340B Compliance & Data Analytics Specialist

Mercy Health; Cleveland (OH); On-site; USD 70,000 - 110,000; Full time

Benefits offered by this job

Competitive pay

Tuition assistance

Medical, dental, vision coverage

Job summary

Mercy Health seeks a 340B Analyst to ensure program integrity and compliance across the 340B Drug Pricing Program. You will manage program coordination, software interfaces with EMR, and real-time guidance to buyers and staff to maximize savings and compliance.

You will develop internal and external relationships, prepare monthly 340B reports, and drive continuous improvement with Epic, contract pharmacies, and stakeholders while aligning with Mercy Health policies.

Qualifications

• 2 year/Associates Degree: Healthcare Administration/Business, Finance, Information Technology/Analytics, Pharmacy or a related field
• 4 year/Bachelors Degree: Healthcare Administration/Business, Finance, Information Technology/Analytics, Pharmacy or a related field
• Licensure/ Certification Required
• 340B University Certificate (Live/On Demand)
• Licensure/Certification Preferred
• 340B Advanced Operations Certificate
• Minimum Years and Type of Experience
• Minimum of 1-2 years’ experience with pharmacy 340B required
• Minimum of 2 years’ experience in business, analytics, or auditing preferred
• Proficiently trained in Microsoft Office Software, specifically Microsoft Outlook and Excel
• Advanced knowledge of 340B Drug Pricing Program and/or healthcare billing regulations and practices
• Experience in Epic Electronic Health Record
• Auditing hospital charging/patient records
• Experience in 340B Split Billing/Third Party Administrator Software and/or manual 340B operations
• Excellent communication skills with ability to develop cross-departmental professional relationships
• Ability to begin 340B operations in new environment (including program operations design, setup of split billing software or manual tracker, staff education, policy and procedure development)
• Knowledge/training in Microsoft Access
• Experience in drafting Policies and Procedures
• Previous drug purchasing and/or wholesaler experience
• Experience in training employees
• Experience in software implementations

Responsibilities

• Coordinate the 340B Drug Pricing Program and maintain the program’s standards
• Ensure HRSA requirements for program qualifications are met
• Work to continuously improve 340B program performance through program surveillance and identification program optimizations
• Serve as first step in scoping and escalating discovered operational or compliance issues in collaboration with internal audits and the 340B Auditors
• Responsible for immediate communication and escalation of compliance issues or gaps in 340B program operations
• Ensures compliant purchasing of 340B medications and provides real-time guidance to pharmacy buyers and staff on purchasing, inventory management, and other practices which maximize 340B compliance and savings
• Assists covered entity leadership to provide ongoing training, education and communication required for the 340B program at the entity
• Develops internal and external customer service relationships for effective program management
• Creates/maintains monthly reports of 340B program metrics and financial savings
• Analyzes monthly reports, completes monthly variance reporting, and identifies cost savings and system improvements to maximize compliance
• Serve as the split billing software expert to troubleshoot software issues and continually improve software functionality
• Works with appropriate teams to ensure that the 340B software is coordinated and integrated with the clinical information system software
• This shall include the electronic interface between the EMR and the virtual accumulator and any interface between Bon Secours Mercy Health and contract pharmacy providers and/or administrators
• Ensures integrity of split billing software and reviews applicable software reports to identify areas of improvement
• Ensure covered entity is successfully utilizing the split billing software to place orders in a compliant manner which demonstrates cost savings for the ministry
• Triage live-site issues within the split billing software, electronic medical record, or charge master as it relates to 340B
• Collaborate with Epic charge team and charge master managers on a corrective action plan and participate in the implementation of any necessary changes
• Coordinate covered entity issue resolution process with split billing software vendor
• Ensure appropriate split billing software configurations are in place and continually update software to ensure alignment with revenue cycle/charging practices, Epic build, and Mercy Health policies
• Serves as primary internal liaison to ensure appropriate utilization of the 340B program and compliance with all program requirements
• Escalates any identified compliance issues to covered entity stakeholders and the 340B Manager
• Develops action plans to mitigate and/or remove any potential or identified compliance concerns and works to implement approved programmatic changes
• Participate in sub-committees of the 340B Executive Oversight Committee to develop and update policies and procedures for the 340B program
• Provides education to covered entity pharmacy team and works to ensure pharmacy operations are in alignment with the 340B policies and procedures
• Works with affiliated departments to ensure 340B program integrity
• Provides ongoing compliance coaching to 340B staff and participants
• Participates in system 340B committees and with covered entity leadership to develop a comprehensive internal audit plan
• Conduct regular 340B internal audits and data analysis to identify risk and prevent a compliance breach
• Document audit completion/results and communicate results and elevate issues to identified parties
• Continually monitor 340B regulations and legislation, attend ongoing trainings/conferences to help ensure continued compliance with current regulations
• 340B Analyst will work collaboratively with other pharmacy 340B team members and become a subject matter expert in one or more fields

Skills

Microsoft Office

Excel

Outlook

Education

Associate Degree in Healthcare Administration/Business/Finance/IT/Analytics/Pharmacy

Bachelor’s Degree (preferred)

Tools

Epic EHR

Split Billing Software

340B Software

Job description

Mercy Health seeks a 340B Analyst to ensure program integrity and compliance across the 340B Drug Pricing Program. You will manage program coordination, software interfaces with EMR, and real-time guidance to buyers and staff to maximize savings and compliance.

You will develop internal and external relationships, prepare monthly 340B reports, and drive continuous improvement with Epic, contract pharmacies, and stakeholders while aligning with Mercy Health policies.