream processes. • Administers end to end audit activities and processes with precision and accuracy. • Responsibilities also include managing detailed work instructions related to assigned responsibilities and/or support of the client audit activities. • Identifies potential process improvements and works closely with the Manager, Client Audits to modify, test, inform, and/or implement. • Assist the Manager, Client Services in subsequent Corrective Action activities if/when applicable. • Directly accountable for tracking progress, updating documentation, and ensuring all monitoring activities ensue, per the CAP specifications. • Participates in internal audit meetings to support in taking minutes, documentation, and other tasks as assigned. • Other duties as assigned.

• Lead negotiation of specialty pharmacy participation agreements across all provider segments, including national chains with specialty capabilities, independent specialty pharmacies, and health system–affiliated providers. • Own reimbursement structures, contract terms, and financial outcomes for specialty pharmacy agreements, including high-cost drug categories. • Establish negotiation strategies that balance market competitiveness, provider sustainability, and enterprise financial objectives within the specialty drug landscape. • Serve as the decision-maker for contract structure, rate positioning, and escalated negotiation decisions. • Approve contract exceptions and ensure alignment to broader specialty network and enterprise strategy. • Provide strategic leadership over specialty pharmacy participation agreements, network addenda, and contract standards, ensuring consistency with enterprise pricing, access, and compliance objectives. • Develop and maintain contracting playbooks, standards, and governance frameworks to support scalable and consistent negotiation practices. • Guide contract structure decisions to support evolving pricing strategies, regulatory changes, and market dynamics. • Recommend enhancements to contract language and structure to improve clarity, enforceability, and long-term sustainability. • Lead specialty provider engagement strategy to support successful contract negotiations, alignment to contract intent, and long-term network stability.