• Perform outbound and inbound medication adherence outreach (e.g., refill reminders, gaps‑in‑therapy follow‑up) using approved scripts and workflows • Identify and document adherence barriers (cost, access, side effects, understanding) and escalate clinical concerns to a pharmacist or clinician • Coordinate refills, prior authorization follow‑ups (as assigned), and pharmacy transfers in partnership with pharmacists • Support population‑based adherence campaigns aligned to quality measures and organizational priorities • Collaborate with interdisciplinary teams (Pharmacy, Care Management, Population Health) to close care gaps • Adhere to all Intermountain policies, privacy standards, and medication‑related procedures

• Prepare and manage enrollment and credentialing applications for health plans, PBMs, Medicaid, and other payors. • Oversee credentialing and re-credentialing processes to ensure compliance with regulatory, accreditation, and payer requirements. • Track and manage credentialing timelines, ensuring all submissions and follow-ups are completed on schedule. • Review documentation for accuracy and completeness, identifying and resolving gaps proactively. • Build and maintain strong relationships with payors, managed care organizations, and state agencies to facilitate timely approvals. • Partner with billing and operations teams to resolve credentialing-related reimbursement and contract issues. • Support network contracting activities by communicating with payors and submitting required documentation. • Provide guidance and support to internal teams regarding credentialing processes and requirements. • Identify opportunities for process improvement and contribute to performance enhancement initiatives. • Maintain confidentiality of all sensitive information and adhere to compliance standards.

• Responds to Client requests for issue resolution, including delivery, rebate and credits, contract inquiries • Develops and sustain long-term customer relationships while engaging customers at all levels • Provides onsite customer support, acts as a liaison, and point of escalation for health system • Serves as the on-site subject matter expert (SME) for Cencora Ordering platforms • Partners appropriately with external client representatives and internal Cencora support

• Responsible for support and input to clinical programs such as: Health Management, Drug Utilization Review, Formulary development, and Prior Authorization programs to encourage appropriate, high quality, cost effective drug therapy; and to identify opportunities for improvement in efficiency, accuracy, and appropriateness of the programs in place • Participate in the Coverage Determination (Certification, Prior Authorization, Medical Exception, Exception to Coverage, etc.) process by reviewing all requests which are not clearly approvable based on specified criteria (algorithms), making all coverage denial determinations, and identifying themselves by first name, title, and responsibility at Navitus in relation to drug utilization management program administration • Continually monitor the quality and efficiency of the Coverage Determination process including coverage criteria, denial language, and communication with prescribers • Provide input to clinical content of new programs and for maintenance of existing programs • Complete all annual URAC training requirements • Facilitation of communication and education to clients, members, and internal staff regarding clinical daily issues and objectives • Provide support to operational departments on the implementation of various PBM programs and daily functioning in support of member/patient quality of care • Responsible for supporting / providing clinical expertise related to formulary decisions made by the Pharmacy and Therapeutics committee • May review health care survey data for Medicare Part D qualified participants and/or perform phone consultations with Med-D enrollees; aid in documentation of calls; designate enrollees for repeat interaction • Other duties as assigned