Pharmacy Compliance Analyst 1

Description:

Statement of Purpose:

This position works with the Pharmacy Compliance Supervisor and VP Quality, Analytics and Pharmacy Operations to ensure compliance with the 340B program as well as to maximize the benefits of the program.
Primary Tasks:
Assist Supervisor with daily operations/auditing of the 340B program (for Contract Pharmacies and In-house Pharmacies).
Ensures compliance, adheres to legal requirements, and maintains data integrity of the 340B program to achieve maximum savings opportunities.
Responsible for following 340B policies and procedures established by the organization and the guidelines established by HRSA.
Collaborating with the 340B Pharmacy Compliance Analyst team and Supervisor to monitor completion of 340B monthly audits.
Strong knowledge of clinical terminology including ICD10 codes, sig codes, pharmaceutical calculations, medications, and other related terminology.
Supporting program projects to ensure operational efficiency targets via data analysis.
Assist Pharmacy Compliance Supervisor in organizing and reporting monthly findings of internal 340B audits.
Developing short- and long-term goals that meet established objectives and contribute to the overall goals of the 340B team/program.
Executes, and documents internal audits of the 340B processes. Coordinates, reviews, and ensures remediation of findings in collaboration with the Pharmacy Compliance Supervisor.
Constructs appropriate KPI metrics to assess areas of improvement.
Ensures compliance with the 340B program requirements of qualified patients, drugs, providers, vendors, payers, and locations.
Supports all ad-hoc/external audit requests and HRSA 340B Audits.
Audits 100% of claims they are responsible for. Ranging from approximately 15,000 - 30,000 claims per 6-month period, at the minimum at 1,500 and maximum of 3,000 claims per month, unless directed otherwise.
Maintains and monitors project workload with Pharmacy Compliance Supervisor.
Assist Pharmacy Compliance Supervisor with extracting monthly files from TPA vendor portals, when applicable.
Responsible for maintaining knowledge of the 340B industry changes.
Assist in developing and ensures Compliance with Training material, Resources, workflows (i.e., EMR SOPs)
Ensures compliance with the In-Clinic Administration 340B program requirements of qualified patients, drugs, providers, wholesaler, payers, and locations.
Promotes and practices CAN Community Health, Inc.'s mission, values and follows policies.
Secondary Tasks:
Cross trains within the department to increase understanding of various 340B programmatic operations.
Performs all other duties as requested.

Requirements:

Skills and Abilities:
Demonstrates ability to self-motivate and be adaptable/flexible to change.
Strong knowledge of healthcare environment and 340B Drug Discount Program.
Experience working with Electronic Health/Medical Record (EMR/EHR systems) preferred.
Excellent organizational skills with attention to detail.
Prior experience with split billing/340B compliance software and tools preferred.
Must be proficient with Microsoft Office Suite, specifically Excel (required).
Ability and willingness to work in a fast-paced and demanding environment.
Demonstrated problem solving, analysis, and resolution at strategic and functional levels.
Proven customer service orientation with exceptional interpersonal and communication skills.
Functional understanding of online technology.
Ability to travel for job-related activities as necessary.
Good oral/written communication skills.
Ability to utilize problem-solving techniques.
Ability to utilize decision-making techniques.
Ability to function autonomously and as a team member in a multidisciplinary team.
Effectively use reports, and other analytical tools to help target efforts for maximum program results.
Ability to work with minimal supervision.
Physical Requirements:
Neat, professional appearance.
Exerts up to 10 lbs. of force occasionally and/or a negligible amount of force frequently or constantly in lift, carry push, pull, or otherwise move objects, including the human body. Involves sitting most of the time but may involve walking or standing for brief periods of time.
Requires expressing or exchanging ideas by means of spoken word, visual and auditory acuity.
CAN Required Training:
General Orientation 104 Violence in the Workplace
Sexual Harassment HIPAA Health Stream Courses (as assigned)
340B University Online Modules Annual Basic Safety
340B Team Online Training Modules HIV
Education/Professional:
3-5 years of experience in pharmacy or healthcare-related area with transferrable skills.
Bachelor's degree and/or business equivalent experience or comparable skills.
Apexus Advanced 340B Operations Certificate (preferred) – Required to be completed within 1 year of hire date.
Machines/Equipment and Tools Used:
Computers and various software programs.
Operate motor vehicle. Valid driver's license.
Other Duties:
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of an employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
Responsible To:

Pharmacy Compliance Supervisor

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