340B Finance & Compliance Analyst

Jefferson Health Plans • Philadelphia, PA

5d • Onsite

About The Position

The 340B Finance Compliance Analyst is responsible for the oversight of the 340B Program at Jefferson. This role involves reviewing all areas and responsibilities related to Jefferson's 340B program, including monitoring, auditing, managing, maintaining, and implementing pharmacy 340B programs. The analyst will assist with data for financial analysis, ensure claims meet eligibility criteria across all settings, and manage provider eligibility. This position requires collaboration with pharmacy buyers, staff, and other stakeholders, as well as providing training when needed. The analyst will also assist in developing policies, procedures, and workflows, and maintain split-billing software to ensure ongoing 340B compliance. Key duties include routine monitoring and interpretation of utilization records, performing regular audits (e.g., mixed-use, contract pharmacy, crosswalk, accumulations), and presenting/resolving reconciliation issues. The role also involves performing internal and external compliance risk assessments, monitoring and auditing claims for compliance and to prevent duplicate discount rebates, and ensuring Jefferson's adherence to HRSA and OPA regulations. The analyst will analyze volumes and trends against benchmarks, review and contribute to policy and procedure updates, and participate in achieving program goals. Staying current with 340B pricing trends and new legislation is crucial, as is analyzing purchasing trends and their economic impact. The position requires assisting in rectifying findings with supervisor and stakeholders, and demonstrating experience in analyzing and reporting data to identify issues and drive improvements.

Requirements

• Associate degree in business, pharmacy, health care, data/IT or related field and/or equivalent relevant experience
• Minimum of two (2) years broad pharmacy financial operations or financial analytics experience
• 340B University training required (can be completed upon hire)
• Experience with analyzing and reporting data in order to identify issues, trends, or exceptions to drive improvement of results and find solutions
• Analytical mindset and ability to present data in a comprehensive manner

Nice To Haves

• Solid understanding of 340B auditing standards, techniques, and procedures preferred
• Experience with 340B Third Party Administrator (TPA) software preferred
• Knowledge of the issues, trends, and challenges presented by participation in the 340B program
• Apexus Certification preferred

Responsibilities

• Monitoring, auditing, managing, maintaining and implementing pharmacy 340B programs
• Assisting with data for financial analysis
• Ensuring claims meet eligibility criteria in all settings of the 340B program
• Manage and oversee provider eligibility
• Working in conjunction with pharmacy buyers, pharmacy staff and other stakeholders
• Assisting and/or providing training to stakeholders as needed
• Assist in the development of policies and procedures and workflows
• Maintain split-billing software and ensure 340B compliance on an ongoing basis
• Routinely monitors and interprets utilization records including drug administrations and purchasing accounts, including direct accounts, to ensure source system software is reconciled properly and accurately
• Performs audits on a schedule basis for mixed-use, contract pharmacy, crosswalk and accumulations, among others; may involve presenting and resolving reconciliation issues as they arise
• Perform internal and external compliance risk assessments to validate processes
• Monitor and audit claims to ensure compliance and to prevent potential duplicate discount rebates
• Ensures Jefferson’s compliance with the Health Resources and Services Administration (HRSA) and Office of Pharmacy Affairs (OPA) regulations and guidelines
• Analyzes volumes and trends as compared to benchmarks, best practices and strategic goals
• Review 340B Program policies and procedures on an ongoing basis and offer contributions and changes to ensure 340B compliance
• Participates in accomplishing 340B Program goals and objectives, evaluates effectiveness and implements changes to achieve desired outcomes
• Keeps up with 340B pricing trends and new legislation
• Analyzes and interprets 340B purchasing trends and the economic impact to the organization
• Assist in rectifying findings as needed, in collaboration with supervisor and stakeholders

Benefits

• medical (including prescription)
• supplemental insurance
• dental
• vision
• life and AD&D insurance
• short- and long-term disability
• flexible spending accounts
• retirement plans
• tuition assistance
• voluntary benefits
• tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree