Medicare Clinical Pharmacist - MTM

Blue Cross and Blue Shield of Louisiana

3d • Onsite

About The Position

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. Provides evidence-based therapeutic recommendations to promote innovative member management and cost-effective care. Ensures compliance with applicable laws and regulations.

Requirements

• Doctorate of Pharmacy (PharmD) or Bachelor’s in Pharmacy.
• 1 year of experience working in a healthcare and/or managed care setting
• Current Louisiana pharmacist license in good standing.
• Proficiency in pharmacology/therapeutics; strong interpersonal, organizational, and communication skills; Word/Excel proficiency

Nice To Haves

• 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

Responsibilities

• 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.
• Perform other job-related duties as assigned, within your scope of responsibilities.

Benefits

• Resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level