Senior Manager, 340B Program Integrity

Bristol Myers Squibb • Washington, DC

6d • Hybrid

About The Position

Challenging. Meaningful. Life-changing. Those aren’t words that are usually associated with a job. But working at Bristol Myers Squibb is anything but usual. Here, uniquely interesting work happens every day, in every department. From optimizing a production line to the latest breakthroughs in cell therapy, this is work that transforms the lives of patients, and the careers of those who do it. You’ll get the chance to grow and thrive through opportunities uncommon in scale and scope, alongside high-achieving teams. Take your career farther than you thought possible. Bristol Myers Squibb recognizes the importance of balance and flexibility in our work environment. We offer a wide variety of competitive benefits, services and programs that provide our employees with the resources to pursue their goals, both at work and in their personal lives. Read more: careers.bms.com/working-with-us. Summary: The Senior Manager, 340B Program Integrity leads enterprise 340B program integrity efforts including validating claims flagged for potential duplicate discounts, identifying diversion activities, and managing Good Faith Inquiries (GFIs) and audits in coordination with vendor partners. This position is responsible for ensuring program integrity efforts are executed in a compliant and timely manner and align with the enterprise 340B strategy.

Requirements

• Bachelor’s degree required; advanced degree or certification in compliance, health administration, or business preferred
• 4–6 years of experience in compliance, audit management, or government pricing, ideally within a pharmaceutical or healthcare environment
• Skilled in managing complex, cross-functional projects within a matrixed organization
• Proven ability to analyze complex data sets and identify trends and insights
• Excellent organizational and communication skills with strong attention to detail and documentation accuracy
• Experience selecting and managing vendors
• Strong knowledge of 340B program requirements, including manufacturer GFI and audit rules and procedures
• Prior experience managing 340B program integrity activities including GFIs and audits within a pharmaceutical manufacturer

Responsibilities

• Review and validate Medicaid claims flagged for potential duplicate discounts
• Analyze chargeback data to identify potential diversion activities
• Lead GFI and audit processes including identification and prioritization of CEs, compiling supporting data, securing necessary internal reviews and approvals, and engaging CEs in collaboration with Legal and external vendors
• Select and manage vendors for GFI support and audits in partnership with the Senior Director, Business Optimization & Analytics Lead
• Ensure all program integrity activities align with HRSA rules and regulations and internal compliance policies and procedures
• Collaborate with the Senior Director,340B Business Optimization & Analytics Lead to provide feedback on analytics and tools used to support duplicate discount and diversion activity identification
• Document and report GFI and audit metrics, outcomes, and trends to the 340B COE leadership team and executives
• Identify and recommend process improvements to strengthen program integrity efforts

Benefits

• Health Coverage: Medical, pharmacy, dental, and vision care.
• Wellbeing Support: Programs such as BMS Well-Being Account, BMS Living Life Better, and Employee Assistance Programs (EAP).
• Financial Well-being and Protection: 401(k) plan, short- and long-term disability, life insurance, accident insurance, supplemental health insurance, business travel protection, personal liability protection, identity theft benefit, legal support, and survivor support.
• Work-life benefits include: Paid Time Off US Exempt Employees: flexible time off (unlimited, with manager approval, 11 paid national holidays (not applicable to employees in Phoenix, AZ, Puerto Rico or Rayzebio employees) Phoenix, AZ, Puerto Rico and Rayzebio Exempt, Non-Exempt, Hourly Employees: 160 hours annual paid vacation for new hires with manager approval, 11 national holidays, and 3 optional holidays Based on eligibility, additional time off for employees may include unlimited paid sick time, up to 2 paid volunteer days per year, summer hours flexibility, leaves of absence for medical, personal, parental, caregiver, bereavement, and military needs and an annual Global Shutdown between Christmas and New Years Day. All global employees full and part-time who are actively employed at and paid directly by BMS at the end of the calendar year are eligible to take advantage of the Global Shutdown.
• Eligibility Disclosure: The summer hours program is for United States (U.S.) office-based employees due to the unique nature of their work. Summer hours are generally not available for field sales and manufacturing operations and may also be limited for the capability centers. Employees in remote-by-design or lab-based roles may be eligible for summer hours, depending on the nature of their work, and should discuss eligibility with their manager. Employees covered under a collective bargaining agreement should consult that document to determine if they are eligible. Contractors, leased workers and other service providers are not eligible to participate in the program.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Number of Employees: 5,001-10,000 employees