Pharmacist, Quality Unit Support

University-of-Louisiana-At-Monroe; Breard (LA); On-site; USD 60,000 - 90,000; Full time

Job summary

The University of Louisiana at Monroe College of Pharmacy seeks a qualified pharmacist to support the Louisiana Medicaid Pharmacy Program in Baton Rouge or Monroe. You will assist with policy implementation, pharmacy program operations, and related reporting.

Responsibilities include 340B pricing, DUR, prior authorization, help desk support, and data extraction for quarterly and monthly MCO reports. Strong organizational skills and licensure are essential for success.

Qualifications

• Graduate of ACPE-accredited School/College of Pharmacy with a B.S. or higher.
• Pharm.D. degree preferred or equivalent work-related experience.
• Current Louisiana Pharmacist License or eligibility; license in good standing.
• Proficient in Microsoft Office; strong communication and organizational skills.
• Ability to work independently or on a team with minimal supervision.

Responsibilities

• Support LDH and ULM with Louisiana Medicaid Pharmacy Program operations.
• Assist with 340B Drug Pricing, DUR, prior authorization, and related audits.
• Respond to Help Desk inquiries and maintain the Medicaid pharmacy lists.
• Prepare reports and defend policy updates; draft provider notices.
• Extract and analyze claims data; serve as report owner for MCOs.
• Support disaster relief activities and cross-functional projects.

Skills

Pharmacist license

Microsoft Office

Communication skills

Organization

Teamwork

Education

ACPE accredited School/College of Pharmacy (B.S. or higher)

Pharm.D. degree preferred

Job description

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.

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.

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.