340B Billing Compliance Analyst

The University of Kansas Health System; United States; Presencial; USD 65.000 - 90.000; Jornada completa

Descripción de la vacante

The University of Kansas Health System is seeking a 340B Billing Compliance Analyst at the Southlake Campus to maintain, audit, and optimize the 340B Drug Pricing Program. You will monitor split billing software, perform audits, and drive efficiency with the 340B Oversight Committee.

Responsibilities include evaluating patient eligibility, identifying cost-saving opportunities, and educating purchasers to ensure compliant operations.

Formación

• Bachelor's Degree required or 2+ years of 340B analyst experience.
• Experience auditing 340B compliance and hospital pharmacy operations.
• ACE certification preferred or within 1 year.

Responsabilidades

• Support 340B Manager with operations and lead 340B program projects.
• Audit eligibility, review records, and monitor 340B split billing.
• Perform scheduled audits and present reconciliation findings.
• Analyze financial impact and identify cost-saving opportunities.
• Collaborate with Oversight Committee to develop audit metrics.

Conocimientos

340B compliance

Data analysis

Audit

Collaboration

Educación

Bachelor's degree

340B experience

ACE certification

Herramientas

Split billing software

Descripción del empleo

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.

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.

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About The University of Kansas Health System

As part of the region’s premier academic medical center, The University of Kansas Health System in Kansas City is a world-class healthcare provider and destination for complex care and diagnosis. We are driven by our commitment to service, continuous improvement and to the highest degree of excellence. Collaboration between physicians, nurses, researchers, educators and other professionals who share their expertise leads to exciting discoveries and life-changing treatments for the people we serve.