Enterprise 340B Audit & Compliance Analyst

Job not on LinkedIn

🔥 5 minutes ago

⚔️ Virginia, West Virginia – Remote

⚔️ Virginia – Remote ⛰️ West Virginia – 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 WVU Medicine Health System • Review operating and regulatory compliance procedures and controls • Perform ongoing internal audits, data analysis, and operational reviews • Develop systems and processes to limit program liabilities and identify risks • Review utilization records and 340B purchasing accounts • Monitor monthly and annual 340B participation reports • Perform monthly compliance audits of pharmacies, patient eligibility, provider eligibility, and location eligibility • Monitor purchasing records, contract compliance, 340B compliance, and pricing • Maintain 340B Program and Split Billing Software, including product mapping, charge codes, testing, validation, and purchase-data uploads • Assist covered entities with reporting, data requests, and inquiries • Provide purchasers with information and assistance to maximize 340B benefits • Review product accumulations, ineligible claims, single-dose vial waste, and charge-code billing units • Create ad hoc reports and perform targeted, negative, accumulator, and compliance audits • Share findings and documentation with pharmacy leadership, Finance, and Administration

🎯 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 and interpersonal skills • Ability to interpret and analyze data • Understanding of basic computer programs and knowledge of MS Office applications including Word, PowerPoint, Excel and Outlook • Preferred: Associate’s or Bachelor’s degree in Information Technology, Business Management, or Hospital Administration • Preferred: Nationally Certified Pharmacy Technician • Preferred: Apexus Advanced 340B Operations Certificate • Preferred: 340B Drug Pricing Program experience • Preferred: Experience in data analysis, audit process and reporting • Preferred: Hospital or retail pharmacy experience