340B Implementation Quality Assurance Analyst
About The Position
The 340B Implementation Quality Assurance Analyst ensures that covered entities’ 340B Drug Discount Programs are implemented, operated, and maintained in compliance with HRSA regulations, internal policies, and program integrity standards. The role oversees implementation, monitoring, and compliance, including audit activities, process validation, and risk mitigation to prevent duplicate discounts, diversion, and eligibility errors. The analyst conducts internal audits of 340B OPAIS records, retail pharmacies, and Medicaid claims; validates patient, provider, and drug eligibility; reviews state Medicaid billing requirements; and supports external audits. The role also develops and maintains program policies, procedures, and workflows, administers referral prescription capture, monitors contract pharmacy portals, and maintains provider tables, site mappings, and excluded drugs. The position identifies compliance risks, develops staff training, monitors regulatory updates, and generates utilization, savings, and exception reports. It collaborates with IT, audit, accounting, pharmacy teams, and other business units to share data, improve efficiency, and support compliance.
Requirements
- High school diploma or GED.
- 1–3+ years of experience in 340B program work.
- In-depth knowledge of HRSA 340B regulations and program mechanics.
- Proficiency in Excel, SQL, data analysis, and 340B software.
- Strong analytical, organizational, and communication skills.
- Ability to work independently and meet deadlines.
Nice To Haves
- Pharmacy- or healthcare-related degree.
- Prior quality assurance, compliance, or pharmacy operations experience.
Responsibilities
- Conduct regular internal audits of 340B OPAIS records, entity-owned and contract retail pharmacies, and Medicaid claims to verify HRSA compliance.
- Validate patient, provider, and drug eligibility for 340B transactions.
- Review and interpret state Medicaid billing requirements and compare them with claims data.
- Participate in external 340B program audits and prepare supporting data and documentation.
- Develop and maintain 340B policies, procedures, and workflows for purchasing, referral capture, and contract pharmacy management.
- Administer referral prescription capture processes and ensure documentation supports eligibility.
- Monitor contract pharmacy portals for missed claims, investigate denials and reversals, and coordinate remediation.
- Configure and maintain eligible provider tables, location and site mapping, and excluded NDCs and drugs in accordance with internal and HRSA standards.
- Identify compliance risks, prevent diversion, and ensure consistent processes across points of service.
- Develop staff training programs on 340B procedures and inventory management.
- Monitor regulatory updates and communicate their implications to program operations.
- Generate program utilization, savings, and exception reports for management and stakeholders.
- Collaborate with IT, audit, accounting, and pharmacy teams to share data, improve efficiency, and ensure compliance.
- Provide data, reports, and insights to support other business units.
Benefits
- Health insurance
- Flexible Spending Account (FSA)
- Dental insurance
- Vision insurance
- 401(k) retirement plan
- Paid time off
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
