340B Analyst

Rochester Regional Health•Auburn, NY

1d•$62,400 - $67,000•Hybrid

About The Position

Provides 340B program regulatory oversight for all 340B contract pharmacies, including compliance auditing, deficiency identification, and written compliance recommendations. Assists the Director of Operations in maximizing 340B revenue. Proficiency in data management and Microsoft Office are essential, along with the ability to work independently through task completion.

Requirements

Demonstrated analytical (critical thinking) skills are essential.
Strong interpersonal communication skills and organizational skills.
Consistently demonstrates ability to respond to changing priorities and situations in a flexible manner in order to meet current needs.
Demonstrated ability to manage and prioritize tasks with attention to detail.
Ability to work in a team environment, use a computer for communication, writing and research.
Proficient with Microsoft Office including Word, Excel, PowerPoint, and Outlook.
Bachelor’s degree preferred, preferably in a Science, Technology, Business, Math Degree.
Equivalent combination of education and/or experience may substitute when experiences are closely related to the duties of the job.

Nice To Haves

Retail Pharmacy experience desired.

Responsibilities

Develops and updates documents, processes, and procedures for daily operations and monthly financial reporting.
Prepares reports regarding the Contract Pharmacy business operations revenue and expenses.
Audits for compliance with OPA/HRSA and other regulatory bodies relating to 340B contracted pharmacies and provider administrated drugs.
Review Pharmacy Benefit Management dashboards to audit data and interact with pharmacies as needed.
Interact with purchasing/pharmacy to obtain 340B pricing on administered drugs in the office and relay this information to RGMG billing department.
Audits contract pricing to ensure accuracy and manages the drug returns process for the retail pharmacies for out of date drugs.
Maintains all files and records such that the information processed and produced reflects the pharmacy information system up to date processes.
Tracks, trends, and reports 340B pharmaceutical sales and purchases data to insure provider/physician and patient eligibility and review ineligibility reports.
Coordinates payment and compliance audits by contracted plans and/or regulatory agencies. Makes recommendations as to whether the third party audit findings are in compliance with reimbursement regulations.
Collaborates with finance, compliance, and other partners to ensure the 340B Program is utilized to its fullest potential; making/recommending necessary changes to the program as needed.
Performs moderately complex statistical, cost, and financial analysis of data.
Through the use of analysis, audit and investigative means, identifies and acts upon reimbursement and revenue opportunities. Ensures revenue optimization through the implementation of charge capture and charge reconciliation tools.
In a collaborative effort, works with medical, clinical and support staff regarding reimbursement issues related to but not limited to; coding, documentation, payer requirements and audit results.
Assists in the investigation of charging and/or billing opportunities for existing and future revenue projects while determining reimbursement potential.
Identifies trends and monitors utilization for the purpose of data analysis and projection.
Utilizes all necessary software and applications to investigate, analyze, report, educate as well as develop procedural improvements related to all components of the 340B Program.
Manages projects independently, prepares governmental disclosures and facilitates external audits by regulatory agencies while working with Administration and Management.
Develops reports reflecting audit results and reports findings to Compliance Director, Administration and management.