340B & Pharm Inv Comp Analyst

At Stamford Health, we believe that every patient deserves compassionate, personalized, person centered care. This commitment guides how we care for patients, support their care partners, and promote the wellbeing of our staff. In alignment with our Planetree philosophy, the individual in this role will foster a respectful, collaborative environment that honors the needs, values, and preferences of every person we serve and the colleagues we partner with.

MAJOR ACCOUNTABILITIES/CRITICAL RESPONSIBILITIES:

Policy and Procedure Development

• Assists in maintaining up-to-date policies and procedures on 340B processes reflect the operational realities and align with federal regulations for 340B.
• Assists in developing systems and processes to limit program liabilities and provide proper audits to identify risks and prevention mechanism(s) for duplicate discounts and diversion.

Education

• Assists in identifying 340B operations areas that needs staff education
• Assists in providing proactive education to staff on policies and procedures related to inventory management and 340B procedures.

Audits

• Be involved in 340B Program audits including routine in-house and contract pharmacy audits and inventory reconciliations.
• Performs internal audits on a regular basis (weekly, monthly, and quarterly) to ensure compliance with 340B Program requirements for qualified patients, drugs, and locations; may involve presenting and resolving reconciliation issues as they arise during the monitoring and reconciliation process.
• Monitors and audits state Medicaid claims to ensure compliance to prevent potential duplicate discount rebates
• Using Excel or a comparable data management program to filter out non-eligible transactions/claims and conduct compliance review of 340B eligibility
• Evaluates patient eligibility for qualified and non-qualified patients in mixed-use areas and clinics by reviewing patient medical records, insurance plans, and, if applicable, hospital status.
• Participates in external 340B audits

Reporting

• Assists in maintaining auditable records and copies of reports for compliance and audit purposes.
• Uses provided tools to monitor prescription data, patient data, hospital data, payer data, site of care and, if required, ICD-10 codes. Summarizes and reports results to the appropriate individuals.
• Assists in monitoring, reporting, and analyzing contract pharmacy 340B activities; provides financial reports to hospitals or other covered entities related to financial impact and liabilities; makes recommendations that would improve efficiency.

Split-Billing, Physical Inventory and Third-Party Administrator Duties

• Develops a thorough understanding of the split-billing/third party administrator systems and the functions to be performed to maintain its integrity
• Assists in maintaining an accurate virtual inventory crosswalk for unknown items, compounded drugs, items without catalog entries and any crosswalk related issues that might arise during routine audits
• Educates others involved in the purchasing processes to ensure proper operation and compliance.
• Assists in monitoring NDCs that should not be purchased at 340B across sites and any related exceptions due to drug supply chain issues
• Assists in coordinating purchasing for dual or multiple split inventories within pharmacies.

Distribution Activities

• Operational support for 340B distribution activities including ordering, shipping, and receiving
• Collaborates with manufacturers, specialty pharmacies, wholesalers, and third-party administrators to support the 340b distribution program

COMPETENCIES AND WORK EXPERIENCE REQUIREMENTS:

• Medium proficiency in and/or openness to learn and regularly use Microsoft Excel (PIVOT TABLES, VLOOKUP, Data Filters, Data Cleansing Techniques, Visual Presentation, etc.)
• Strong ability to communicate clearly in writing and synthetize data for informational use
• Strong ability to communicate verbally to a group of colleagues
• Strong ability to be a self-directed worker who possesses an efficient and organized approach to handling competing priorities while providing timely deliverables

EDUCATION REQUIREMENTS (INCLUDE LICENSE, REGISTRATION, CERTIFICATION):

Pharmacy Technician registration in the State of CT required

Certified Pharmacy Technician credential from PTCB or equivalent required

PHYSICAL EFFORT:

Must be able to regularly move bulk materials including boxes, carts, and pallets. Individual boxes could reach 30 pounds.