Pharmacy Compliance Auditor 340B Program

Trihealth•Norwood, OH

About The Position

Join our team as a Pharmacy Compliance Auditor - 340B Program and play a vital role in ensuring access to affordable medications for underserved communities. In this position, you will help safeguard the integrity of the 340B Drug Pricing Program—a federal initiative that enables healthcare organizations to stretch resources and provide comprehensive care to more patients. As a Pharmacy Compliance Auditor, you'll work closely with pharmacy leadership to conduct audits, monitor compliance, and identify opportunities for improvement. This role offers the chance to develop specialized expertise in 340B operations, gain advanced certifications, and make a meaningful impact on patient care and organizational success. If you are detail-oriented, passionate about compliance, and eager to grow in a critical area of pharmacy operations, we'd love to hear from you! The Pharmacy Compliance Auditor works under the supervision of the Sr. Director of Pharmacy and guidance of the 340B Pharmacy Compliance Coordinator to audit and monitor the 340B Program. Functions will include, but not limited to execution and documentation of daily, weekly, monthly, and quarterly audits to verify adherence with the 340B Program regulations and/or guidelines and as outlined in 340B policies and procedures. The 340B Drug Pricing Program is a US Federal program that requires drug manufacturers to provide outpatient drugs to eligible health care organizations and covered entities at significantly reduced prices. The intent of the program is to allow covered entities to stretch scarce federal resources as far as possible, reaching more eligible patients and providing more comprehensive services.

Requirements

Minimum of High School Degree or GED is required
Must successfully complete: - Apexus 340B University, within the first 6 months in the position. - Advanced 340B Operations Certificate, within the first 12 months in the position
Minimum of 2-3 years of experience in one or more of the following: - Hospital Pharmacy Technician. - Pharmacy purchasing. - 340B Program operations.
Healthcare system knowledge base/skills
Proficiency in Microsoft Office software, specifically Excel, Word, and Outlook
Ability to quickly learn technical systems such as EMR systems, retail pharmacy systems, and/or 340B software systems
Ability to work in a complex team environment and to collaborate with peers to complete required work
Strong interest in pharmacy practice advancement
Excellent verbal and written communication skills; communication style that is open and fosters trust, credibility and understanding.

Responsibilities

Accurately and efficiently performs 340B audits on a scheduled basis, including contract pharmacy, mixed use pharmacy, and outpatient pharmacy, and ensures compliance to the 340B Program. Addresses any reconciliations that arise.
Monitors and audits state Medicaid claims. Uses Excel, to filter out non-eligible transactions.
Evaluates patient eligibility for qualified and non-qualified patients in mixed-use areas and clinics.
Maintains and audits the Prescriber file provided by Medical Staffing Office.
Assists with external audits, as assigned.
Maintains easily retrievable copies of audits and reports for compliance and audit purposes.
Review's findings, issues, and steps taken to reconcile the issue with the Pharmacy Compliance Coordinator.
Ensures that reporting meets organizational, regional, national, state, and federal requirements/guidelines.
Routinely monitors industry publications and websites, and that organization has latest updates and information. Signs up for 340b webinars.
Audits Contract Pharmacy matches and analyzes the causes of incorrect accumulations and reverses incorrect matches. Identifies and accumulates eligible matches from suspects. Maintains auditable records of purchases sent to Contract Pharmacies and payments made to the Covered Entity.
Audits Outpatient Pharmacy matches and analyzes the causes of incorrect accumulations and reverses incorrect matches. Audits whether correct pricing plan was applied to Medicaid/Managed Medicaid. Audits the sub-clarification code 20 application to all FFS and MCO Medicaid claims, as well as verifying that the 08 code was applied. Identifies and accumulates eligible matches from suspects.
Responsible for loan-borrow tracking. Maintains auditable records and facilitates inventory reconciliations.
Compiles purchasing information, such a list of TriHealth purchasing accounts. Provides the Pharmacy Buyers with information needed to place orders using the appropriate accounts to replenish inventory in the mixed-use inventory setting.
Verifies data integrity within 340B software and wholesaler/vendor purchase reports to after corrections and rebills are made and approves the order review in the queue. Provides root cause analysis and corrections of NDCs. Identifies and submits Individual wastes.