340B Informatics Pharmacist

Bassett Healthcare Network•Village of Cooperstown, NY

2d•Remote

About The Position

The 340B Informatics Pharmacist serves as the primary liaison between Pharmacy Operations, 340B Program Management, Revenue Cycle, and Information Technology, providing subject matter expertise for medication-specific challenges, workflow, and functionality across varying audiences, both clinical and non-clinical, with a specific focus on systems that support the Bassett Healthcare Network340B Drug Pricing Program. Serves as the point of contact for pharmacy to overcome technical challenges affecting hospital, 340B, and outpatient pharmacy operations, and as a liaison between Pharmacy Operations, 340B Management and Information Technology areas for current and future endeavors involving pharmacy and medication systems, applications, and technology (e.g., Epic, automated dispensing cabinets, split-billing software, and 340B third party administrator (TPA) software). Participates in the procurement, development, implementation, customization, modification, maintenance, and improvement of technology solutions involving medications, with an emphasis on 340B regulatory compliance, split-billing accuracy, alternate distribution model (ADM) architecture and third-party administrator (TPA) platform maintenance. Manages medication-related data, information, and knowledge while promoting integration, interoperability, and information exchange. Engages with Pharmacy Informatics and 340B professional development opportunities that translate to improvements in pharmacy practice, and advocates for pharmacy is technological and 340B compliance needs within the organization. Responsible for reporting 340B program key performance indicators and ad hoc 340B metrics as requested by Pharmacy leadership.

Requirements

4 year/bachelor's degree Graduate of an ACPE accredited College of Pharmacy required
2-4 years of prior Pharmacy hospital operations experience required
2 years of Information Systems (IS) -related experience working with Electronic Medical Records (e.g., Epic/Cerner, Cardinal/McKesson,) required, or completion of a pharmacy informatics residency or fellowship in lieu of experience
Licensed or eligible for licensure to practice pharmacy in New York is required
Project Management/Planning
Technical Skills
Analysis & Evaluation
Critical Thinking
Strategic Thinking
Self-Motivated
Clinical Skills
Communication
Multi-Tasking
Take Initiative
Decision Making

Nice To Haves

MBA, MHA, or other advanced degree preferred
Doctor of Pharmacy (PharmD) preferred
2 years of 340B experience preferred
2 years of 340B TPA and split-billing software experience preferred
2 years of Information Systems (IS) -related experience working with Electronic Medical Records (e.g., Epic/Cerner, Cardinal/McKesson) preferred
Project management experience preferred

