Pharmacy Compliance Auditor – 340B Program

Pharmacy Compliance Auditor – 340B Program

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Play a vital role in ensuring access to affordable medications for underserved communities. Protect the integrity of the 340B Drug Pricing Program—a federal initiative that enables healthcare organizations to stretch resources and provide comprehensive care.

As a Pharmacy Compliance Auditor, you’ll work closely with pharmacy leadership to conduct audits, monitor compliance, and identify opportunities for improvement. This role offers the chance to develop specialized expertise in 340B operations, gain advanced certifications, and make a meaningful impact on patient care and organizational success.

• Minimum of High School Degree or GED is required
• Must successfully complete Apexus 340B University within the first 6 months in the position.
• Advanced 340B Operations Certificate within the first 12 months.
• Minimum of 2-3 years of experience in one or more of the following:
  Hospital Pharmacy Technician, Pharmacy purchasing, 340B Program operations.

The Pharmacy Compliance Auditor works under the supervision of the Sr. Director of Pharmacy and guidance of the 340B Pharmacy Compliance Coordinator to audit and monitor the 340B Program. Functions include execution and documentation of daily, weekly, monthly, and quarterly audits to verify adherence with the 340B Program regulations and/or guidelines as outlined in 340B policies and procedures.

Accurately and efficiently perform 340B audits on a scheduled basis, including contract pharmacy, mixed use pharmacy, and outpatient pharmacy, and ensure compliance with the 340B Program. Address reconciliations that arise. Monitor and audit state Medicaid claims using Excel to filter out non-eligible transactions. Evaluate patient eligibility for qualified and non-qualified patients in mixed-use areas and clinics. Maintain and audit the Prescriber file provided by Medical Staffing Office.

Assist with external audits as assigned.

Maintain easily retrievable copies of audits and reports for compliance and audit purposes. Review findings, identify issues, and steps taken to reconcile the issue with the Pharmacy Compliance Coordinator. Ensure that reporting meets organizational, regional, national, state, and federal requirements/guidelines. Routinely monitor industry publications, websites, and that organization has latest updates and information. Sign up for 340B webinars.

Audit Contract Pharmacy matches, analyze causes of incorrect accumulations, and reverse incorrect matches. Identify and accumulate eligible matches from suspects. Maintain records of purchases sent to Contract Pharmacies and payments made to the Covered Entity. Audit Outpatient Pharmacy matches, analyze causes of incorrect accumulations, and reverse incorrect matches. Audit whether correct pricing plan was applied to Medicaid/Managed Medicaid. Audit the sub-clarification code 20 application to all FFS and MCO Medicaid claims, as well as verifying that the 08 code was applied.

Identify and accumulate eligible matches from suspects.

Responsible for loan‑borrow tracking. Maintain records and facilitate inventory reconciliations. Compile purchasing information such as list of Tri Health purchasing accounts. Provide Pharmacy Buyers with information needed to place orders using appropriate accounts to replenish inventory in the mixed‑use inventory setting. Verify data integrity within 340B software and wholesaler/vendor purchase reports after corrections and rebills are made and approve the order review in the queue.

Provide root cause analysis and corrections of NDCs. Identify and submit Individual wastes.

• Healthcare system knowledge base/skills
• Proficiency in Microsoft Office software, specifically Excel, Word, and Outlook
• Ability to quickly learn technical systems such as EMR systems, retail pharmacy systems, and/or 340B software systems
• Ability to work in a complex team environment and to collaborate with peers to complete required work
• Strong interest in pharmacy practice advancement
• Excellent verbal and written communication skills; communication style that is open and fosters trust, credibility and understanding.

• Climbing – Rarely
• Concentrating – Consistently
• Continuous Learning – Consistently
• Hearing:
  Conversation – Frequently
• Interpersonal Communication – Consistently
• Kneeling – Rarely
• Lifting