340B Billing Compliance Analyst

The University of Kansas Health System•Southlake, TX

About The Position

The 340B compliance analyst is responsible for maintaining, auditing, and optimizing the health system’s 340B Drug Pricing Program. Regular maintenance includes monitoring the 340B split-billing software for accuracy. Audits are completed in accordance with hospital 340B policy. The work is performed as part of the 340B compliance team, with direction from the 340B Oversight Committee.

Requirements

Bachelor’s degree, or at least 2 years of prior experience as a 340B Analyst or in a similar role, including 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 from Apexus within 1 year.

Responsibilities

Assist the 340B Manager with 340B Drug Pricing Program pharmacy operations.
Serve as a project leader for 340B Drug Pricing 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 drugs used during inpatient care, for Medicaid patients, provided free by manufacturers, provided at non-eligible locations, or prescribed by non-eligible providers.
Perform scheduled audits and help present and resolve reconciliation issues arising during monitoring and reconciliation.
Use financial analysis to identify value opportunities in the 340B Drug Pricing Program.
Assess cost-saving opportunities and system improvements that may improve compliance.
Develop a thorough understanding of the 340B Drug Pricing Program and split-billing system.
Work to improve the efficiency, value, and internal support of the 340B program.
Collaborate with the 340B Oversight Committee to develop monthly, quarterly, and yearly audit metrics.
Perform covered-entity-specific gross financial analyses and recommend ways to improve program performance.
Track financial impact over time, identify root causes of adverse trends, and recommend ways to improve the program’s financial stability.
Educate others involved in purchasing to support proper split-billing system operation and compliance.
Manage manual or non-automated 340B data in the split-billing software.
Provide buyers with information needed to place orders using the appropriate WAC, GPO, and 340B accounts to replenish mixed-use inventory.
Perform the professional, clinical, or technical competencies of the assigned unit or department and other duties as assigned.