• Demonstrates comprehensive knowledge of current pharmacotherapeutic principles, medical terminology, pathologies, disease state and population management, age appropriate therapy, and other information as related to medical and/or pharmaceutical care management. • Work with Sentara Health Plan (SHP) members to close medication-related gaps in care • Work on the referrals from the team • Counseling members on their medication therapy

• Advocate for members understanding pharmacy benefit options • Support transition from retail to mail-order services • Address questions related to pharmacy • Assist with Rx Education/Enrollment processes and medication research • Triage calls requiring consultation with pharmacist • Make outbound calls offering medication therapy management programs • Schedule medication review sessions with consultative pharmacists • Document member interactions thoroughly in accordance with compliance standards • Adhere to scripting protocols while maintaining member-centered conversation style

• Utilization management pharmacists are responsible for reviewing each plans policy to determine if coverage can be granted for a medication • Provide clinical support and oversight for all utilization management (UM) activities • Responsible for finalizing all denials of clinical prior authorization requests • Supports the Coverage Review Department (CRD) as a clinical resource for drug therapy questions • Applies critical thinking to achieve proper clinical decisions when performing clinical reviews • Utilizes multiple systems and other clinical resources to achieve proper decisions in Utilization Management reviews • Works and maneuvers within a queue system that prioritizes clinical reviews • Makes clinical decisions quickly and at times decides and acts with limited information • Works and collaborates with a multi-disciplinary clinical team to provide a customer centric experience

• Under the direct supervision of the Department Business Administrator, coordinate the pharmacy’s financial assistance programs • Demonstrate special skills, knowledge, and task completion not required by other pharmacy technicians • Support operations ensuring patients receive the lowest out of pocket expense possible • Research data, work with Outpatient clinic staff, connect patients with appropriate assistance • Assist in applications, process prescriptions, communicate with billing, and follow up with patients • Maintain and improve program workflows and expansion