340B Billing Compliance Analyst

Kansas Health System; Lenexa (KS); On-site; USD 65,000 - 90,000; Full time

Job summary

The Kansas Health System is seeking a 340B Billing Compliance Analyst at the Southlake Campus to maintain, audit, and optimize the 340B Drug Pricing Program. This role monitors the 340B split billing software, conducts regular audits, and collaborates with the 340B Oversight Committee to improve efficiency and compliance.

Key duties include evaluating patient eligibility, performing scheduled audits, identifying cost-savings opportunities, and providing data-driven recommendations to strengthen

Qualifications

• Bachelor's Degree OR 2+ years of prior experience as a 340B Analyst with 2+ years in a pharmacy retail or hospital setting.

Responsibilities

• Assist the 340B Manager with pharmacy operations.
• Lead projects for 340B program functions.
• Evaluate patient eligibility across mixed-use areas and clinics.
• Audit 340B data and present reconciliation findings.
• Identify cost savings and system improvements for compliance.
• Develop understanding of the 340B program and educate others.

Skills

340B compliance

Audit & monitoring

Financial analysis

Data management

Education

Bachelor's degree

2+ years 340B experience

Tools

340B split-billing software

Job description

Position Title

340B Billing Compliance Analyst

Southlake Campus

Position Summary / Career Interest

The 340B compliance analyst is responsible for maintenance, audit, and optimization of the 340B Drug Pricing Program for the health system. Regular maintenance includes regular monitoring of the 340B split billing software to ensure accuracy. Audits must be completed in accordance to the hospital 340B policy. All activities are to be performed as part of the 340B compliance team with direction from the 340B Oversight Committee.

Responsibilities and Essential Job Functions

Assist the 340B Manager with any 340B Drug Pricing Program pharmacy operations.

• Demonstrates the ability to serve as a project leader for the 340B Drug Pricing Program functions


• Evaluate patient eligibility for qualified and non-qualified patients in mixed-use areas and clinics by reviewing patient medical records, insurance plans, and hospital status.


• Utilizing a data management program, filter out non-eligible transactions, including, but not limited to, drugs used to treat patients during inpatient care, Medicaid patients, drugs provided free by manufacturers, those provided at non-eligible locations, or prescriptions written by non-eligible providers.


• Perform audits on a scheduled basis; may involve presenting and resolving reconciliation issues as they arise during the monitoring and reconciliation process.


• Through financial analysis, strive to recognize the value opportunity of the 340B Drug Pricing Program.


• Assess opportunities for cost savings and system improvements to yield higher compliance.


• Develop a thorough understanding of the 340B Drug Pricing Program.


• Strive to consistently improve the overall efficiency, value, and internal support of the 340B program.


• Collaborate with the 340B Oversight Committee to develop monthly, quarterly, and yearly audit metrics.


• Perform hospital- or other covered entity-specific gross financial analysis and make recommendations to improve program performance.


• Track financial impact over time, identify root causes of adverse trends, and make recommendations to improve the program's financial stability. - similar to \"C\" - Develop a thorough understanding of the split-billing system and the functions to be performed. Educate others involved in the purchasing process to ensure proper operation and compliance.


• Manage any manual or non-automated 340B data within the split billing software. Provide each buyer with information needed to place orders using the appropriate accounts (e.g., WAC, GPO, and 340B) to replenish inventory in the mixed-use inventory setting


• Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.

These statements are intended to describe the essential functions of the job and are not intended to be an exhaustive list of all responsibilities. Skills and duties may vary dependent upon your department or unit. Other duties may be assigned as required.

Required Education and Experience

• Bachelors Degree OR 2 or more years of prior experience as a 340B Analyst (or similar title) with experience reviewing and auditing for 340B compliance AND 2 or more years of prior experience in a pharmacy retail or hospital setting

Required Licensure and Certification

340B Apexus Certified Expert (ACE) - Apexus within 1 Year

Knowledge Requirements

Prior knowledge and experience regarding requirements of the 340B Drug Pricing Program.

Important information for you to know as you apply

The health system is an equal employment opportunity employer. Qualified applicants are considered for employment without regard to race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, ancestry, age, disability, veteran status, genetic information, or any other legally-protected status. See also Diversity, Equity & Inclusion.

The health system provides reasonable accommodations to qualified individuals with disabilities. If you need to request reasonable accommodations for your disability as you navigate the recruitment process, please let our recruiters know by requesting an Accommodation Request form using this link [e-mail].

Employment with the health system is contingent upon, among other things, agreeing to the health-system-dispute-resolution-program.pdf and signing the agreement to the DRP.