340B Program Manager

Philadelphia, PA, United States

The 340B Program Manager/Auditor Support Specialist will develop expertise with the 340B program and may provide information to staff and participants regarding ongoing compliance. Also, they will act as a subject matter expert and provides oversight to all 340B Program Covered Entities, ensuring that the program is maximally utilized by all Covered Entities, that related records are complete, accurate, auditable, and that primary objectives as defined by hospital/non-hospital leadership are met. This position will be required to request and obtain electronic auditable records of all 340B documentation for each 340B audit engagement. The position may assist in implementing effective, reliable data gathering processes as it relates to the 340B program. Moreover, this position assists with implementation of and adherence to 340B related policies and procedures

Responsibilities:

Coordinates directly with 340B Auditor to manage the transition between audit phases: Kick-off, document gathering, and completion of audit report.

Communicates daily with active Audit clients to request and receive outstanding items documents from the audit checklist.

Reviews documentation delivered by active audit clients for accuracy and completeness.

Provide education or clarification to help audit clients deliver incomplete or inaccurate documentation.

Upon receipt of client documents, uploads documents to the appropriate audit folder and updates the audit checklist to confirm receipt.

Completes detailed claim audit review of randomly sampled claims to confirm each claim meets each of the 340B eligibility requirements.

Prepares a client briefing for Consultant that provides a detailed summary of any comments or feedback related to the documents received.

Completes updates to internal documentation templates related to client audit to facilitate the transfer of information to Audit Consultant.

Obtain login credentials from various third-party applications to login and download necessary claim details files.

Manages updates to client project plans in real-time to keep project information up to date.

Navigates the Health Resources and Services Administration OPAIS application to search and download audit documentation.

Develops, executes, and completes ongoing quarterly audits of all Assent active client program. Coordinates and ensures notes of findings are thoroughly documented in the claim detail notes.

Coordinates and facilitates an annual independent audit of all 340B processes. Provides oversight for all audits performed by independent external auditors.

Coordinates external compliance assessments and data retrieval with outside firms, pharmaceutical companies and/or HRSA as directed.

Responsible for the day-to-day management, compliance review, and operations of clinic-administered medications in eligible locations.

Develops and maintains internal relationships (accounting, legal, pharmacy) and external relationships (wholesalers, manufacturers, contract pharmacies, pharmacy benefits managers (PBMs), and third-party administrator (TPA) vendors) as needed.

Keeps abreast of trends and issues pertaining to the program and relays applications and interpretations to Pharmacy Director.

Responsible for verifying that the HRSA 340B Database is accurate for all organization entities.

Maintain professional growth and development through seminars, workshops and professional meetings and affiliations as approved by management. Review research and review literature for revised and current best practices related to the 340B program. Attend approved local and national 340B training and planning meetings.

Effectively and continually maintains open lines of communication with all staff and management involved with the 340B program. Provides timely and accurate communication, both written and verbal as appropriate, regarding changes and continuous quality improvement activities, including goals and objectives of the 340B program. Reports any deficiencies identified during auditing and review for appropriate resolution.

Assists with implementation of action plans to correct 340B compliance deficiencies, if indicated.

Participates in the development of quarterly and annual 340B participation reports documenting utilization, savings, and exceptions or discrepancies.

Shares expertise and assists with training, education, and communication to staff and Program participants regarding updates to 340B policies and procedures.

Audits all points of service where 340B participation occurs to ensure compliance with 340B program requisites, including entity and patient qualifications and ensure consistent processes are followed across all.

Utilizes, and maintains a working knowledge of computerized systems, split-billing software programs and specialized equipment and technologies utilized in operations related to the 340B program in collaboration with the Pharmacy 340B Program Manager and Information Services.

Perform other duties as assigned.

EEO

Requirements

Specific 340B training and/or knowledge required.

Travel requirement – 35%, to client locations within the Philadelphia area.

Bachelor of Science in HealthCare Administration or related field with experience in Project Management is preferred.

2-3 years of 340B Drug Pricing Program experience in healthcare and/or with a healthcare provide is preferred.

Aptitude to understand regulatory standards relating to the 340B program and pharmacy operations.

Knowledge of pharmacy related matters and requirements for practice.

Work is normally performed remotely, however there may be times where the employee will have to travel to corporate or other locations for internal and external meetings. The employee will have to work with various computer applications and will be required to sit and work with data at a computer (desktop or laptop) for extended periods of time.

Excellent verbal and writing skills.

Ability to adapt to a complex organizational environment.

Ability to promote and maintain positive relationships with all departments and staff.

Advanced interpersonal communication skills to provide effective consultation and collaboration.

Ability to relate to diverse ages and demographic backgrounds.

Ability to organize and define problems, develop strategies, and carry out action plans.

Ability to coordinate the work of a wide range of constituencies.

Capable of exercising sound judgment and making intelligent decisions based on the information provided.

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