MINIMUM QUALIFICATIONS:
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1. Bachelors Degree in Business Administration, Information Technology, Hospital Administration, or other healthcare related field AND three (3) years’ of healthcare or pharmacy experience
OR
High School Diploma AND Seven (7) years’ of healthcare or pharmacy experience.
2. Apexus Advanced Operations Certificate within twenty-four (24) months of hire.
PREFERRED QUALIFICATIONS:
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1. Master’s Degree in Business Administration, Information Technology, Hospital Administration or other health care related field.
2. Apexus Advanced Operations Certificate preferred upon hire.
EXPERIENCE:
1. Experience with 340B Drug Pricing Program.
2. Experience with data analysis, audit process and reporting.
3. Experience with Hospital or retail pharmacy.
CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.
1. Oversees and ensures compliance of the 340B Drug Discount Program to include documentation of policy and procedure, tracking of software, documented cost savings, and appropriate safeguards/system integrity.
2. Provides regular 340B training, education, and communication to appropriate stakeholders throughout the system.
3. May assist in the development, implementation, or promotion of programmatic resources/tools to support staff.
4. Acts as the liaison with necessary affiliated departments and contract pharmacies throughout the system to ensure 340B Program integrity.
5. Develops, executes, documents and oversees self-audits of the 340B process. Coordinates and ensures remediation of findings.
6. Periodically performs spot audits or compliance assessments in specific areas and specific products to ensure that the CDM is accurate, charges are coming across accurately, and the utilization numbers are translating accurately into report for 340B reorders.
7. Maintains 340B split-billing software integrity and reviews applicable reports to identify areas for improvement.
8. Works with WVUHS outpatient pharmacy, hospitals and specialty pharmacies to ensure entity wide 340B compliance.
9. Analyzes utilization of the program and existing software to identify ways to compliantly use the 340B program to its fullest extent.
10. Monitors purchasing and utilization records for each 340B participant; clearly documents utilization, savings, problem areas, and exceptions or discrepancies. Relays results to pharmacy leadership and administration.
11. Participates with the Prime Vendor and routinely reviews 340B formulary pricing, potential alternatives, and possible additional savings as a result of GPO formulary. Performs quarterly review of the new 340B pricing list, searching for costly changes to be detected quickly and addressed.
12. Performs Diversion Detection & monitor WAC spend and dispensing patterns to determine trends and find solutions to decrease WAC spending.
13. Identifies and facilitates 340B program improvement projects.
14. Regularly communicates with all staff involved with the 340B Program to be sure that processes remain standardized, efficient and to address any problems or suggestions for improvement.
15. Ensures that the 340B pharmacy program is continuously compliant with 340B federal regulations.
16. Responsible for managing and troubleshooting pharmacy billing issues and ensuring that adequate systems checks are reviewed to prevent billing issues.
17. Evaluates patient eligibility for qualified and non-qualified patients in hospital-based mixed-use areas and clinics by reviewing patient medical records, insurance plans, and hospital status.
18. Coordinates monthly financial reporting and analysis, including, but not limited to, metric reporting, scorecards, and variance analysis and reporting.
19. Ensures that reporting meets organizational, regional, national, state, and federal requirements/guidelines.
20. Reviews and updates First Data Bank information.
21. Required to be on site for support of all 340B HRSA program audits and all external 340B audits
22. Monitors and assesses 340B guidance and/or rule changes, including, but not limited to, HRSA/OPA rules and Medicaid changes.
PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. While performing the duties of this position, the employee may be required to sit or stand for long periods of time.
2. Extended periods of computer and telephone usage.
3. Must be able to move throughout the department work areas.
WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. Standard office environment.
SKILLS AND ABILITIES:
1. Ability to handle and maintain confidential information.
2. Ability to work independently or cooperatively as a team member.
3. Ability to adapt to various workloads and assignments.
4. Must possess analytical and problem solving skills.
5. Ability to work with multi-disciplinary groups and facilitate meetings.
6. Must have effective verbal and written communication skills, as well as interpersonal skills necessary to communicate effectively with all levels of management.
7. Ability to interpret and analyze data.
8. Knowledge of MS Office applications including Word, PowerPoint, Excel and Outlook
Additional Job Description:
Scheduled Weekly Hours:
40Shift:
Day (United States of America)Exempt/Non-Exempt:
United States of America (Exempt)Company:
SYSTEM West Virginia University Health SystemCost Center:
248 SYSTEM 340B Pharmacy Admin
Hashicorp
Cynet Systems
Armis
ICF
Canva
