| Location | Asheville, North Carolina |
JOB SUMMARY:
MAHEC isseekingto fill a full time andbenefitted340B Program Auditor whois responsible forauditing MAHEC’s 340B Pharmacy Program. This positionis responsible forensuring compliance with state and federal requirements of a 340B program. This role will train inpersonand remote/hybrid work environment may be available after theinitialtraining period. The ideal candidate will be regionallylocated.
SPECIFIC RESPONSIBILITIES:
All required audits/ reports for the 340B Pharmacy Program are completed monthly per HRSA guidelines.
Review340B Programpolicies and procedureson anongoingbasisandoffercontributionsand changestoensure340Bcompliance.
Develop a thorough understanding of the split-billing/third party administrator systems and the functions to be performed.
Audit prescription data, patient data, hospital data, payer data, site of care, and, if, ICD-10 codes. Summarize and report results to the Compliance Officer and the Director of the 340B Program.
Audit the purchasing process to ensure proper operation and compliance.
Audit invoices, shipping, and inventory processes.
Performmonthly auditsofcontract pharmacies.
Performmonthly auditsof340B pharmacyoperations.
Audit forcompliancewith 340B Programrequirementsforqualifiedpatients,drugs,and locations.
AuditstateMedicaid claimstoensure compliancetoprevent potential duplicatediscountrebates.
UsingExcel or acomparable datamanagementprogram,filteroutnon-eligibletransactions,including, butnotlimitedto,drugsusedtotreat patientsduringinpatientcare,Medicaid patients,drugsprovidedfreebymanufacturers,thoseprovided at non-eligible locations,orprescriptionswrittenbynon-eligible providers.
Audit dataregardingpatienteligibilityforqualifiedandnon-qualifiedpatientsinmixed-useareasandclinicsbyreviewingpatientmedicalrecords,insuranceplans,and, if applicable,hospitalstatus.
Audit to ensurethatMAHEC Pharmaciesmaintainadherenceto 340B Programregulationsandguidelines.
Compile reports, as appropriate, to monitor and improve 340B Program compliance.
Maintain copies of reports for compliance and auditing purposes.
This role description is a general description of the essential job functions. It is not intended to describe all the duties the340BProgram Auditormay perform.
KEY COMPETENCIES:
Communication Skills
Effectively and respectably communicate with other individuals, whether it be a colleague, patient, or patient’s family member and appropriatelyenumerateinformation in a manner easily understood by all parties. We do this to foster a culture of understanding between all parties, especially in complex anddifficult situations, toultimately providethe best care possibletoour patients and their families.
Decision Making
Ability to make the mostappropriate decisionin a givensituation and thentakingthe next steps to ensureappropriateandtimelycompletion. This requires conflict resolution skills, critical thinking skills, confidencein your ability to make the right decision in most situations. This also includesabilityto prioritize your workday appropriately to ensure the most important tasks are completed on time.
HealthCare Knowledge
Having the drive to keep yourself abreast and up to date on the new breakthroughs in your area of expertise and communicating them to the rest of the team, as appropriate. This also includes keeping up with your licensure and yearly training requirements within yourareaexpertisealong with MAHEC’sorganizational training. Finally, the ability to apply the depth of knowledgemaintainedand gained through this process in real life scenarios asappropriate.
Interpersonal Skills
Showing the ability to meetdifficult situationswith grace, professionalism, and understanding. Within your area of expertise, showing respect and showing empathy where appropriate with your colleagues, patients, and their family at all times, even whenitsmost difficult to do so. This is done, in part, by effective listening, being your authentic self, showing responsibility and dependability, and being patient with others.
Organizational Values
Adherence to MAHEC’s founding principles and incorporating them every day. This includes, among others, having integrity and accountability, reverence for other cultures andequitablepractices,abilityto manage change, and displaying a clear understanding of organizational dynamics. Doing these things creates a culture where people want to dothebest for each other and gives personal ownership towards the goal of helping people in their time of need.
Problem Solving
Having an analytical mind and ability to work autonomously to solve complex problems that may arise. The wherewithal to think logically through a difficult problem and come toan appropriate resolutionfor a given issue. This helps to drive continuous improvement by thinkingthroughwhere we can improve in a novel way. Measures success byunderstanding where we are currently and where we want to go and then applying thosenew ideasto affect positive change.
SPECIFIED SKILLS
COMPUTER
Must have advanced computer skills including Microsoft Office Suite.
FOREIGN LANGUAGE
Spanish speaking skills preferred.
PHYSICAL DEMANDS
Light- Moderate energy level: Lift and carry 25 - 35lbs, Push/Pull 50 - 100lbs(empty bed, stretcher, etc.)
Physical Activity:Occasional(0-33% of Workday)
SUPERVISORY RESPONSIBILITIES:
Not Applicable.
EDUCATION AND EXPERIENCE
MINIMUM QUALIFICATIONS:
Associate’s Degree in healthcareor equivalent work experience and/or a minimum of three (3) yearsof auditing experience.
PREFERRED QUALIFICATIONS:
340B Pharmacy Program experience and/orFederally Qualified HealthcareOrganization (FQHC) experiencestronglypreferred.
Allscripts PM/EMR Pro software experience preferred.
DESIREDLICENSES/ CERTIFICATIONS:
Certified Pharmacy Tech (CPhT).
Registered Health Information Technician (RHIT).
Certified Professional Medical Auditor (CPMA).
SCHEDULE:
COMPENSATION:
At MAHEC, we strive to equip all team members with Total Rewards (pay + benefits) to honor their service, support their health, manage their financial security, build their career, and thrive.
MAHEC is a qualifying employer for the Public Service Loan Forgiveness (PSLF) Program. Employees who meet federal requirements may be eligible to have remaining student loan balances forgiven after 10 years of qualifying payments while working full-time at MAHEC.
If you are interested in this role, and you have related experience and qualifications, we encourage you to apply or reach out to
AskTalent@mahec.net
for support in your job search process. You could be the talent we are seeking for this or other opportunitiesAll MAHEC employees and learners will be required to receive the Flu vaccine or have an approved exemption.
MAHEC does not provide employment-based US visa sponsorship, now or in the future. All new employees must provide valid, original I-9 documents on their first day of work.
MAHEC Talent Management is located at 121 Hendersonville Road, Asheville, NC 28803. Equal Opportunity Employer.