The Louisiana Department of Health is dedicated to fulfilling its mission through direct provision of quality services, the development and stimulation of services of others, and the utilization of available resources in the most effective manner.
LDH serves as a model employer for individuals with disabilities.
This position is located within the Louisiana Department of Health / Medical Vendor Administration / Director's Office/Executive Management Team / East Baton Rouge Parish
Announcement Number: MVA/SP/198896
Cost Center: 3052010100
Position Number: 50560114
This vacancy is being announced as a Classified position and may be filled as a Probationary appointment, Promotional appointment, Detail to Special Duty or WAE Appointment.
• *Please note** Part-time WAE appointments are temporary and may last up to a year. Employees can only work a total of 1,245 hours within a 12-month period.
No Civil Service test score is required in order to be considered for this vacancy.
Occupational Summary
The Louisiana Department of Health's Pharmacy Section is responsible for the development, implementation and administration of the Medicaid pharmacy operations within the Bureau of Health Services Financing (BHSF). The Pharmacy staff are charged with the responsibility of assuring access to quality pharmacy services while maintain efficiencies in operation, service and cost. Multiple initiatives are in place in the pharmacy program to achieve recipient access to appropriate medications, administrative simplification, provider collaboration and savings.
The pharmacy program staff monitors the Pharmaceutical and Therapeutics (P&T) Committee process, Drug Utilization Review (DUR) Board process, the Single Preferred Drug List (PDL) process, the pharmacy rebate program, pharmacy provider enrollment process, provider portal enrollment process, pharmacy vendor contracts, implements federal and state regulations with rule making and State Plan Amendments and review and approve Managed Care Organizations (MCO) and Magellan Medicaid Management (MMA) policies, procedures and clinical medical drug policy.
Duties include but are not limited to the following:
Participates in the daily operations of the Pharmacy Program.
Assist pharmacy staff in managing and ensuring compliance with multiple contractors, state and federal regulations, and provider and recipient assistance with claims, coordinate legislative requests/proposed legislation and implement P&T and DUR program changes.
Support pharmacy staff in developing, implementing and maintaining pharmacy policies and procedures.
Provide support to pharmacy staff in communicating and collaborating with federal officials at the Centers for Medicare and Medicaid Services (CMS), state and federal legislators and legislative auditors, professional experts, and clinicians.
Assist pharmacy staff with pharmacy provider enrollment and the provider portal enrollment process with the recent rebaseline initiative. The rebaseline initiative includes pharmacy providers and medical providers. The MCOs and MMA will be required to adhere to provider rebaseline requirements to allow pharmacy claims to be paid.
Support pharmacy staff in managing the MCO single PBM for accurate PDL & DUR program changes, pharmacy reimbursement, and claims processing.
Provide support to pharmacy staff in monitoring contract compliance, the single PBM timely response to recipient and provider issues and review and approve the single PBM policy and procedures.
Assist the single PBM and MCO staff with beneficiary eligibility issues such as third party liability (TPL) and accurate enrollment segments to assure Medicaid beneficiaries have access to appropriate life-saving medications.
Performs other pharmacy related program activities as requested by Pharmacy staff.
Registered pharmacist with a Louisiana state license in good standing is required.
To apply for this vacancy, click on the “Apply” link above and complete an electronic application, which can be used for this vacancy as well as future job opportunities. Applicants are responsible for checking the status of their application to determine where they are in the recruitment process. Further status message information is located under the Information section of the Current Job Opportunities page.
• Resumes WILL NOT be accepted in lieu of completed education and experience sections on your application. Applications may be rejected if incomplete.*
A resume upload will NOT populate your information into your application. Work experience left off your electronic application or only included in an attached resume is not eligible to receive credit
For further information about this vacancy contact:
Shambrielle Pooler
Shambrielle.Pooler@la.gov
LDH/HUMAN RESOURCES
BATON ROUGE, LA 70821
This organization participates in E-verify, and for more information on E-verify, please contact DHS at 1-888-464-4218. MINIMUM QUALIFICATIONS:
Possession of a current Louisian
Location: Baton Rouge, LA
Posted: Sept. 11, 2024, 6:18 a.m.
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