Note: The job is a remote job and is open to candidates in USA. Mercy Health is an integrated health system delivering exceptional coordinated care across multiple hospitals and clinics. They are seeking a 340B Compliance Analyst to assist with daily 340B program operations and compliance activities, while leading projects and collaborating with stakeholders to enhance program efficiency and ensure regulatory compliance.
Responsibilities
- Maintain up-to-date policies and procedures on 340B purchasing processes
- Develop systems and processes to limit program liabilities and provide proper audits to identify risk and prevent duplicate discounts and diversion
- Review 340B Program policies and procedures on an ongoing basis and offer contributions and changes to ensure 340B compliance
- Develop proper 340B quality assurance training for employees as appropriate
- Assign staff training based on their role/responsibility
- Provide proactive education to staff on policies and procedures related to inventory management and 340B procedures
- Expand professional development through related classes and seminars, current publications, and regional/national association membership participation
- Be involved in any and all 340B Program audits
- Perform audits on a scheduled basis; may involve presenting and resolving reconciliation issues as they arise during the monitoring and reconciliation process
- Perform monthly audits of contract pharmacies
- Perform monthly self-audits of 340B pharmacy operations
- Ensure compliance with 340B Program requirements for qualified patients, drugs, and locations
- Monitor and audit state Medicaid claims to ensure compliance to prevent potential duplicate discount rebates
- Using Excel or a comparable data management program, filter out non-eligible transactions, including, but not limited to, drugs used to treat patients during inpatient care, Medicaid patients, drugs provided free by manufacturers, those provided at non-eligible locations, or prescriptions written by non-eligible providers
- Evaluate patient eligibility for qualified and non-qualified patients in mixed-use areas and clinics by reviewing patient medical records, insurance plans, and, if applicable, hospital status
- Ensure that facilities maintain adherence to 340B Program regulations and guidelines
- Develop and foster working relationships with internal working counterparts (IT, internal audit, results, accounting, and others) to facilitate productive exchanges of information to improve program efficiency and promote program compliance
- Provide data, information, and reports as needed for other business units within the organization
- Develop a thorough understanding of the 340B Program and improve the overall efficiency, value, and internal support of the 340B Program
- Assess opportunities for cost savings and system improvements to yield higher compliance
- Continue to build knowledge of the health care and pharmacy services industry, and use that knowledge to identify ways and make recommendations to improve the 340B Program
- Evaluate and implement cost savings opportunities
- Assist all customers to clarify requirements, propose sourcing options; evaluate and recommend the best sourcing solution
- Develop reports that can be used to educate staff and assist management in tracking the overall financial impact to the organization
- Build other reports, as appropriate, to monitor and improve 340B Program compliance and performance
- Maintain copies of reports for compliance and audit purposes
- Collaborate with the Pharmacy, Compliance, and 340B Oversight council to develop monthly, quarterly, and yearly audit metrics
- Construct appropriate financial metrics to assess areas of improvement
- Develop and update 340B Program reporting packages detailing volume, financial value, and other reporting metrics as needed
- Use provided tools to monitor prescription data, patient data, hospital data, payer data, site of care, and, if required, ICD-10 codes
- Summarize and report results to the appropriate individuals
- Monitor, report, and analyze contract pharmacy 340B activities; provide financial reports to hospitals or other covered entities relative to financial impact and liabilities; make recommendations that would improve efficiency
- Perform covered entity-specific gross financial analysis and make recommendations to improve program performance
- Track financial impact over time, identify root causes of adverse trends, and make recommendations to improve the program’s financial stability
- Review and refine monthly 340B cost savings reports detailing purchasing and replacement practices, as well as dispensing patterns
- Oversee all aspects of the inventory purchasing process for applicable pharmacies
- Procure supplies, equipment, services, and merchandise; request price quotes; facilitate purchasing proposals and contract negotiations
- Process requisitions and issue purchase orders; expedite deliveries; resolve receiving and invoicing issues or problems
- Manage existing contracts and supplier relations
- Manage drug selection, procurement, and inventory control
- Manage purchasing, receiving, and inventory control processes
- Continually monitor product par levels to effectively balance product availability and cost- efficient inventory control
- Ensure appropriate safeguards and system integrity
- Perform annual inventory and monthly cycle counts
- Monitor ordering processes, integrating the most current pricing from wholesalers
- Analyze invoices, shipping, and inventory processes
- Comply with all track-and-trace legal requirements of the Drug Supply Chain Security Act for purchasing and distribution of drug products
- Develop a thorough understanding of the split-billing/third party administrator systems and the functions to be performed
- Educate others involved in the purchasing process to ensure proper operation and compliance
- Provide each buyer with information needed to place orders using the appropriate accounts (e.g. WAC, GPO, and 340B and non-340B) to replenish inventory in the mixed-use inventory setting
- Coordinate purchasing for dual or multiple split inventories within pharmacies
Skills
- Associate degree in a related field
- In lieu of a degree, one to two years related experience and/or training; or equivalent combination of education and experience
- Bachelor's degree in a related field
Benefits
- Medical, Dental, Vision
- Life & Disability Insurance
- FSA/HSA Options
- Generous, accruing paid time off
- Paid Parental and caregiver leave
- Career advancement and educational opportunities
- Tuition and certification reimbursement
- Certification Reimbursement
- Well-being Programs
- Employee Discounts
- On-Demand Pay
- Financial Education
- Annual recognition/awards events
- Partner appreciation days
- Family entertainment/attractions discount
- Community service/improvement opportunities
Company Overview