• Provide clinical review and consultation on medication requests, prior authorizations, and benefit determinations. • Evaluate therapy appropriateness, dosing, and safety based on evidence-based guidelines. • Collaborate with providers to clarify prescriptions and recommend alternatives when appropriate. • Support complex case reviews and appeals with accurate clinical documentation. • Identify opportunities to improve medication adherence, safety, and cost-effectiveness. • Educate internal teams on formulary management, utilization review, and pharmacy policy updates.

• Provide consultations through the patient's preferred method of communication (text, app messaging, email, or phone) • Perform initial assessments by gathering/reviewing chart notes to determine appropriateness of prescribing patterns • Perform clinical check-ins to monitor adherence, efficacy, adverse reactions, and drug interactions • Identify patients in need of clinical interventions and work collaboratively with providers to provide therapeutic recommendations resulting in improved patient outcomes • Ensure transition of care by transferring out prescriptions to appropriate pharmacies in situations where Alto is unable to fulfill a patient’s prescription • Being responsible for communicating prescription statuses to patients and providers • Work closely with Specialty Operations to provide quality care through the following: Maintain an in-depth understanding of pharmacy billing including but not limited to Medicaid, Medicare, ADAP, commercial insurance, and foundation assistance programs to help troubleshoot patient cost barriers • Proactively identify and communicate areas of concern regarding scheduling/delivery procedures • Develop and provide drug information material designed to enhance Specialty Operations’ performance • Stay abreast of relevant and evolving regulatory and industry standards, ensure that appropriate action is initiated, and communicate these trends to applicable personnel • Work interactively with a local and/or dispersed team to achieve company business and compliance goals/objectives

• Work collaboratively with quality management to support HEDIS adherence projects • Support the accurate implementation and coding of pharmacy benefits, formulary, and program changes • Review pharmacy services recommended for denial and investigate data from plan providers • Assist in the management of members by collecting pertinent information from plan providers and pharmacy data systems • Assist in various pharmacy, utilization review/management, quality improvement, provider relations, and population health initiatives • Serve as a pharmacy liaison and resource person to plan pharmacies and members • Assist the Pharmacist with monitoring and evaluation of pharmacy utilization

• Performing Activities Associated With Administration And Management Of Pharmacy Programs Including But Not Limited To Assisting In The Development, Implementation And Maintenance Of A Disease State Formulary System. • Utilization Management Programs. • Specialty Pharmacy Management. • Medication Therapy Management, Client Relationships And Support; And Development Of Innovative Clinical Programs.