Consulting Managed Care Staff Pharmacist in Baton Rouge, LA

Job Description

Job Description

Doctor of Pharmacy (PharmD) degree, active Pharmacist license, and minimum 1+ years Pharmacist experience required. Applicants who do not meet these qualifications will not be considered.

A full-time telehealth opportunity is available for an experienced pharmacist licensed in Maine, North Dakota, or Louisiana, with Louisiana licensure offering priority for ongoing work. This 13-week contract role focuses on Medication Therapy Management (MTM) consulting through remote virtual patient interactions, supporting a patient population expected to reach 250,000 lives this fall.

Key Responsibilities:

• Conduct telephonic or video Comprehensive Medication Reviews (CMRs) and Targeted Medication Reviews (TMRs) to address side effects, therapy questions, and improve medication adherence.
• Evaluate prior authorization requests, formulary exceptions, and step-therapy limits based on clinical guidelines and safety parameters.
• Collaborate with prescribing providers to recommend cost-effective, formulary-compatible alternatives for restricted or non-formulary medications.
• Proactively identify care gaps and work with patients and physicians to optimize therapy outcomes, particularly in chronic disease management.
• Support formulary management by assisting in coding clinical intent for Pharmacy Benefit Manager (PBM) claims adjudication systems and analyzing secondary-level claims data.
• Ensure compliance with HIPAA, state telepharmacy regulations, and contractual requirements through meticulous documentation and adherence to telepharmacy standards.

Qualifications:

• Doctor of Pharmacy (PharmD) or Bachelor of Science in Pharmacy degree.
• Active and unrestricted pharmacist license in one or more of the specified states, with multi-state licensure preferred.
• Minimum of 2 years clinical pharmacy experience, ideally within pharmacy benefit management, managed care, or telehealth clinical settings.
• Strong knowledge of chronic disease state management, drug utilization review (DUR), and formulary processes.
• Comfortable with telehealth platforms, electronic health records (EHR), and PBM claims software.
• Excellent verbal and written communication skills suited for sensitive patient consultations and professional engagement with healthcare providers.

Location:

• Remote (Telehealth)

This contract opportunity offers the chance to engage in a dynamic telepharmacy MTM project focusing on improving patient outcomes across multiple states. Pharmacists interested in leveraging their clinical expertise in a flexible, remote environment are encouraged to apply.

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