Compliance Specialist

Primary Health Care, Inc (PHC)

Des Moines (IA)

On-site

USD 47,000 - 59,000

Full time

4 days ago

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Benefits offered by this job

PTO accrual (4 weeks) + paid holidays

PHC University training opportunities

Emerging Leaders program

Job summary

PHC in Des Moines, IA is seeking a Compliance Specialist to oversee 340B compliance across in-house and contract pharmacies, develop quality assurance training, and support cost-saving initiatives for the PHC network.

You will conduct monthly audits, review contracts, maintain up-to-date policies, and create reports for the Compliance Committee, Pharmacy leadership, and executive leadership to sustain program integrity.

Qualifications

Bachelor’s degree in Health Care Administration, Business Administration, accounting, or related field or equivalent combination.

Responsibilities

Provides expertise to PHC staff related to the 340B Program; develops and maintains a thorough understanding of the 340B Program within the organization and works to improve the overall efficiency, value, and internal support of the 340B Program.
Serves as the compliance expert on 340B, reviewing, monitoring and ensuring that policies and procedures are in compliance with federal requirements.
Maintains up-to-date policies and procedures on 340B purchasing processes.
Recommends and implements changes as needed to ensure 340B compliance.
Conducts monthly audits of all 340B-eligible locations, in-house pharmacy, and contract pharmacies to verify adherence with program guidelines and policies.
Presents and resolves reconciliation issues and ensures program compliance for qualified patients, drugs, and locations.
Assists Compliance & Risk Director and Pharmacy Director in assessing opportunities for cost savings and business improvements in the 340B program and within PHC’s 340B Program.
Monitors drug inventory, utilization records and 340B accounts for proper replenishment.
Reviews and refines monthly 340B cost savings reports detailing purchasing and replacement practices, as well as dispensing patterns.
Provides recommendations as appropriate.
Works with the pharmacy team to ensure that best practices are being followed regarding 340B through monitoring, reporting, and analyzing contract pharmacy and in-house pharmacy 340B activities.
Provide reports to PHC’s Compliance Committee; recommends efficiency improvements.
Develops and maintains reports that can be used to educate staff and assist management in tracking the overall financial impact to the organization.
Builds other reports, as appropriate, to monitor and improve 340B Program compliance and performance.
Collaborates with the Pharmacy, Compliance, and Compliance Committee to develop monthly, quarterly, and yearly audit metrics.
Maintains all 340B contracts.
Assists Compliance & Risk Director in reviewing and negotiating any new 340B contracts; managing relationships, billing services, and compliance with contracted 340B pharmacies; and in evaluating all current and future contract pharmacy opportunities, including contract language, fee structure, data setup, and internal and independent external auditing.
Ensures that all required annual recertifications and quarterly registrations are completed within the allowable time frame.
Assists Compliance & Risk Director with event reporting, patient survey tracking, and other data elements as needed.
Collaborates with Training Manager and others as appropriate to develop effective compliance training, including for new employees as well as ongoing training for all employees.
Assists with risk assessment audits targeting potential vulnerabilities in conjunction with the Corporate Compliance Committee.
Develops/implements corrective action plans as needed in conjunction with the Compliance & Risk Director.
Provides reports regularly to executive leadership, other areas of the organization including the Board of Directors and the Corporate Compliance Committee.
Performs other duties as assigned.

Skills

Health care compliance

Auditing

Contract review

340B Certification

Interpersonal skills

Communication skills

Team orientation

Detail orientation

Microsoft Office

Education

Bachelor’s degree in Health Care Administration, Business Administration, accounting, or related field

340B Certification within first year

Master’s degree (preferred)

Tools

Microsoft Excel

Job description

Are you looking for an opportunity to do amazing work helping others? You've come to the right place. Let's make a difference!

Primary Health Care (PHC) was founded in 1981 by Dr. Bery Engebretsen in Des Moines, IA. Our mission has remained unchanged since that time, to provide healthcare and supportive services to all, regardless of insurance, immigration status, or ability to pay.

Based on the needs of the communities we serve, PHC offers a spectrum of medical and dental services including family practice, behavioral health, HIV care and services, and pharmacy. PHC’s Homeless Support Services is the entry point for serving people experiencing homelessness in Polk County. Enabling services are available to help patients with benefits enrollment, case management, transportation, translation, and patient education. We currently have locations in Ames, Des Moines, & Marshalltown.

