340B Billing Compliance Analyst
About The Position
The 340B Billing Compliance Analyst maintains, audits, and optimizes the health system’s 340B Drug Pricing Program. The role regularly monitors 340B split-billing software for accuracy and completes audits in accordance with hospital 340B policy. Work is performed as part of the 340B compliance team, with direction from the 340B Oversight Committee. The analyst supports pharmacy operations and program projects, evaluates patient eligibility, reviews and filters transactions, and performs scheduled audits and reconciliation. The role also analyzes program finances, identifies opportunities for cost savings and system improvements, tracks financial trends, and recommends ways to improve compliance and program performance. The analyst develops expertise in the 340B program and split-billing system, manages manual or non-automated program data, and educates purchasing staff to support compliant inventory replenishment.
Requirements
- Bachelor’s degree, or at least 2 years of prior experience as a 340B Analyst or similar role with experience reviewing and auditing for 340B compliance.
- At least 2 years of prior experience in a pharmacy retail or hospital setting.
- Prior knowledge and experience regarding the requirements of the 340B Drug Pricing Program.
- Obtain 340B Apexus Certified Expert (ACE) certification within 1 year.
Responsibilities
- Assist the 340B Manager with 340B Drug Pricing Program pharmacy operations and serve as a project leader for program functions.
- Evaluate patient eligibility in mixed-use areas and clinics by reviewing medical records, insurance plans, and hospital status.
- Use a data management program to filter out non-eligible transactions, including those involving inpatient care, Medicaid patients, free manufacturer-provided drugs, non-eligible locations, or non-eligible providers.
- Perform scheduled audits and present and resolve reconciliation issues that arise during monitoring and reconciliation.
- Analyze the financial value and performance of the 340B Drug Pricing Program, identify cost-saving opportunities, and recommend system improvements.
- Collaborate with the 340B Oversight Committee to develop monthly, quarterly, and yearly audit metrics.
- Conduct gross financial analyses specific to the hospital or other covered entity and recommend ways to improve program performance.
- Track financial impact over time, identify root causes of adverse trends, and recommend actions to improve financial stability.
- Develop a thorough understanding of the split-billing system and its functions.
- Educate others involved in purchasing to support proper operation and compliance.
- Manage manual or non-automated 340B data within the split-billing software.
- Provide buyers with information needed to order using appropriate WAC, GPO, and 340B accounts to replenish mixed-use inventory.
- Improve the overall efficiency, value, and internal support of the 340B program.
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What This Job Offers
Job Type
Full-time
