Pharmacist, Quality Unit Support

Job Summary

This position may be located at the Louisiana Department of Health (LDH), in Baton Rouge, Louisiana, OR at the University Louisiana Monroe College of Pharmacy in Monroe, Louisiana, and involves support for the Louisiana Medicaid Pharmacy Program in the following areas: Medicaid Pharmacy Lock-In Program, 340B Drug Pricing Program, drug utilization review (DUR), pharmacy prior authorization, and other duties, such as audit and rebate, as directed by the Louisiana Medicaid Pharmacy Program.

Duties and Responsibilities

• Support the Louisiana Medicaid Pharmacy Program, the fiscal intermediary, and University of Louisiana at Monroe (ULM) with the operations of the Louisiana Medicaid Pharmacy Program;
• Support the Medicaid Lock-In Program by evaluating selection criteria, reviewing profiles, managing recipients, communicating with providers, conducting research, and reporting;
• Support the Louisiana Medicaid Pharmacy Program with the 340B Drug Pricing Program, including, but not limited to, the HRSA Medicaid Exclusion File and responding to questions/concerns from 340B Louisiana Medicaid providers;
• Support the Louisiana Medicaid Pharmacy Program by responding to Pharmacy Help Desk calls from Medicaid stakeholders (recipients, providers, health plans, etc.);
• Support the Louisiana Medicaid Pharmacy Program by maintaining a local pharmacy list;
• Support the Louisiana Medicaid Pharmacy Program in the management of physician-administered drugs, to include the review of MCO medical drug criteria and policies;
• Support the Louisiana Medicaid Pharmacy Rebate Program with drug related questions and reporting;
• Support the Louisiana Medicaid Pharmacy program by reviewing and suggesting revisions to Medicaid Member Notifications;
• Draft provider notices regarding implementation of pharmacy-related Medicaid policy and procedure updates;
• Review and make recommendations for updates to the Louisiana Medicaid Pharmacy Benefits Management Services Manual;
• Assist the Louisiana Medicaid Pharmacy Program in cross-over claim reconciliation;
• At the direction of the Louisiana Medicaid Pharmacy Program, extract and analyze pharmacy-related claims data from the P-Web database;
• Serve as report business owners for MCO quarterly and monthly reports;
• Support the Louisiana Medicaid Pharmacy Program with legislative fiscal impact questions and reporting;
• Research clinical questions and policy issues;
• Prepare management and utilization reports as directed by the Louisiana Medicaid Pharmacy Program;
• Work with other contractors on special applications/projects as directed by the Louisiana Medicaid Pharmacy Program (such as the POS User Guide, ECHO’s, etc.);
• Review of MCO Remittance Advices;
• Participate in disaster relief activities at the request of the Louisiana Medicaid Program, LDH or ULM;
• Perform other duties as assigned.

Minimum Qualifications

• Must be a graduate of an ACPE accredited School/College of Pharmacy with a B.S. degree or higher;
• A Pharm.D. degree or equivalent work-related experience is preferred;
• Position requires a current Louisiana Pharmacist License or eligibility for licensure in Louisiana;
• Pharmacist license must be in good standing;
• Position requires experience with Microsoft Office (Microsoft 365) applications, good interpersonal communication skills, and exceptional organization skills with attention to detail;
• Self-motivation and the ability to work on a team or individually with minimal supervision are required; and
• Experience in or knowledge of pharmacy policy is preferred.

Supplemental Information

Required Attachments:

Please provide a CV/Resume
Cover Letter
3 Professional References