Unitas

Title: Clinical Account Manager (REMOTE) Location: Remote - United States Department: PBM Positions Job Description: UNITAS provides clinical staffing and consulting solutions, including contract staff augmentation, permanent talent recruiting, consulting, and clinical coaching. Our extensive experience includes Pharmacy Benefit Management, Long-Term Care, Retail Pharmacy, Hospital, and Leadership, enabling us to connect the best clinical talent with outstanding companies. We know clinicians because we are clinicians! * This position is being recruited on behalf of a client in the Pharmacy Benefit Manager (PBM) industry. Company name disclosed upon advancing in the process. * Position Summary: This open position is seeking a strategic, client-focused professional to lead and develop strong relationships with key decision-makers in the healthcare space. In this role, you'll oversee account management, ensuring client satisfaction, retention, and trend management, while analyzing pharmacy data to provide actionable insights. You’ll collaborate with clients to develop clinical strategies, execute contract renewals, and contribute to process improvements. Position Responsibilities: - Establish and develop relationships with key client decision-makers to understand their healthcare strategy and goals - Provide oversight of client account management team with a focus on member and client satisfaction, trend management, and client retention - Partner with account team members to provide best-in-class member and client service - Support member issue resolution at client-level - Identify and contribute to process improvement efforts within the team - Responsible for management and execution of client contractual requirements - Responsible for client retention including execution of contract renewals - Analyze and interpret pharmacy claims data to identify clinical trends and insights for individual clients - Meet with clients to discuss clinical trends, review relevant pharmacy data, and provide recommendations with supportive rationale for clinical management strategies - Interpret current pharmacy and healthcare trends and provide proactive recommendations - Incorporate treatment & practice guidelines, clinical education, and pharmacy pipeline details into client presentations - Comprehend and effectively explain formulary and clinical programs to clients, including member experience - Communicate drug information to clients and respond to plan-specific clinical inquiries - Analyze and evaluate pharmacy benefit reporting and create ad-hoc reports as requested - Build and manage strong relationships with third-parties who also service our clients - Support general business needs and operations, as required - Certain times of year may require meeting participation, testing, claims review, or other requirements outside of standard business hours, including weekends. - Responsible for adherence to the client Code of Conduct, including reporting of noncompliance Required Qualifications: - Bachelor of Pharmacy (B.S. Pharmacy) or Doctor of Pharmacy (PharmD) degree from an accredited institution - Relevant experience for at least three (3) years in pharmacy - health plan, managed care, or pharmacy benefits management (PBM) experience preferred; or completion of managed care residency - Prior account management experience preferred - Proficient in Microsoft Office Suite with emphasis on Microsoft Excel - Experience working with large datasets and analyzing raw data in Excel - Ability to balance multiple complex projects simultaneously - Exceptional written and verbal communication skills - Flexible, highly organized, and able to shift priorities easily - Attention to detail & commitment to delivering high quality work product - Ability to travel and present to small and large groups - Travel estimated not to exceed 25% The pay range for this role is: 140,000 - 160,000 USD per year (Remote)

• 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.

Title: Formulary Operations Manager (REMOTE) Location: Remote (United States) Department: PBM Positions Job Description: Position Summary: The Formulary Operations Manager is responsible for providing operational support for the evaluation, implementation, and maintenance of our standard and custom Commercial and Exchange formularies and utilization management. This individual supports the creation and maintenance of formulary, clinical adjudication list, and utilization management lists, preparation of Exchange JSON formulary submission files and member formulary drug lists, preparation and review of updates for implementation, and other formulary and utilization management related tasks and processes. The role requires strong cross functional collaboration and communication skills, and an understanding of formulary operations processes. Position Responsibilities: - Define, configure, and maintain standard and custom formularies for the Commercial and Health Information Marketplace/Exchange lines of business - Provide client-facing strategic and operational support for the configuration, implementation, maintenance, and quality control of custom formularies, drug lists, custom formulary marketing materials, clinical adjudication lists, and utilization management edits - Evaluate appropriateness and operationalize custom client formulary and benefit requests within the formulary/adjudication platform - Collaborates with teams in a cross-functional environment including, but not limited to; benefit administration, rebate administration, client account management, analytics, software development/product, regulatory/compliance, government programs, member experience, prior authorization operations, and marketing - Develop weekly drug product review and formulary recommendations by assessing drug use trends, new drug releases, and review of primary literature - Analyze pharmacy cost of care, clinical updates, and coordinate the development of appropriate formulary management programs and utilization management edits - Set criteria for medication analysis and coordinate methodology for client requested and regulatory formulary reporting requirements - Evaluate drugs/drug classes and make formulary positioning and utilization management recommendations and formulary management strategies and associated adjudication requirements to operationalize - Provide cross functional support for claim troubleshooting within the adjudication platform - Support comprehensive testing of client formulary and benefit elections - Support formulary change processes within URAC/NCQA/SOC guidelines and requirements - Support client formulary requests, as required - Support quality improvement projects, as required - Support the company pharmaceutical pipeline, as needed - Support Request for Information (RFI) and Request for Proposal (RFP) submissions, as needed - Support general business needs and operations, as required - Responsible for adherence to the company Code of Conduct including reporting of noncompliance Minimum Qualifications: - Doctor of Pharmacy (PharmD) Degree from an accredited institution, with record of strong academic performance - Current, unrestricted registered pharmacist license(s) - Residency/fellowship preferred - 2-3 years of formulary experience working for a health plan or PBM preferred - 2-3 years of Medicare experience preferred - Knowledge of formulary development and maintenance processes - Knowledge of highly managed specialty medications/strategy - Knowledge of rebate and financial implications of formulary strategies - Experience working with large datasets preferred - Ability to independently identify, research, and resolve issues - Ability to balance multiple complex projects simultaneously - Ability to work extended hours, weekends, and holidays consistent with industry demands - Exceptional written and verbal communication skills - Extremely flexible, highly organized, and able to shift priorities easily - Attention to detail & commitment to delivering high quality work product - Microsoft office suite with emphasis on Microsoft excel proficiency required * This position is being recruited on behalf of a client in the Pharmacy Benefit Manager (PBM) industry. Company name disclosed upon advancing in the process.

• 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.