Pharmacy 340B Analyst - Pharmacy- 1.0 FT - 8hrs days variable

Washington Hospital•Fremont, CA

1d•Onsite

About The Position

Under the direction of the Director of Pharmacy, with day-to-day position direction from the Pharmacy 340B Program Coordinator, the Pharmacy 340B Analyst performs the data analysis, reconciliation, and reporting that support daily operation of the 340B Drug Program. The Analyst validates 340B accumulations, replenishment, and split-billing accuracy, prepares compliance and savings reporting, supports internal and external audits, and escalates identified compliance risks. This position performs analysis and executes established processes; program policy, vendor contracting, external commitments, and institutional compliance authority remain with the Pharmacy 340B Program Coordinator and pharmacy leadership.

Requirements

California State Board of Pharmacy Technician Registration and Pharmacy Technician National Certification, maintained in active status and available for primary source verification.
Demonstrated ability to work accurately with large data sets in Microsoft Excel, including pivot tables, lookup functions, and reconciliation of data from multiple sources.
Completes hospital orientation, initial competency assessment, and all required annual compliance education (including HIPAA, workplace violence prevention, and safety) within required timeframes.

Nice To Haves

Two (2) year degree or higher preferred.
One (1) year of experience in pharmacy operations, pharmacy purchasing, revenue integrity, health system finance, or healthcare data analysis preferred.
Working knowledge of 340B Drug Program requirements, split-billing software, and contract pharmacy operations preferred.
Familiarity with wholesaler ordering platforms and GPO/WAC/340B account structures preferred.
Critical thinking skills and the ability to identify issues, trends, and exceptions in data and trace them to root cause.
Ability to organize work, meet recurring deadlines, and work independently within established procedures in a rapidly changing environment.

