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Schedule

Full-Time: 40 Hours/Weekly

7 to 3:30 but flexible M-F. No weekends or Holidays

General Summary

Performs a variety of duties to ensure that the organization remains compliant with the 340B Drug Pricing Program requirements. Performs regularly scheduled audits of contract pharmacies (if applicable) and 340B pharmacy operations to ensure compliance with 340B Program requirements for qualified patients, drugs and locations. Monitors and audits state Medicaid claims to ensure compliance to prevent potential duplicate discount rebates. Evaluates patient eligibility for qualified and non-qualified patients in mixed-use areas and clinics by reviewing patient medical records, insurance plans, and, if applicable, hospital status. Develops and maintains reports to monitor and improve 340B Program compliance and performance and for compliance and audit purposes. Maintains up-to-date policies and procedures on 340B purchasing processes. Provides proactive education to staff on policies and procedures related to inventory management and 340B procedures.

Essential Functions:

+ Policy and Procedure Development - Maintains up-to-date policies and procedures on 340B purchasing processes. - Develops systems and processes to limit program liabilities and provide proper audits to identify risk and prevent duplicate discounts and diversion. - Reviews 340B Program policies and procedures on an ongoing basis and offer contributions and changes to ensure 340B compliance.

+ Education - Develops proper 340B quality assurance training for employees as appropriate. - Provides proactive education to staff on policies and procedures related to inventory management and 340B procedures. - Expands professional development through related classes and seminars, current publications, and regional/national association membership participation.

+ Audits - Perform audits on a scheduled basis; may involve presenting and resolving reconciliation issues as they arise during the monitoring and reconciliation process. - Performs monthly audits of contract pharmacies, if applicable and self-audits of 340B pharmacy operations. - Ensures compliance with 340B Program requirements for qualified patients, drugs, and locations. - Monitors and audits state Medicaid claims to ensure compliance to prevent potential duplicate discount rebates. - Uses Excel or a comparable data management program to filter out non-eligible transactions, including, but not limited to, drugs used to treat patients during inpatient care, Medicaid patients, drugs provided free by manufacturers, those provided at non-eligible locations, or prescriptions written by non-eligible providers. - Evaluates patient eligibility for qualified and non-qualified patients in mixed-use areas and clinics by reviewing patient medical records, insurance plans and, if applicable, hospital status. - Ensures that facilities maintain adherence to 340B Program regulations and guidelines. - Develops and fosters working relationships with internal working counterparts (e.g., IT, internal audit, accounting, etc.) to facilitate productive exchanges of information, to improve program efficiency and promote program compliance. Provides data, information and reports as needed for other business units within the organization.

+ Program Enhancement/Optimization - Develops a thorough understanding of the 340B Program and improves its overall efficiency, value and internal support. - Assesses opportunities for cost savings and system improvements to yield higher compliance. Evaluates and implements cost savings opportunities. - Continues to build knowledge of the health care and pharmacy services industry. Uses that knowledge to identify ways and make recommendations to improve the 340B Program. - Provides assistance to all customers to clarify requirements and propose sourcing options. Evaluates and recommends the best sourcing solution.

+ Reporting - Develops reports that can be used to educate staff and assist management in tracking the overall financial impact to the organization. Builds other reports, as appropriate, to monitor and improve 340B Program compliance and performance. - Maintains copies of reports for compliance and audit purposes. - Collaborates with the Pharmacy, Compliance and 340B governing board to develop monthly, quarterly and yearly audit metrics. - Constructs appropriate financial metrics to assess areas of improvement. - Develops and updates 340B Program reporting packages detailing volume, financial value and other reporting metrics as needed. - Uses provided tools to monitor prescription data, patient data, hospital data, payer data, site of care and, if required, ICD-10 codes. Summarizes and reports results to the appropriate individuals. - Monitors, reports, and analyzes contract pharmacy 340B activities. Provides financial reports to hospitals or other covered entities relative to financial impact and liabilities. Makes recommendations that would improve efficiency. - Performs covered entity-specific gross financial analysis and makes recommendations to improve program performance. Tracks financial impact over time, identifies root causes of adverse trends and makes recommendations to improve the program's financial stability. - Reviews and refines monthly 340B cost savings reports detailing purchasing and replacement practices, as well as dispensing patterns.

+ Purchasing/Inventory/Split-Billing Duties - Provides coverage for the Pharmacy Buyer as necessary. - Analyzes and audits invoices, shipping and inventory processes. Makes recommendations for purchasing practices as needed. - Develops a thorough understanding of the split-billing/third party administrator systems and the functions to be performed.

Common Expectations:

+ Demonstrates a commitment to patient, visitor and staff by: complying with all applicable safety regulations; learning the impact of medical errors and methodologies that will lead to reduction of errors; reporting actual and potential errors, as well as hazardous conditions; identifying opportunities to standardize processes and "error proof" systems that will lead to increased safety; and participating in safety education programs and root cause analyses as required.

+ Maintains established policies and procedures, objectives, quality assessment, safety, environmental and infection control standards.

+ Participates in educational programs and inservice meetings.

+ Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.

Qualifications

Minimum Education:

+ High School Diploma or GED Required

Work Experience:

+ 2 years Including at least 1 year working with healthcare applications or technologies. Required

Licenses:

+ Certified Pharmacy Technician Upon Hire Required

Knowledge, Skills, and Abilities:

+ Ability to learn new technologies and software programs.

+ Excellent communications skills and interpersonal skills.

+ Proficiency in Microsoft Excel and general computer skills including accurate and efficient entry and navigation in multiple software systems.

+ Organizing and managing multiple priorities.

Benefits Offered:

+ Comprehensive health benefits

+ Flexible spending and health savings accounts

+ Retirement savings plan

+ Paid time off (PTO)

+ Short-term disability

+ Education assistance

+ Financial education and support, including DailyPay

+ Wellness and Wellbeing programs

+ Caregiver support via Wellthy

+ Childcare referral service via Wellthy

WellSpan Health's vision is to reimagine healthcare through the delivery of comprehensive, equitable health and wellness solutions throughout our continuum of care. As an integrated delivery system focused on leading in value-based care, we encompass more than 2,300 employed providers, 250 locations, nine award-winning hospitals, home care and a behavioral health organization serving central Pennsylvania and northern Maryland. Our high-performing Medicare Accountable Care Organization (ACO) is the region's largest and one of the best in the nation. With a team 23,000 strong, WellSpan experts provide a range of services, from wellness and employer services solutions to advanced care for complex medical and behavioral conditions. Our clinically integrated network of 3,000 aligned physicians and advanced practice providers is dedicated to providing the highest quality and safety, inspiring our patients and communities to be their healthiest.

Quality of Life. Founded in 1741, the city of York is considered by many as the first capital of the United States. The Articles of Confederation were signed by the Second Continental Congress here in 1777. Its beautifully restored historic district is an architectural treasure. While York retains its farming and manufacturing heritage, at its heart York is a thriving cultural community that has attracted creative talent and innovative entrepreneurial investors from across the nation. Life in York County offers affordable housing, options for higher education, a thriving arts and cultural community, historical attractions, parks and recreational resources, semi-professional baseball team, fine dining and more - within an easy drive of major East Coast cities. York County residents can find local employment in healthcare, manufacturing, technology, agricultural and service sectors. (Patient population: 445,000)

WellSpan Health is an Equal Opportunity Employer. It is the policy and intention of the System to maintain consistent and equal treatment toward applicants and employees of all job classifications without regard to age, sex, race, color, religion, sexual orientation, gender identity, transgender status, national origin, ancestry, veteran status, disability, or any other legally protected characteristic.