As a Compliance Specialist, you will assist with the day-to-day activities of the Corporate Compliance Program. Assists with overseeing 340B-related activities for in-house pharmacy and contract pharmacies. Monitors and maintains the adherence to 340B Program regulations, providing expertise to PHC staff for ongoing compliance. Develops and maintains relationships in multiple areas of PHC along with a wide variety of external contacts as needed. Acts as a liaison with different departments to ensure 340B program integrity. Demonstrates PHC’s iCare Values in daily work.

What's Great About this Position?

Earn 4 weeks of PTO throughout your first year of employment and enjoy paid holidays as well.
Continue to develop your skills and grow your career through PHC’s training opportunities including: PHC University, Emerging Leaders, and medical and dental assistant training programs.

What You Will Do

Provides expertise to PHC staff related to the 340B Program; develops and maintains a thorough understanding of the 340B Program within the organization and works to improve the overall efficiency, value, and internal support of the 340B Program. Responsible for ensuring a 340B quality assurance training program for employees as appropriate.

Serves as the compliance expert on 340B, reviewing, monitoring and ensuring that policies and procedures are in compliance with federal requirements. Maintains up-to-date policies and procedures on 340B purchasing processes. Recommends and implements changes as needed to ensure 340B compliance.

Conducts monthly audits of all 340B-eligible locations, in-house pharmacy, and contract pharmacies to verify adherence with program guidelines and policies. Presents and resolves reconciliation issues and ensures program compliance for qualified patients, drugs, and locations.

Assists Compliance & Risk Director and Pharmacy Director in assessing opportunities for cost savings and business improvements in the 340B program and within PHC’s 340B Program. Monitors drug inventory, utilization records and 340B accounts for proper replenishment. Reviews and refines monthly 340B cost savings reports detailing purchasing and replacement practices, as well as dispensing patterns. Provides recommendations as appropriate.

Works with the pharmacy team to ensure that best practices are being followed regarding 340B through monitoring, reporting, and analyzing contract pharmacy and in-house pharmacy 340B activities. Provide reports to PHC’s Compliance Committee; recommends efficiency improvements. Develops and maintains reports that can be used to educate staff and assist management in tracking the overall financial impact to the organization. Builds other reports, as appropriate, to monitor and improve 340B Program compliance and performance. Collaborates with the Pharmacy, Compliance, and Compliance Committee to develop monthly, quarterly, and yearly audit metrics.

Maintains all 340B contracts. Assists Compliance & Risk Director in reviewing and negotiating any new 340B contracts; managing relationships, billing services, and compliance with contracted 340B pharmacies; and in evaluating all current and future contract pharmacy opportunities, including contract language, fee structure, data setup, and internal and independent external auditing.

Ensures that all required annual recertifications and quarterly registrations are completed within the allowable time frame.

Assists Compliance & Risk Director with event reporting, patient survey tracking, and other data elements as needed.

Collaborates with Training Manager and others as appropriate to develop effective compliance training, including for new employees as well as ongoing training for all employees.

Assists with risk assessment audits targeting potential vulnerabilities in conjunction with the Corporate Compliance Committee. Develops/implements corrective action plans as needed in conjunction with the Compliance & Risk Director.

Provides reports regularly to executive leadership, other areas of the organization including the Board of Directors and the Corporate Compliance Committee.

Performs other duties as assigned.

REQUIRED QUALIFICATIONS AND SKILLS

Bachelor’s degree in Health Care Administration, Business Administration, accounting, or a related field or equivalent combination of education and experience.
A minimum of 2 years’ experience in health care compliance and auditing, 340B or other relevant experience, plus contract review.
Community Health Center experience.
340B Certification to be completed within the first year of employment.
Excellent interpersonal and communication skills in verbal and written form.
Team orientation with ability to work effectively and positively with diverse employees.
Excellent computer skills. Proficiency with Microsoft Office applications.
Good problem solving and decision-making skills with ability to exercise good judgment under pressure.
Ability to deal with a variety of abstract and concrete variables.
Detail orientation with high degree of accuracy.
Organization and time management skills with ability to multi-task and manage priorities.
Licenses/Certifications: 340B Certification to be completed within the first year of employment.

PREFERRED QUALIFICATIONS AND SKILLS

Master’s degree in Health Care Administration, Business Administration, accounting or a related field.
5 years’ relevant experience to include reviewing and managing contracts.
2 years’ experience working with 340B program rules and regulations and HRSA regulations.
340B Certification

We Take Care of Our People

Your experience and skills determine your base pay. The hiring range for this position is typically $47,120 - $58,900 annually. Candidates with extensive work experience related to this position may be considered for additional compensation up to the pay grade maximum of $70,680. PHC also offers a comprehensive benefits package, including: