340B Program Compliance Monitoring & Audit Specialist
Fairview Health Services
- Minneapolis, MN
- Permanent
- Full-time
Responsibilities Job Description
- Serve as a covered entity compliance expert on 340B Program details, policies, and procedures to assist with development and implementation of a comprehensive audit program sufficient to ensure compliance with 340B guidance and regulations.
- Define, conduct and document targeted and random risk assessment activities to identify, prioritize, evaluate, and resolve areas of risk.
- Able to manage mid-level to complex compliance projects, ensuring remediation of findings.
- Review and interpret risk assessment results to address and implement proper controls. Assist in promoting and monitoring compliance to FPS policies and procedures related to 340B. Understand and articulate the financial impact of risk resolutions or opportunities identified when auditing.
- Provide ongoing reporting of key metrics to ensure that stakeholders are aware of program compliance and associated risks.
- Leverage data mining skills to evaluate all sources of necessary data and exception reporting to monitor, identify, investigate, and mitigate compliance risks and opportunities.
- Provide impact analysis related to new and proposed 340B guidance and/or rule changes, including, but not limited to, HRSA/OPA rules and Medicaid changes. Attends regular 340B trainings and shares lessons and hot topics with staff.
- Use technical skills and tools to create reports that identify and summarize monitoring and audit findings such as policy or process gaps, legal or regulatory deficiencies or other deviation in target areas to articulate and/or quantify concern and risk.
- Escalate concerns and make recommendations to pharmacy leadership for monitoring and audit discrepancy response and resolution as well as corrective actions when necessary. Make recommendations on training procedures for 340B.
- Work with pharmacy leadership and operations partners to drive compliance and awareness around diversion and GPO prohibition prevention as well as other elements of the 340B Program.
- Develop and maintain internal and external relationships, acting as a team player with strong negotiating skills to tactfully resolve problems.
- Works daily tasks including billing compliance and 340B tool setup/review.
- Bachelor’s degree in a related field or a minimum of 7 years’ experience in healthcare with a pharmacy and/or audit focus.
- 5+ years’ pharmacy or healthcare experience including experience with healthcare pharmacy software or 3+ years’ experience with auditing/compliance concepts and principals
- 3+ years’ experience in conducting drug audits and investigations, data analysis or modeling including large data sets
- General compliance and monitoring experience
- 10 years’ pharmacy or healthcare experience
- 5 years’ experience with auditing/compliance concepts and principals
- 3+ years of EPIC electronic medical record system, Enterprise Rx, CPR+ and/or MacroHelix
- Expertise with databases and reporting
- Experience with vendor relationships
- Experience with 340B statues, compliance, guidance and policies.
- Retail and/or hospital pharmacy experience
- Current pharmacy technician registration with the MN Board of Pharmacy and Certified Pharmacy Technician
- Certified Healthcare Compliance