340B Auditor - Pharmacy - Biltmore Campus

Mountain Area Health Education Center - MAHEC•Asheville, NC

1d•Hybrid

About The Position

MAHEC is seeking to fill a full-time and benefitted 340B Program Auditor who is responsible for auditing MAHEC’s 340B Pharmacy Program. This position is responsible for ensuring compliance with state and federal requirements of a 340B program. This role will train in person and a remote/hybrid work environment may be available after the initial training period. The ideal candidate will be regionally located.

Requirements

Associate’s Degree in healthcare or equivalent work experience and/or a minimum of three (3) years of auditing experience.
Advanced computer skills including Microsoft Office Suite.

Nice To Haves

Spanish speaking skills preferred.
340B Pharmacy Program experience and/or Federally Qualified Healthcare Organization (FQHC) experience strongly preferred.
Allscripts PM/EMR Pro software experience preferred.
Certified Pharmacy Tech (CPhT).
Registered Health Information Technician (RHIT).
Certified Professional Medical Auditor (CPMA).

Responsibilities

All required audits / reports for the 340B Pharmacy Program are completed monthly per HRSA guidelines.
Review 340B Program policies and procedures on an ongoing basis and offer contributions and changes to ensure 340B compliance.
Develop a thorough understanding of the split-billing / third party administrator systems and the functions to be performed.
Audit prescription data, patient data, hospital data, payer data, site of care, and, if required, ICD-10 codes. Summarize and report results to the Compliance Officer and the Director of the 340B Program.
Audit the purchasing process to ensure proper operation and compliance.
Audit invoices, shipping, and inventory processes.
Perform monthly audits of contract pharmacies.
Perform monthly audits of 340B pharmacy operations.
Audit for compliance with 340B Program requirements for qualified patients, drugs, and locations.
Audit state Medicaid claims to ensure compliance to prevent potential duplicate discount rebates.
Using Excel or a comparable data management program, 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.
Audit data regarding 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.
Audit to ensure that MAHEC Pharmacies maintain adherence to 340B Program regulations and guidelines.
Compile reports, as appropriate, to monitor and improve 340B Program compliance.
Maintain copies of reports for compliance and auditing purposes.