Utilization Reviewer Jobs in Baton Rouge, LA (NOW HIRING)

Pharmacist 4

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Pharmacist 4

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

• Description

• Benefits

• Questions

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 (https://ldh.la.gov/)

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 (https://apps01.civilservice.louisiana.gov/onestopjobinfo/DisplayJobSpec.aspx?JobCode=168970) .

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 a Probationary 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). Resumeswill notbe 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 (https://ldh.la.gov/assets/docs/hr/Forreferenceonly/LDH-Application-Status-Guide-4.2026.pdf) .

Contact Information:

Shambrielle Pooler

Shambrielle.Pooler@la.gov (Staff.Email@la.gov)

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 (https://www.laworks.net/workforcedev/lrs/lrs_rehabilitation.asp) .

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 tomake a differencethrough 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 https://info.groupbenefits.org/

Parental Leave– Up to six weeks paid parental leave

More information can be found athttps://www.civilservice.louisiana.gov/Parental-Leave/Default.aspx

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 (www.lasersonline.org). LASERS has provided this video (https://lasersonline.org/wp-content/uploads/2016/07/Your_Retirement_System.mp4) to give you more detailed information about their system

• Teacher's Retirement System of Louisiana (www.trsl.org),

• Louisiana School Employees Retirement System (www.lsers.net), 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

Employer

State of Louisiana

Address

1201 N 3rd St

Baton Rouge, Louisiana, 70802

Phone

(866) 783-5462

Website

http://agency.governmentjobs.com/louisiana/default.cfm

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