Analyst, 340B Program - Contract Pharmacy

Education & Experience

• Associates degree or equivalent related work experience
• 2 years of 340B related work experience

• Associates degree or equivalent related work experience
• 2 years of 340B related work experience

• Bachelor's degree in business, accounting, or finance
• 3 years of direct experience with pharmacy 340B Drug Pricing Program
• 3 years of experience in business and analytics
• Working knowledge and understanding of medication and contract terminology; healthcare insurance collections, reconciliation, or analysis; supply chain management
• EPIC experience

• Apexus 340B University

• Apexus Advanced 340B Certificate Program
• Registered as a Pharmacy Technician with the Texas State Board of Pharmacy

Under the direction of the 340B Program Director, this position oversees day-to-day 340B operations, compliance monitoring, and auditing of the University’s 340B Drug Pricing Program. Collaborates with Pharmacy Buyers to monitor ordering processes to ensure pharmacy supply chain management is consistent with established inventory split billing software practices, compliant with 340B Program rules, there are no GPO (group purchasing organization) prohibition violations, and inventory management is optimized to maximize benefits.

Performs audits including claim analysis to determine if use is compliant with 340B regulations and established policies to ensure prevention of duplicate discounts and drug diversion to ineligible patients. Prepares self-audit reports. Ensures records and documentation for the 340B program are thorough and accurate. Supports the weekly operations of ADM.

This role will require the ability to analyze large data sets, clearly summarize the results for leadership, be able to speak to the results at both a detailed and high level, and recommend appropriate next steps to resolve any identified variances. Responsible for appropriately escalating issues and tracking to resolution and participating in routine meetings with multiple areas of the organization as well as external entities.

• Develops a thorough understanding of the 340B Program. Strives to consistently improve the overall efficiency, value, and internal support of the 340B Program.
• Maintains knowledge of, and complies with, all relevant laws, regulations, policies, procedures, and standards including all HRSA Office and Pharmacy Affairs regulations related to the 340B Drug Pricing Program.
• Maintains up-to-date policies and procedures on 340B purchasing and inventory processes.
• Provides proactive education to staff on policies and procedures related to inventory management, split billing software, and 340B procedures including staff at contract pharmacies, clinics, and UTMB-owned pharmacies.
• Effectively communicates to wholesalers, pharmacists, leaders, and others as needed.
• Builds reports to monitor and improve 340B program compliance and performance. Maintains copies of reports for compliance and audit purposes.
• Participates in on-site mock HRSA audits with consulting firm and HRSA audits.
• Collaborates with the pharmacies and 340B Team to develop monthly, quarterly, and yearly audit metrics.
• Performs audits on a scheduled basis including presenting and resolving issues as they arise during the monitoring and reconciliation process.
• Uses the electronic health record (EPIC) to research patient encounters and records within the specified audit period. Documents and identifies whether the encounter was with an eligible physician, at an eligible location, and eligible patient status.
• Monitors and audits state Medicaid prescriptions to ensure compliance to prevent potential duplicate discount. Performs audits to ensure split billing software accumulators are accurate on an NDC level; performs physical inventory cycle counts as needed to verify the drug accumulations and/or NDC’s.
• Develops a thorough understanding of the 340B Third Party Administrator software and the functions to be performed. Reviews and monitors utilization records, 340B purchases, and contract pharmacy usage to ensure software and tools are…