340B Audit and Compliance Analyst – Mixed-Use Pharmacy

🔥 12 hours ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🚔 Compliance

👻 Ghost score 10%

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WVU Medicine

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

WVU Medicine is a comprehensive health system affiliated with West Virginia University, providing medical services through a network of hospitals across West Virginia. The system includes notable facilities such as J. W. Ruby Memorial Hospital, WVU Medicine Children's, and various other regional medical centers. WVU Medicine offers a wide range of healthcare services, including specialized and advanced medical treatments such as robotic heart surgery. It's also involved in medical education, research, and community health initiatives, emphasizing a mission of delivering high-quality care to the communities it serves.

📋 Description

• Assist with coordination of the 340B Drug Pricing Program for qualified entities throughout the WVU Medicine Health System • Review operating and regulatory compliance procedures and controls • Conduct ongoing internal audits, data analysis, and operational reviews • Develop systems and processes to limit program liabilities and prevent duplicate discounts and diversion • Review utilization records and 340B purchasing accounts • Monitor monthly and annual 340B participation reports • Perform monthly compliance audits of contract pharmacies, hospital-owned retail pharmacies, specialty pharmacies, and hospital mixed-use pharmacy • Audit patient, provider, and location eligibility • Monitor purchasing records, utilization, savings, problem areas, and discrepancies • Maintain 340B Program software product mapping, charge codes, and ratios • Maintain, test, and validate 340B Split Billing Software and its communication with pharmacy software • Monitor purchases for contract compliance, 340B compliance, and accurate pricing • Assist covered entities with reporting, data requests, and inquiries • Upload purchase data to 340B Split Billing Software monthly • Perform mapping verification audits • Provide purchasers with information and assistance for 340B ordering • Review product accumulations and ineligible claim data • Complete single-dose vial reporting and waste input • Update charge-code billing units from Epic in split-billing software • Create ad hoc reports for program optimization and compliance • Perform targeted audits, negative audits, referral process development, suspect pending claim reviews, accumulator reviews, and compliance audits

🎯 Requirements

• High School Diploma or Equivalent • Three (3) years of healthcare, finance, or pharmacy experience • Ability to handle and maintain confidential information • Ability to work independently or cooperatively as a team member • Ability to adapt to various workloads and assignments • Analytical and problem-solving skills • Effective verbal and written communication skills • Interpersonal skills necessary to communicate effectively with all levels of management • Ability to interpret and analyze data • Understanding of basic computer programs • Knowledge of MS Office applications including Word, PowerPoint, Excel and Outlook • Must be able to sit for long periods of time • Extended periods of computer and telephone usage • Must be able to move throughout department work areas

🏖️ Benefits

• Full-time position • 40 scheduled weekly hours