• Define and develop standard and custom formularies for all lines of business including Commercial, Medicaid, Medicare Part D and the Health Information Marketplace • Develop drug product review and formulary recommendations by assessing drug use trends, new drug releases and review of primary literature • Analyze pharmacy cost of care, trends, and coordinate the development of appropriate use protocols and guidelines • Set criteria for medication analysis, coordinate reports to clients, meet regulatory reporting requirements for drug utilization review and fraud and abuse reporting • Develop clinical criteria for review of non-formulary or non-preferred drug lists medications and communicate recommendations to clients • Develop and design clinical edits to adjudicate claims and enhance drug utilization • Develop and review guideline criteria for prior authorization and non-formulary drugs in support of Pharmacy and Therapeutics Committee function and pharmacy benefit design • Research drug information to maintain drug knowledge and disease state understanding for application to prior authorization reviews • Provide clinical guidance and support to the assigned pharmacy technicians • Provide support documentation and develop communication for the Pharmacy & Therapeutic (P&T) Committee review process and decisions • Performs other duties as assigned

• Manage all aspects of pharmacy operations in two markets with multiple products • Perform duties to develop, direct and implement a pharmacy benefit management program • Aid in formulating and administering related organizational policies and procedures, including pharmacy service quality, pharmacy utilization management and achievement of Company goals for pharmacy and medical programs • Establish the strategic vision, objectives and policies and procedures for the pharmacy program in support of the Corporate strategic vision for multiple plans and markets • Plan, direct and implement pharmacy activities for multiple plans and products • Act as the pharmacy contract administrator for the development and implementation of key contracts and ensure that relevant performance standards are met by vendors • Participate in external accreditation initiatives for multiple plans and products • Manage and analyze operating costs and participate in preparing materials needed for budget planning or special initiatives • Generate, review and analyze drug utilization, utilization management, financial and other ad-hoc reports, records and directives • Confer with staff to obtain data required for planning work function activities • Review statistical analysis in support of recommendations and/or decision making for policies and operational procedures • Maintain daily communication with plan management relative to each market and product • Manage pharmacy department staff to assure adequate coverage and support in multiple locations and for multiple products • Support provider education initiatives such as counter detailing and incentive programs in multiple markets

• Respond to patient inquiries via a ticketing system with clear, accurate, and empathetic written communication • Manage inbound calls and make outbound calls to patients to address queries, concerns, and offer support • Maintain accurate documentation of all patient interactions • Collaborate with internal teams across time zones • Deliver a high standard of patient care while adhering to regulatory and compliance requirements

• Respond to patient inquiries via a ticketing system with clear, accurate, and empathetic written communication • Manage inbound calls and make outbound calls to patients to address queries, concerns, and offer support • Maintain accurate documentation of all patient interactions • Collaborate with internal teams across time zones • Deliver a high standard of patient care while adhering to regulatory and compliance requirements