Responsibilities

Responsible for maintenance of 340B technology systems, including split-billing software and third-party administrator (TPA) platforms: coordinates build and configuration to ensure data integrity and compliance, confirms files are received on schedule, and clears exceptions in split-billing software.
Updates EMR eRx records as needed to ensure 340B modifiers are applied appropriately to claims; reviews Medicaid NDC-to-HCPCS crosswalks and Medicare Addendum B of OPPS to keep 340B modifiers correctly set.
Reviews split-billing savings and accrual reports to identify variances, investigates discrepancies, and confirms accruals are calculating accurately; identifies opportunities for 340B program optimization, including items contributing to WAC losses.
Participates in internal and external 340B Program audits on a scheduled basis, including data collection, analysis, and development of corrective action plans.
Designs future-state clinical and 340B workflows from a user perspective and delivers functional requirements, ensuring system design follows best-practice design principlesAssists in implementing new software packages and other changes in business practice based on changing regulations and policies.
Works with outpatient pharmacy management and pharmacy informatics teams to ensure that the organization’s clinical information system is coordinated and integrated into the work with the 340B Program. This includes the electronic interfaces between the EMR and the virtual accumulator and any interfaces between the organization and contract pharmacy providers and/or administrators.
Collaborates with split-billing software and/or TPA partners to ensure consistent program compliance and address any issues or discrepancies.
Periodically performs audits or compliance assessments in specific areas and specific products to ensure that the charge description master (CDM) is accurate, charges are coming across accurately, and the utilization numbers are translating accurately into reports for 340B reorders.
Integrates information from the pharmacy chargemaster system into the 340B split-billing computer system and incorporates that information into auditable and compliant processes.
Establishes a routine approach to updating the CDM/crosswalk for new products and product changes to ensure both the accuracy of the utilization report and the efficiency and accuracy of the charge process.
Monitors mixed use, entity-owned, and contract pharmacy 340B & GPO pricing to ensure accuracy. Identifies discrepancies and escalates to relevant pharmacy partners and vendors as needed.
Coordinates and leads clinical content development and maintenance within clinical applications (e.g., Epic Willow, Beacon, Clarity, Pyxis, and 340B TPA/split-billing software); collaborates closely with different teams to ensure functional design matches system capabilities and architecture.
Manages and audit National Drug Code (NDC) mappings, billing unit crosswalks (HCPCS/revenue codes), and CDM (Charge Description Master) configurations to ensure accurate accumulation and split-billing mapping.
Researches coding data and establishes drug-billing codes using appropriate HCPCS codes for inclusion in the organization's charge description master (CDM); collaborates with Cost Accounting, Finance, and Reimbursement to interpret drug cost and billing complexities.
Investigates and troubleshoots issues affecting the interface of the MR with pharmacy automation systems, 340B split-billing software, and related programs.
Leverages clinical and process knowledge to identify and implement best practices; maintains a process for periodic review and updating of application and 340B program content as required by evolving regulations and evidence-based practice.
Facilitates multidisciplinary teams — pharmacists, physicians, nurses, IT, revenue cycle, and finance — to evaluate current state and design future-state 340B and clinical informatics solutions as needed.
Functions as subject matter expert and liaison between clinicians, business owners, and build teams to design informatics and 340B compliance solutions.
Leads project management activities for assigned 340B and EMR-related initiatives through the full life cycle: planning, design, development, testing, end-user training, implementation support, and adoption.
Monitors and reports on system and 340B program implementation, tracking progress toward established goals and outcomes.
Reviews and refines training content and communications for clinical and 340B end users to ensure relevance and accuracy.
Maintains open, ongoing communication with 340B TPA and split-billing software vendors; facilitates communication between vendors and clinical/operational staff.
Maintains current knowledge of 340B program regulatory requirements (HRSA, Apexus Prime Vendor Program, 340B Health) pharmacy informatics trends, and advances in relevant hardware, software, and operating systems.
Provides real-time remote support for clinical informatics and 340B-related issues; participates in rounding or at-the-elbow support onsite during audit visits or other scheduled onsite engagements as needed.
Routinely monitors monthly and annual reports on 340B participation that clearly document utilization, savings, problem areas, and exceptions or discrepancies, to be passed on to pharmacy leadership and administration.
Develops routine reports that are a by-product of the inventory process and software, allowing concise information to be communicated to the leadership responsible for 340B inventory management.
Constructs appropriate financial metrics to assess areas of improvement.
Prepares and assists in the monitoring and various tracking and reporting measurements to ensure compliance with the program.
Reviews and refines 340B cost savings reports detailing purchasing and replacement practices, as well as dispensing patterns.
Ensures that reporting meets organizational, regional, national, state, and federal requirements and guidelines. Ensures appropriate documentation and audit trail across areas of responsibility
Prepares and submits claims-level data to third party portals such as 340B ESP, Truzo, Beacon MFP, and other stakeholder-related data repositories. Pursue good faith inquiries (GFI) as needed.
Audit manufacturer look-back windows (e.g., 45-day submission limits) within the data feeds. Program system logic to automatically flag, prioritize claims at risk of expiring to minimize financial leakage, and denied 340B chargebacks.
Build analytical infrastructure to transition data tracking from traditional up-front discount models to manufacturer-proposed post-purchase rebate validation models, ensuring clean clinical documentation is attached to each rebate claim.