Pharmacy Compliance Specialist

Virginia Garcia Memorial Health Center•Hillsboro, OR

About The Position

Virginia Garcia Memorial Health Center provides comprehensive primary health care to communities in Washington and Yamhill counties, with an emphasis on migrant and seasonal farm workers and reducing barriers to care. The organization aims to create an environment that welcomes and values the people it employs and serves. The Pharmacy Compliance Specialist supports compliance across Virginia Garcia’s six pharmacies, which serve eligible patients through the 340B drug pricing program and operate under Oregon Board of Pharmacy requirements. Reporting to the Pharmacy Director, the specialist oversees 340B and pharmacy regulatory compliance, contract administration, pharmacy staff credentialing, and insurance payment reconciliation. The role brings work previously handled by outside vendors in-house and cross-trains with the Pharmacy Operations Department Administrator, including providing backup technical support for Epic Willow. The position has access to protected health information to verify 340B patient eligibility, audit pharmacy claims, reconcile insurance payments, and support quality and compliance reviews. Access is subject to HIPAA’s minimum necessary standard. The employee must meet the organization’s immunization requirements and submit to a background check; drug screening may also be required at a supervisor’s request. The role requires travel between clinic locations and a reliable mode of transportation, a valid driver’s license, and personal car insurance. The work environment is well-lighted and ventilated. The employee may be exposed to drug vapor or particles, such as powdered antibiotics being reconstituted, and occasionally to potentially hazardous chemicals. Physical activity may include standing or walking up to 50% of the time, sitting up to 50%, lifting or carrying up to 5% of the time (frequently 5–20 pounds and infrequently 20–40 pounds), and occasional stooping, bending, and reaching.

Requirements

High school diploma or GED.
Pharmacy technician experience at a Federally Qualified Health Center (FQHC).
Strong knowledge of the 340B Program.
Effective written and verbal communication skills.
Working knowledge of, or ability to learn, 340B Program and Oregon Board of Pharmacy requirements.
Ability to apply regulatory compliance guidelines.
Experience with insurance claims, remittances, and payment reconciliation.
Computer skills, including spreadsheets, pivot tables, and data entry.
Ability to analyze data, critically evaluate it, and provide recommendations.
Attention to detail and strong organizational skills, including tracking deadlines, renewals, and documentation.
Strong commitment to working with staff from a wide range of ethnic, economic, cultural, and social backgrounds.
Ability to collaborate with decision-makers, influence strategy, and deliver financial results.
Self-motivation and ability to work independently toward positive results within a team environment.
Willingness to cross-train on Epic Willow support.
Ability to travel between clinic locations; must have a reliable mode of transportation, a valid driver’s license, and personal car insurance.
Must meet the organization’s immunization requirements.
Must submit to a background check; may be required to undergo drug screening at a supervisor’s request.

Nice To Haves

Familiarity with Epic or pharmacy dispensing software.
Bilingual English/Spanish.
Associate degree in business.
340B Apexus Certified Expert (340B ACE).

Responsibilities

Serve as an internal resource on 340B Program requirements, Oregon Board of Pharmacy requirements, and related organizational policies and procedures.
Coordinate with affiliated departments to support 340B Program integrity and pharmacy regulatory compliance.
Support the Pharmacy Director’s oversight of pharmacy compliance and participate in the organization’s 340B oversight committee as directed.
Coordinate with external compliance vendors and consultants, and bring their work in-house as internal capacity is developed.
Provide compliance guidance to pharmacy managers and staff at each site.
Coordinate annual HRSA recertification, maintain accurate HRSA 340B OPAIS records for organizational entities, and ensure timely registration of new associated sites.
Develop, conduct, and document 340B self-audits at owned pharmacies, clinic-administered medication locations, and contract pharmacies; coordinate remediation of findings.
Review 340B-eligible locations for compliance with program policies, covered entity eligibility, and covered-patient eligibility.
Monitor utilization records and 340B purchasing accounts, and work with the 340B third-party administrator to verify reports and software accuracy.
Investigate and resolve 340B billing and eligibility discrepancies, and recommend system checks to prevent recurrence.
Coordinate requests and responses for external audits and maintain audit readiness.
Monitor Oregon Board of Pharmacy laws and rules and communicate relevant changes to pharmacy leadership.
Track pharmacy license and registration renewals and ensure they are completed on time.
Support pharmacy inspection readiness through self-inspections, documentation, and follow-up on corrective actions.
Support the development, review, and maintenance of pharmacy policies and procedures with the Pharmacy Director.
Maintain pharmacy contracts and agreements, tracking terms, fees, renewal dates, and performance obligations.
Support reviews of new contracts and renewals with the Pharmacy Director, Compliance, and Legal, in accordance with organizational contracting policy.
Evaluate contract language, fee structures, and data requirements, and recommend changes to the Pharmacy Director.
Monitor vendor and contract pharmacy performance and compliance with contract terms.
Coordinate credentialing and re-credentialing of pharmacy clinical staff with the Credentialing department and support pharmacy privileging and scope-of-practice processes.
Verify and track pharmacy staff licenses, registrations, and certifications, following up before expiration dates.
Maintain secure, audit-ready credentialing records.
Reconcile pharmacy claims and insurance payments to prescriptions dispensed and identify underpayments, denials, and discrepancies.
Work with billing, finance, and pharmacy managers to resolve payment issues and close process gaps.
Track payer reimbursement trends and report exceptions and recovered amounts to the Pharmacy Director and finance.
Cross-train with the Pharmacy Operations Department Administrator to provide mutual coverage during absences.
Provide backup technical support for Epic Willow when the Administrator is unavailable.
Document procedures to support coverage and continuity of work.
Prepare routine reports for the Pharmacy Director and leadership on audit results, corrective actions, license and credential status, contract status, and reconciliation findings.
Maintain records related to job responsibilities and ensure appropriate documentation and audit trails.
Communicate questions, issues, or discrepancies to the appropriate authority.
Provide pharmacy staff training and communication on 340B and pharmacy compliance requirements.
Develop compliance-related training and competency materials as assigned.
Perform other duties as assigned.