340B Compliance & Audit Specialist

WVU Medicine; United States; Remote; USD 65,000 - 85,000; Full time

Job summary

SYSTEM West Virginia University Health System is seeking a dedicated role to coordinate the 340B Drug Pricing Program across the health system. The position focuses on reviewing compliance procedures, conducting audits, data analysis, and monitoring 340B participation to ensure regulatory adherence and program effectiveness.

The role requires experience in data analysis, audit processes, and hospital or retail pharmacy settings, with preferred IT/business administration education and 340B

Qualifications

• High School Diploma or equivalent.
• Three (3) years of healthcare, finance, or pharmacy experience.
• Associate or Bachelor's degree in Information Technology, Business Management, or Hospital Administration.
• Nationally Certified Pharmacy Technician.
• Apexus Advanced 340B Operations Certificate.
• 340B Drug Pricing Program experience.
• Experience in data analysis, audit process and reporting.
• Hospital or retail pharmacy experience.

Responsibilities

• Develop systems and processes to limit program liabilities and provide proper audits to identify risk and prevent duplicate discounts and diversion.
• Reviews and monitors utilization records and 340B purchasing accounts to ensure software or tools are working properly and accurately, performing audits or compliance assessments to validate processes.
• Monitors monthly and annual reports on 340B Program participation documenting utilization, savings, problems, exceptions.
• Performs monthly compliance audits of contract pharmacies, hospital owned retail pharmacies, specialty pharmacies and hospital mixed use pharmacy to ensure that all 340B HRSA regulations are upheld.
• Performs monthly compliance audits of patient eligibility, provider eligibility, and location eligibility.
• Monitors purchasing records where 340B participation occurs, documenting utilization, savings, problems, and discrepancies for leadership.
• Maintains 340B Program software to ensure products are mapped to correct charge codes and ratios; maintains system when new codes are created.
• Responsible for daily maintenance of the 340B Split Billing Software and testing/validation of its integration with pharmacy software.
• Monitors purchases for contract compliance, 340B compliance, and accurate pricing.
• Assists WVUHS covered entities with reporting and data requests.
• Uploads purchase data to 340B Split Billing Software monthly for purchases outside wholesaler.
• Performs monthly audit to verify mapping in 340B Split Billing Software.
• Provides purchasers with information to place orders using appropriate accounts to maximize 340B benefit.
• Reviews product accumulation in split-billing software to ensure proper accumulations and trends.
• Reviews ineligible claim data to ensure maximum benefit and identify third-party issues.
• Responsible for single dose vial reporting and monthly input of vial waste into software.
• Updates charge code billing units from Epic into the split-billing software for accuracy.
• Creates ad hoc reports to support program optimization and compliance.
• Performs targeted audits and reviews suspect pending claims.

Skills

Analytical skills

Data analysis

Communication skills

MS Office

Problem solving

Confidentiality

Teamwork

Education

High School Diploma

Associate/Bachelor's degree in IT/Business/Hospital Admin

Nationally Certified Pharmacy Technician

Apexus Advanced 340B Operations Certificate

Tools

Epic software

340B Split Billing Software

MS Excel

Job description

SYSTEM West Virginia University Health System is seeking a dedicated role to coordinate the 340B Drug Pricing Program across the health system. The position focuses on reviewing compliance procedures, conducting audits, data analysis, and monitoring 340B participation to ensure regulatory adherence and program effectiveness.

The role requires experience in data analysis, audit processes, and hospital or retail pharmacy settings, with preferred IT/business administration education and 340B