Pharmacy 340B Specialist

Brown Medicine•Providence, RI

128d•Hybrid

About The Position

SUMMARY: Reports to the Manager, 340B Program. Serves as a member of the 340B Team to effectively achieve and optimize 340B program goals in assigned areas, while ensuring that related records are complete, accurate, auditable, and that primary objectives as defined by hospital leadership are met.Responsibilities relate to the day-to-day operations of compliant medication procurement, billing, auditing, and inventory management to ensure compliance standards are being upheld. Monitors adherence to 340B related policies and procedures. Assists in multiple areas of 340B program compliance including mixed use, grantees, and contract pharmacy, as needed. Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include: Instill Trust and Value Differences Patient and Community Focus and Collaborate RESPONSIBILITIES: PRINCIPAL DUTIES AND RESPONSIBILITIES: Responsible for knowing and acting in accordance with the principles of the Brown University Health Corporate Compliance Program and Code of Conduct. Actively utilizes computerized systems, including but not limited to electronic medical records, third party vendor portals, and specialized equipment and technologies to monitor activity related to the 340B Program. Audits pharmacy claims data where 340B participation occurs to ensure compliance with 340B program statute requisites for patient definition, diversion, and duplicate discounts as delineated in existing hospital and pharmacy department policies and procedures. Maintains auditable records on a common shared drive.Inputs audit results into applicable Third Party Administrators (TPA) portal systems and internal 340B Artificial Intelligence (AI) dashboards. Reports claims eligibility corrections to 340B TPAs and tracks status in reversal data sheet(s).Monitors subsequent refills are not captured in error and requests corrections as needed. Reviews drug accumulations and 340B purchasing records to ensure TPA software systems are correctly reflecting all purchase orders and shipped drug quantities. Communicates issues to the applicable TPA for correction. Works with members of the 340B Team to identify and communicate compliance risks in their assigned areas to Manager, 340B Program, assists with implementation of corrective action plans to address 340B compliance deficiencies, as needed. Identifies trends and opportunities to improve program design, information system/software functionality, and compliance automation. Attends 340B vendor calls, providing updates on program operations for their assigned areas. Effectively and continually maintains open lines of communication with staff and management involved with the 340B program.Provides timely and accurate communication, both written and verbal as appropriate, regarding changes and continuous quality improvement activities, including goals and objectives of the 340B program. Reports identified compliance deficiencies in a timely manner to facilitate appropriate follow-up and resolution in accordance with established policies and procedures. Participates in continuous quality assessment and performance improvement (QAPI) initiatives. Performs other duties as required.

Requirements

Bachelor of Science or Bachelor of Arts degree in business or health related field or current unrestricted licensure as a Pharmacy Technician in the State of Rhode Island and nationally recognized pharmacy technician certification (CPhT).
Excellent interpersonal and presentation skills.
Ability to provide targeted communication, both verbal and written, to internal and external constituents
Proficient in the use of computers and a variety of spreadsheet and database applications, including Microsoft Office Word, Excel and PowerPoint.
Knowledge and ability to download, import, and merge information from a variety of sources, platforms, and programs.
One year of 340B Drug Pricing Program, pharmacy purchasing, or related experience in healthcare or with a healthcare provider.

Responsibilities

Responsible for knowing and acting in accordance with the principles of the Brown University Health Corporate Compliance Program and Code of Conduct.
Actively utilizes computerized systems, including but not limited to electronic medical records, third party vendor portals, and specialized equipment and technologies to monitor activity related to the 340B Program.
Audits pharmacy claims data where 340B participation occurs to ensure compliance with 340B program statute requisites for patient definition, diversion, and duplicate discounts as delineated in existing hospital and pharmacy department policies and procedures.
Maintains auditable records on a common shared drive.
Inputs audit results into applicable Third Party Administrators (TPA) portal systems and internal 340B Artificial Intelligence (AI) dashboards.
Reports claims eligibility corrections to 340B TPAs and tracks status in reversal data sheet(s).
Monitors subsequent refills are not captured in error and requests corrections as needed.
Reviews drug accumulations and 340B purchasing records to ensure TPA software systems are correctly reflecting all purchase orders and shipped drug quantities.
Communicates issues to the applicable TPA for correction.
Works with members of the 340B Team to identify and communicate compliance risks in their assigned areas to Manager, 340B Program, assists with implementation of corrective action plans to address 340B compliance deficiencies, as needed.
Identifies trends and opportunities to improve program design, information system/software functionality, and compliance automation.
Attends 340B vendor calls, providing updates on program operations for their assigned areas.
Effectively and continually maintains open lines of communication with staff and management involved with the 340B program.
Provides timely and accurate communication, both written and verbal as appropriate, regarding changes and continuous quality improvement activities, including goals and objectives of the 340B program.
Reports identified compliance deficiencies in a timely manner to facilitate appropriate follow-up and resolution in accordance with established policies and procedures.
Participates in continuous quality assessment and performance improvement (QAPI) initiatives.
Performs other duties as required.