UNKNOWN

FEED

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. 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.

<h5>Pharmacist Position </h5>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. <h5>Position Purpose </h5>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 <ul><li>Perform comprehensive medication reviews per CMS MTM Program Standards using claims, clinical/lab values, and member-reported usage. </li><li>Work directly with members and prescribers to resolve adherence and other medication-related problems (care gaps, adverse events, regimen optimization). </li><li>Maintain thorough knowledge of pharmacy benefits (formulary, outreach programs, UM tools, medical policies). </li><li>Provide evidence-based therapeutic recommendations to promote innovative member management and cost-effective care. </li><li>Ensure compliance with applicable laws and regulations. </li></ul>Required Qualifications <ul><li>Doctorate of Pharmacy (PharmD) or Bachelor's in Pharmacy. </li><li>1 year of experience working in a healthcare and/or managed care setting OR successful completion of a relevant Louisiana Blue externship </li><li>Current Louisiana pharmacist license in good standing. </li><li>Proficiency in pharmacology/therapeutics; strong interpersonal, organizational, and communication skills; Word/Excel proficiency </li></ul>Preferred Qualifications <ul><li>ASHP or AMCP-accredited residency and/or master's training. </li><li>Rounding with physicians/ancillary staff, MTM certification, managed care experience, LTC consulting, specialty medication management </li></ul>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 <ul><li>Perform other job-related duties as assigned, within your scope of responsibilities. </li><li>Job duties are performed in a normal and clean office environment with normal noise levels. </li><li>Work is predominately done while standing or sitting. </li><li>The ability to comprehend, document, calculate, visualize, and analyze are required. </li></ul>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.

Louisiana Blue

Medicare Clinical Pharmacist - MTM

Adverse Events

Analysis Skills

Clinical Laboratory

Communication Skills

Consulting

Content Management Systems (CMS)

Cost Control

Formulary

Insurance

Interpersonal Skills

Law Enforcement

Long-Term Care

Maintain Compliance

Managed Care

Medicare

Medications

Microsoft Excel

Microsoft Word

Organizational Skills

Pharmacology

Pharmacy

Physical Demands

Regulations

Regulatory Compliance

Social Security Administration

IRecruitee

ADAPTED_NOW

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. 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._.

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 required. 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._ JOB CATEGORY:Insurance

Blue Cross and Blue Shield of Louisiana

The Pharmacist-in-Charge (PIC) / Senior Clinical Staff Member is responsible for overseeing the clinical and operational functions of the pharmacy department at Reliant Healthcare. Medication Management and DistributionOversee the distribution of oral, intravenous (IV), and intramuscular (IM) medications, including associated medical supplies and equipment such as IV pumps.

