Address
Form of workGENERAL SUMMARY:
Shift: Full-Time 40-hour work week
Eligible: Full-Time Benefits
Performs a wide variety of financial, database, auditing and compliance reporting analyses to ensure HFHS entities to reinforce eligibility, integrity and compliance for the 340B Federal Discount Program. Provides program support for both the financial and compliance operations of the 340B program through investigating, analyzing and reporting accurate data related to the 340B billing and contract pharmacy operations.
Utilizes multiple data sources and business intelligence tools to analyze statistical and financial information in order to recommend strategies for optimizing 340B program initiatives while ensuring compliance with all applicable regulations. Maintains database to reflect changes in drug formularies, assures system integrity, analyzes purchasing data and monitors ordering processes and documentation related to pharmacy supply chain compliance with state and federal regulations.
PRINCIPLE DUTIES AND RESPONSIBILITIES:
Oversight and responsibility for overall compliance, auditing and financial analytics for the 340B Pharmacy Program within Henry Ford Health System (HFHS)
- Conducts regular audits of claims data to ensure 340B program compliance. Evaluates all eligibility criteria for qualified and non-qualified patients. Performs chart and medical record review.
- Utilizing multiple data sources and business strategies for optimizing 340B program initiatives while ensuring compliance with all applicable regulations.
- Performs a variety of financial and compliance reporting and auditing. Maintains accurate tracking of financial and productivity data related to 340B and purchasing program.
- Reviews trends, creates forecasts and develops predictive models. Analyzes data reports for trends and discrepancies while assessing cost savings opportunities for maximum optimization and compliance.
- Monitors and tracks all payments received by contract pharmacies. Acts as a liaison between the covered entity and contract pharmacy when payment discrepancies occur.
- Validates necessary patient, provider and medication information to ensure proper claims submission, and to maintain accurate documentation of records related to 340B and purchasing program.
- Continually monitors product levels to effectively balance product availability and cost-efficient inventory control factoring in 340B utilizing Retail Usage Ratios.
This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and duties. It should be understood, therefore, that employees may be asked to perform job-related duties beyond those explicitly described above.
EDUCATION/EXPERIENCE REQUIRED:
- Bachelor's Degree in Business, Finance, Healthcare or related field -or- equivalent related work experience required.
- Prior Pharmacy operations experience preferred.
- Working knowledge of 340B program, including eligibility and compliance requirements.
- General working knowledge in areas of compliance, finance, supply chain and database tools.
- Proficient working knowledge and/or experience with Microsoft Office products Excel, Assess, Word, PowerPoint, Team, etc., along with relational database and other analytical tools such as Tableau.
- Effective verbal, written and interpersonal communication skills to interact effectively and cooperatively with all internal and external customers.
- Must possess excellent project planning and time management skills. Ability to work independently while managing multiple tasks and meeting established deadlines.
CERTIFICATIONS/LICENSURES REQUIRED:
- 340B Apexus Certified Expert (ACE) certification required within one year of employment (highest 340B certification currently available
- Organization: Community Care Services
