Compliance Analyst - Spartanburg Regional Healthcare System : Job Details

The 340B Compliance Analyst ensures policy and procedures are current and maintained in a constant state of audit readiness for the 340B Program at SMC. The Analyst will help develop, execute, and maintain a robust auditing program that ensures the on-going participating in the Federal 340B Drug Pricing Program both for hospital and retail pharmacy programs.

Minimum Requirements

• Bachelors degree in healthcare, business, accounting, or related field
• Five to seven years of relevant experience may be considered in lieu of the education degree requirement

Experience

• 5-7 years full-time healthcare pharmacy experience required, preferably in a hospital pharmacy setting- will consider retail pharmacy setting
• 340B experience required
• Highly proficient in Microsoft Office with an emphasis in Microsoft Excel
• Leading small groups to facilitate outcomes, communicating outcomes to hospital leadership
• Auditing for compliance, analyzing financial impact of a department/business unit
• Requires application of intermediate to advanced-level analytical and skills to provide data-driven recommendations

License/Registration/Certifications

• Certified Pharmacy Technician
• 340B university required
• 340B ACE certification (must be completed within 1 year of hire date)

Preferred Requirements

Preferred Experience

• EPIC experience preferred

Core Job Responsibilities

• Policy and Procedure Development
• Develops and modifies 340B policies in accordance with state, federal, and system program requirements
• Maintains current operating procedures
• Rules/Guidance Surveillance
• Ensures that the 340B program is continuously compliant with 340B federal regulations.
• Maintains knowledge of the policy changes that affect the 340B program, including, but not limited to HRSA/OPA rules and Medicaid changes.
• Provides expertise on all 340B program legislation and policy changes from HRSA and OPA, informing and collaborating with legal and compliance teams.
• Develops knowledge and maintains awareness of current regulations, trends, and issues pertaining to the 340B program
• Self-Audits
• Develops, executes, and documents self-audits of the 340B process. Coordinates and ensures remediation of findings.
• Conducts and/or coordinates an annual audit of all contract pharmacies. Documents results and follow-up on any findings.
• Evaluates patient eligibility for qualified and non-qualified patients in hospital based mixed-use areas and clinics by reviewing patient medical records, insurance plans, and hospital status.
• Monitors 340B compliance within workflow processes.
• Conducts monthly audits of all 340B eligible locations to verify adherence with the 340B program guidelines and policies.
• External Audits
• Serves as the point person and coordinator for all audits. Coordinates all requests and responses. Maintains a current state of audit readiness.
• Program Enhancement/Optimization
• Provides input and implements business plans in coordination with the organizations pharmacy leadership for organization facilities to help use 340B savings to expand and improve care provided to underserved and vulnerable patient populations; assists facilities prioritize and implement outpatient program development and contract pharmacy agreements related to 340B; and assists the organizations leadership with program development and optimization.
• Reporting
• Participates in the development and implementation of reports generated on the 340B program that outline savings, utilization, exceptions, and discrepancies.
• Develops, audits, and trends contract pharmacy and manufacturer requirements for data submission for all four wholly owned pharmacies.
• Other duties as assigned
• Must be able to view computer monitor for extended period.
• Must be able to withstand many long hours of standing, walking, stooping, bending, and sitting.