Overnight Medical Claims Processor Jobs in Baton Rouge, LA

Salary : $8,961.00 - $16,158.00 Monthly
Location : Baton Rouge, LA
Job Type: Classified
Job Number: MVA/SP/225011
Department: LDH-Medical Vendor Administration
Opening Date: 08/19/2026
Closing Date: 9/2/2026 11:59 PM Central
About this Job
The mission of the Louisiana Department of Health is to protect and promote health and to ensure access to medical, preventive, and rehabilitative services for all residents of the State of Louisiana.
Learn more about Louisiana Department of Health
Lead the Future of Medicaid Pharmacy Services! Join the Louisiana Department of Health's Medicaid team and help shape a pharmacy program serving approximately 1.7 million Louisianans. In this leadership role, you'll guide innovative pharmacy initiatives, oversee program operations, and help drive access, quality, efficiency, and cost savings across a complex statewide program. If you're ready to lead meaningful work that impacts healthcare access for millions, bring your expertise to LDH and apply today!
Minimum Qualifications
Possession of a current Louisiana license to practice pharmacy plus three years of experience as a licensed pharmacist.
Job Specification
The official job specifications for this role, as defined by the State Civil Service, can be found here.
Job Duties and Other Information
Job Duties:

• Directs and manages pharmacy policy and operations, establishing priorities, work plans, and performance expectations to ensure Medicaid Pharmacy Benefits Management goals and objectives are achieved.
• Supervises and provides guidance to professional staff and program managers responsible for pharmacy policy, program development, operations, rebates, outcomes management, and other pharmacy benefit activities.
• Develops, interprets, and implements Medicaid pharmacy policies and procedures in compliance with federal and state laws, regulations, and Louisiana Board of Pharmacy requirements.
• Oversees pharmacy program operations, including reimbursement methodologies, claims processing, drug utilization review, claims reconciliation, and the fiscal intermediary's pharmacy-related activities.
• Manages and maintains the Medicaid Preferred Drug List (PDL), coordinating updates with the Pharmaceutical and Therapeutics Committee, fiscal intermediary, managed care organizations, and supplemental rebate contractors.
• Provides oversight of the Pharmacy Point of Sale and Prospective Drug Utilization Review systems, analyzes program data and reports, and identifies opportunities to improve cost containment, claims accuracy, and program integrity.
• Advises leadership and communicates with Medicaid providers, recipients, pharmaceutical manufacturers, legislators, auditors, federal agencies, and other stakeholders regarding pharmacy policy, legislation, program operations, and fiscal impacts.

Position-Specific Details:
Location: Medical Vendor Administration/ Director's Office/Executive Management Team / East Baton Rouge Parish
Appointment Type: This position may be filled as aProbationary appointment, Promotional appointment, or Detail to Special Duty
Cost Center: 3052010100
Position Number(s): 188753
How To Apply:
No Civil Service test score is required in order to be considered for this vacancy.
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.
* Information to support your eligibility for the position must be included in the application (i.e., relevant, detailed experience/education). Resumes will not be accepted in lieu of completed education and experience sections. Applications may be rejected if incomplete.
For information on how to check your application status and understand status updates, please click HERE
Contact Information:
Shambrielle Pooler
LA Department of Health (LDH)
Division of Human Resources
PO Box 4818
Baton Rouge, LA 70821
225-342-6477
This organization participates in E-verify, and for more information on E-verify, please contact DHS at 1-888-464-4218.
LDH supports Louisiana's commitment to being a State as a Model Employer (SAME) by promoting the recruitment, hiring, and retention of individuals with disabilities.
Information on the Louisiana Works, Louisiana Rehabilitation Services is available here.
LDH is an equal opportunity employer and seeks to recruit a highly productive and diverse workforce and will provide equal employment opportunities to all employees and prospective employees. Employment decisions shall be based strictly on merit and without regard to religious or political beliefs, sex, race, or any other non-merit factor.
Louisiana State Government represents a wide variety of career options and offers an outstanding opportunity to make a difference through public service. With an array of career opportunities in every major metropolitan center and in many rural areas, state employment provides an outstanding option to begin or continue your career.
As a state employee, you will earn competitive pay, choose from a variety of benefits, and have access to a great professional development program:
Insurance Coverage More information can be found at
Parental Leave - Up to six weeks paid parental leave
More information can be found at
Holidays and Leave - State employees receive the following paid holidays each year:

• New Year's Day
• Martin Luther King, Jr. Day,
• Mardi Gras,
• Good Friday,
• Memorial Day,
• Independence Day,
• Labor Day,
• Veteran's Day,
• Thanksgiving Day and Christmas Day.

***** Additional holidays may be proclaimed by the Governor
State employees earn sick and annual leave which can be accumulated and saved for future use. Your accrual rate increases as your years of service increase.
Retirement- State of Louisiana employees are eligible to participate in various retirement systems (based on the type of appointment and agency for which an employee works). These retirement systems provide retirement allowances and other benefits for state officers and employees and their beneficiaries. State retirement systems may include (but are not limited to):

• Louisiana State Employees Retirement System (). LASERS has provided this video to give you more detailed information about their system
• Teacher's Retirement System of Louisiana (),
• Louisiana School Employees Retirement System (), among others

01
To ensure compliance with LDH Nepotism Policy#41, if you have any immediate family members that are currently employed by LDH, please list the name and relationship. Please type "N/A" if no immediate family members are employed by LDH.
02
Do you possess a current Louisiana license to practice pharmacy?

• Yes
• No

03
If yes, please list the license number, original issue date, and expiration date of your license. If no, please type "N/A".
Required Question