340B Program Auditor

Salinas Valley Health•Salinas, CA

81d•$38 - $48

About The Position

The 340B Program Auditor is responsible for conducting comprehensive audits of 340B prescription claims, verifying patient eligibility, prescriber-location relationships, and ensuring site compliance to maintain the hospital's eligibility and prevent diversion in the 340B Drug Pricing Program. This role supports both in-house and contract pharmacy auditing, provides documentation for HRSA audit readiness, and ensures adherence to federal program requirements.

Requirements

High school diploma or equivalent required.
Apexus 340B University Certificate required within 90 days of hire.
California Pharmacy Technician license required.
One (1) year of healthcare auditing, pharmacy technician, or compliance experience required.

Nice To Haves

Bachelor’s degree in Information Technology, Business Management, or Hospital Administration preferred.
Apexus Advanced Operations Certificate preferred.
Nationally Certified by the Pharmacy Technician Certification Board preferred.
340B Drug Pricing Program experience preferred.
Experience in data analysis, audit process, reporting and hospital or retail pharmacy experience preferred.

Responsibilities

Review accumulations and dispensing events from third party administrator (TPA) and contract pharmacy management systems
Validate prescriber-patient-location relationships for each claim to ensure compliance
Identify and document exceptions or potential diversion risks
Perform monthly compliance audits of contract pharmacies, hospital-owned retail pharmacies, specialty pharmacies, and hospital mixed-use pharmacy operations
Monitor and audit state Medicaid claims to ensure compliance and prevent duplicate discounts
Perform monthly compliance audits of patient eligibility criteria
Verify provider eligibility and location eligibility requirements
Review utilization records and 340B purchasing accounts to ensure software tools are working properly and accurately
Conduct targeted audits and negative audits to identify additional eligibility opportunities
Maintain 340B Program software to ensure appropriate products are mapped to correct charge codes and ratios
Perform daily maintenance of 340B Split Billing Software
Upload purchase data to 340B Split Billing Software monthly for all purchases made outside of wholesaler
Conduct monthly audits to verify mapping accuracy in 340B Split Billing Software
Update charge code billing units from EHR into split-billing software for accuracy and consistency
Prepare and maintain comprehensive audit logs and exception reports
Support HRSA audit responses and internal compliance reviews
Ensure data traceability and documentation readiness for regulatory requirements
Monitor monthly and annual reports on 340B Program participation documenting utilization, savings, problem areas, and exceptions
Monitor purchases for contract compliance, 340B compliance, and accurate pricing
Review product accumulation in split-billing software to ensure proper accumulations and identify negative trends
Analyze purchasing records where 340B participation occurs, documenting utilization, savings, and discrepancies
Provide purchasers with information and assistance for placing orders using appropriate accounts to maximize 340B benefit
Performs other duties as assigned.