Medicare Clinical Pharmacist - MTM

We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with us.

Residency in or relocation to Louisiana is preferred for all positions.

POSITION PURPOSE.

Engages members who meet CMS criteria for MTM to review and assess complex medication regimens, counsel on medications and supplements, address pharmacy-related care gaps, and collaborate with the BCBSLA care management team to improve outcomes and reduce costs.

How You Contribute to the Company’s Mission In This Role

• Perform comprehensive medication reviews per CMS MTM Program Standards using claims, clinical/lab values, and member-reported usage.
• Work directly with members and prescribers to resolve adherence and other medication-related problems (care gaps, adverse events, regimen optimization).
• Maintain thorough knowledge of pharmacy benefits (formulary, outreach programs, UM tools, medical policies).
• Provide evidence-based therapeutic recommendations to promote innovative member management and cost-effective care.
• Ensure compliance with applicable laws and regulations.

Required Qualifications 

• Doctorate of Pharmacy (PharmD) or Bachelor’s in Pharmacy.
• 1 year of experience working in a healthcare and/or managed care setting OR successful completion of a relevant Louisiana Blue externship
• Current Louisiana pharmacist license in good standing. Candidates with an active Louisiana Pharmacy Intern license may be considered but will be hired into a Pharmacy Intern role.
• Proficiency in pharmacology/therapeutics; strong interpersonal, organizational, and communication skills; Word/Excel proficiency

Preferred Qualifications

• ASHP or AMCP-accredited residency and/or master’s training.
• Rounding with physicians/ancillary staff, MTM certification, managed care experience, LTC consulting, specialty medication management

The Physical Demands described here are representative of those that must be met by an employee to successfully perform the Accountabilities and Essential Functions of the job. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions

• Perform other job-related duties as assigned, within your scope of responsibilities.
• Job duties are performed in a normal and clean office environment with normal noise levels.
• Work is predominately done while standing or sitting.
• The ability to comprehend, document, calculate, visualize, and analyze are required.

An Equal Opportunity Employer

All internal employees please apply through Workday Careers.

PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME, FIREFOX, SAFARI)

Additional Information

Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted. To monitor the status of your application, please visit the "My Applications" section in the Candidate Home section of your Workday account. 

If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact recruiting@bcbsla.com for assistance.

In support of our mission to improve the health and lives of Louisianians, we encourage the good health of its employees and visitors. We want to ensure that our employees have a work environment that will optimize personal health and well-being. Due to the acknowledged hazards from exposure to environmental tobacco smoke, and in order to promote good health, our company properties are smoke and tobacco free. 

We perform background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner.

Additionally, we are a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results.