Medicare Clinical Pharmacist - MTM

Job description

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 r...