Responsibilities

Reviews daily 340B accumulation, replenishment, and order activity in the split-billing system and resolves or escalates exceptions within established timeframes.
Validates patient, provider, and location eligibility on 340B-identified claims against the hospital’s established eligibility criteria and documents the result of each review.
Reconciles 340B purchases against accumulations to confirm that quantities purchased are supported by qualifying dispenses, and investigates variances to root cause.
Prepares recurring 340B savings, utilization, and compliance reports for pharmacy leadership on a defined schedule.
Monitors contract pharmacy third-party administrator (TPA) reports and dispensing activity and identifies discrepancies for follow-up.
Maintains documentation supporting each review, reconciliation, and correction so that the program’s work is auditable.
Supports the Pharmacy 340B Program Coordinator in preparing data and materials for the 340B oversight team and other committees.
Escalates suspected diversion, duplicate discount, or eligibility concerns to the Pharmacy 340B Program Coordinator and pharmacy leadership promptly upon identification.
Uses the 340B split-billing software to review accumulations, mappings, exclusions, and exception queues, and recommends mapping corrections to the Pharmacy 340B Program Coordinator.
Analyzes NDC-level purchasing, dispensing, and billing data to identify discrepancies and works with Revenue Integrity and Pharmacy IT to research and resolve them.
Applies intermediate to advanced spreadsheet and data analysis skills to reconcile purchase, dispense, and claims data drawn from multiple systems.
Supports maintenance of the hospital’s records in the 340B Office of Pharmacy Affairs Information System (OPAIS), including preparing child site and contract pharmacy information for review and assembling documentation for annual recertification.
Executes established duplicate discount prevention procedures for Medicaid, including applying carve-in/carve-out rules, billing identifiers, and state-specific billing and modifier requirements, including Medi-Cal.
Compiles and validates data supporting nonduplication between 340B and the Medicare Drug Price Negotiation Program, including identifying claims for selected drugs and supporting reconciliation of maximum fair price (MFP) refunds.
Prepares data sets required under manufacturer contract pharmacy policies and, where the hospital elects to participate, for submission to CMS or manufacturer platforms, subject to review and approval by the Pharmacy 340B Program Coordinator.
Compares invoice pricing to published 340B ceiling prices, identifies suspected overcharges, and prepares documentation supporting credit or refund requests.
Monitors 340B inventory accumulation, replenishment, exclusions, and shortages, and notifies the Pharmacy Buyer and Pharmacy 340B Program Coordinator when alternative products are needed.
Follows established standard operating procedures for the 340B program and contract pharmacies, and recommends revisions when a process does not work as intended.
Maintains working knowledge of wholesaler ordering platforms and GPO/WAC/340B account structures and how purchasing decisions affect program compliance.
Presents analysis clearly in writing and verbally, translating technical findings into information that pharmacy, finance, and compliance staff can act on.
Responds to routine requests regarding 340B data and activity, referring policy interpretation and any external commitment to the Pharmacy 340B Program Coordinator.
Maintains accuracy across multiple recurring deadlines in a changing environment.
Plans and completes recurring reconciliation, reporting, and self-audit tasks on schedule with limited supervision.
Performs self-audit sampling under the direction of the Pharmacy 340B Program Coordinator, covering patient and provider eligibility, child site and contract pharmacy activity, and duplicate discount prevention, and documents findings.
Assembles documentation, samples, and data extracts requested during HRSA audits, manufacturer audits, and internal compliance reviews.
Tracks corrective action items to completion and reports status to the Pharmacy 340B Program Coordinator.
Coordinates with pharmacy, revenue integrity, finance, information technology, and departmental staff to obtain the data required for analysis.
Prepares audit findings, reports, graphs, and charts, and contributes to presentations delivered to work groups and committees.
Prioritizes competing deadlines and escalates conflicts rather than allowing compliance deliverables to lapse.
Works effectively with a variety of personnel with backgrounds varied in education and skill sets.
Maintains organized, retrievable working files so that another staff member can follow and reproduce the analysis.
Contributes to orientation and training of staff on 340B data processes as requested.
Identifies trends and exceptions in 340B data that indicate opportunities for savings, improved capture, or compliance risk, and recommends them to the Pharmacy 340B Program Coordinator for evaluation.
Recommends refinements to reconciliation, mapping, and reporting processes to improve accuracy and reduce manual effort.
Analyzes utilization of the split-billing system and other existing software to identify underused functionality that would strengthen compliance or capture.
Prepares supporting data for evaluation of outpatient points of service that may qualify for the 340B program.
Participates in departmental performance improvement activities.
Prepares and analyzes data.
Contributes 340B data, audit results, and corrective action outcomes to the hospital’s performance improvement program (LD 12.01.01).
Participates in projects, councils, and special initiatives related to 340B, compliance, and medication management as assigned.
Supports implementation of approved process changes and monitors results after implementation to confirm the intended effect.
Maintains working knowledge of 340B program rules and of changes issued by HRSA/OPA, CMS, and Joint Commission that affect the hospital’s 340B operations.
Completes Apexus 340B University within six months of hire and maintains current knowledge as guidance is updated.
Maintains licensure/certification in active status and supplies documentation required for primary source verification of credentials (HR 11.01.03).
Completes competency assessment at orientation and at least once every three years, or more frequently as determined by the organization (HR 11.04.01, EP 1).
Participates in ongoing education and training necessary to maintain or increase competence, including 340B program and data analysis training (HR 11.03.01).
Attends and completes all required health and safety classes, updates, and health screenings/testing (NPG Goal 12).
Seeks out opportunities to learn and apply best practices.
Must be able to demonstrate the knowledge and skills necessary to provide service based on the physical, psycho/social, educational, safety, and related criteria appropriate to the age of the patients served in his/her assigned service area.
Demonstrates awareness of and compliance with regulatory standards; i.e., 340B federal requirements (HRSA Office of Pharmacy Affairs), CMS Conditions of Participation — including Pharmaceutical Services (42 CFR §482.25), Joint Commission Accreditation 360 standards and National Performance Goals (NPGs), Title 22, HIPAA, and other service specific regulations.
Performs all work in a manner consistent with 340B program integrity requirements under section 340B of the Public Health Service Act (42 U.S.C. §256b), including the prohibitions on diversion to ineligible individuals and on duplicate discounts and, as applicable to the hospital’s covered entity type, the group purchasing organization (GPO) prohibition and orphan drug exclusion.
Supports compliance with Joint Commission Medication Management requirements as they apply to 340B purchasing, inventory, and storage records, including management of drugs and biologicals in accordance with federal and state law (MM 11.01.01), the medication formulary (MM 12.01.01), and medication storage, records and disposition (MM 13.01.01).
Handles 340B claims, split-billing, and reporting data consistent with Information Management requirements for privacy, confidentiality, security, and integrity of health information (IM 12.01.01 and IM 12.01.03), and uses only approved standardized terminology, abbreviations, acronyms, symbols, and dose designations (IM 13.01.01).
Maintains auditable 340B records and working files sufficient to demonstrate compliance to HRSA, manufacturers, and the hospital’s compliance function throughout the applicable audit look-back period.
Reports suspected noncompliance promptly through the Pharmacy 340B Program Coordinator or the hospital’s compliance reporting channels, and does not independently resolve or dispose of potential program integrity issues.
Knows and complies with all Hospital safety policies and procedures as identified in the Hospital Safety Manual, Disaster Preparedness Manual and the Employee Safety Handbook, including Physical Environment (PE) requirements.
Completes workplace violence prevention training and reports workplace violence events in accordance with hospital policy (NPG 02.04.01, EP 2), supporting the organization’s workplace and patient safety goal (NPG Goal 11).
Knows and uses the right safety practices and equipment or materials.
Takes immediate action and/or reports to supervisor or other appropriate personnel any potential unsafe condition, practice or hazard.
Immediately reports every work related injury.