Job Type Full-time Description The Pharmacist-in-Charge (PIC) / Senior Clinical Staff Member is responsible for overseeing the clinical and operational functions of the pharmacy department at Reliant Healthcare. This role ensures compliance with regulatory standards, maintains high-quality patient care, and supports the organization's clinical and business objectives. Leadership and Operations <ul><li>Assume responsibility for day-to-day operational and management activities in the absence of the President and Vice President of Operations.</li><li>Oversee and maintain accountability for all pharmacy department operations and workflow.</li><li>Manage pharmacy support staff and coordinate daily activities, including weekend and evening on-call schedules. Supervise pharmacy students and ensure proper training and oversight.</li></ul>Clinical Oversight<ul><li>Provide leadership and guidance for all clinical operations within the pharmacy program.</li><li>Serve as Director of the Clinical Committee, composed of all licensed pharmacists within the organization.</li><li>Oversee clinical decision-making processes and ensure high standards of patient care.</li><li>Perform or supervise clinical monitoring of patients, including laboratory values, therapies, and disease states.</li><li>Conduct pharmacokinetic evaluations, dosing adjustments, medication assessments, and drug therapy monitoring.</li></ul>Program Development and Quality Assurance<ul><li>Develop and implement Reliant Healthcare's vision for a regional specialty pharmacy program across relevant disease states.</li><li>Ensure patient outreach protocols align with current clinical guidelines and standards of care.</li><li>Review medication therapy goals annually with the clinical team to ensure appropriate patient monitoring.</li><li>Assign relevant clinical literature annually to staff to enhance the quality of care and professional development.</li></ul>Education and Competency<ul><li>Establish internal continuing education requirements beyond state mandates, including ACPE-accredited programs aligned with disease states managed by Reliant Healthcare.</li><li>Ensure pharmacists are competent in evaluating patient needs and performing Drug Utilization Reviews (DUR).</li><li>Coordinate ongoing education to ensure compliance with manufacturer-specific medication requirements and restrictions.</li><li>Ensure staff remain current on evolving disease state guidelines and integrate updates into patient care programs.</li></ul>Regulatory Compliance<ul><li>Ensure full compliance with FDA guidance, manufacturer requirements, and all applicable federal and state regulations.</li><li>Oversee adherence to HIPAA, state board of pharmacy requirements, and accreditation standards (URAC, ACHC, JCAHO).</li><li>Maintain all required documentation, logs, policies, and procedures.</li><li>Monitor for unethical practices and collaborate with the Governing Body to address and remediate issues.</li></ul>Medication Management and Distribution<ul><li>Oversee the distribution of oral, intravenous (IV), and intramuscular (IM) medications, including associated medical supplies and equipment such as IV pumps.</li><li>Ensure proper maintenance of clean room environments and sterile compounding areas (if applicable).</li></ul>Collaboration and Care Coordination<ul><li>Collaborate with physicians, nurses, dietitians, social workers, and other healthcare professionals to improve patient outcomes and operational efficiency.</li><li>Consult with external providers to enhance care quality and business performance.</li></ul>Safety and Risk Management<ul><li>Ensure adherence to the latest patient safety standards and medication error prevention practices.</li><li>Subscribe to and review industry safety publications and updates.</li><li>Communicate safety updates to clinical staff through quarterly meetings and additional communications as needed.</li><li>Review external literature quarterly to incorporate safety and error prevention strategies into pharmacy practice.</li></ul>Business and Industry Knowledge<ul><li>Maintain a working knowledge of pharmacy and infusion business processes.</li><li>Demonstrate understanding of third-party payer systems, including Medicare and Medicaid regulations and coverage requirements</li></ul>Accountability<ul><li>Ensure the organization maintains qualified clinical staff accountable for decisions impacting patient care.</li><li>Uphold Reliant Healthcare's commitment to quality, compliance, and patient-centered services.</li></ul>Requirements<ul><li>Doctor of Pharmacy (PharmD) degree or equivalent required.</li><li>Active, unrestricted pharmacist license in the state where the pharmacy operates and in all states of licensure.</li><li>Minimum of five (5) years of post-graduate experience in retail, infusion, hospital, and/or specialty pharmacy settings.</li><li>Management experience preferred but not required.</li></ul>

Pinnacle Family Health

Pharmacist-in-Charge (PIC)

Accreditation Standards

Business Processes

Cleanroom

Clinical Monitoring

Clinical Practices/Protocols

Disease

Distribution Management

Drug Manufacturing

Drug Therapy

FDA (Food and Drug Administration)

Federal Laws and Regulations

HIPAA (Health Insurance Portability and Accountability Act)

Healthcare

Healthcare Management

Hospital

Industry/Trade Press

Leadership

Medicaid

Medical Equipment

Medical Products

Needs Assessment

Nursing

On Call

Operational Strategy

Operations Management

Patient Assessment

Patient Care

Patient Safety

People Management

Pharmacokinetics

Pharmacovigilance

Pumps

Quality Assurance

Quality Management

Quality of Care

Retail

Risk Management

Safety Standards

Social Work

Standards of Care

State Laws and Regulations

The Joint Commission (TJC)

Third-Party Payer

Training/Teaching

Utilization Management

Utilization Review Accreditation Commission (URAC)

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Medicare Clinical Pharmacist - MTMLouisiana Blue

Medicare Clinical Pharmacist - MTMBlue Cross and Blue Shield of Louisiana

Pharmacist-in-Charge (PIC)Pinnacle Family Health

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