340B Specialist

GENERAL SUMMARY:

Responsible for the 340B Program integrity. Responsible for the day to day management, compliance review and operations of the 340B Program. Includes, but is not limited to, regularly performing audits for internal and external pharmacies, performing purchasing and inventory functions, and compiling reports.

PRINCIPAL JOB FUNCTIONS:

1. *Commits to the mission, vision, beliefs and consistently demonstrates our core values.

2. *Ensures that established policies and procedures are followed to maintain a compliant program.

3. *Develops action plans to close identified gaps in collaboration with organizational leadership.

4. *Routinely monitors monthly and annual reports on 340B participation that clearly document utilization, savings, problem areas and exceptions or discrepancies, to be passed on to pharmacy leadership and administration.

5. Acts as the liaison with necessary affiliated departments to ensure 340B Program integrity. Ensures that the 340B pharmacy program is continuously compliant with 340B federal regulations.

6. Develops, executes and documents self-audits of the 340B process.

7. *Reviews and monitors all points of service where 340B participation occurs to ensure policy and procedure compliance, covered entity eligibility and “covered patient” eligibility.

8. *Evaluates patient eligibility for qualified and non-qualified patients in hospital-based mixed-use areas and clinics by reviewing patient medical records, insurance plans and hospital status.

9. Ensures that audits follow current regulatory compliance recommendations and are completed at the facility level.

10. *Monitors and assesses 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.

11. Provides support for any inventory practices for the 340-B program.

12. *Monitors utilization records and 340B purchasing accounts to ensure that software or tools are working properly and accurately, performing audits or compliance assessments internally as needed; coordinates external compliance assessments with outside firms, when appropriate, to validate internal processes.

13. Performs 340B purchasing and utilization audits or compliance assessments internally, as needed.

14. Assesses opportunities for cost savings and system improvements to yield higher compliance.

15. Develops routine reports that are a by-product of the inventory process and software, allowing for concise information to be communicated to the leadership responsible for 340B inventory management.

16. *Manages and tracks 340B drug inventory, including proper replenishment.

17. Oversees 340B regulatory aspects of the inventory purchasing process for outpatient, inpatient and mixed-use areas.

18. Participates in the development and implementation of reports generated on the 340B Program that outline savings, utilization, exceptions, and discrepancies. Ensures that reporting meets organizational, regional, national, state and federal requirements/ guidelines. Maintains records related to job function and contributes to reports.

19. *Ensures appropriate documentation and audit trail across areas of responsibility.

20. Participates with the Prime Vendor and routinely reviews 340B formulary pricing, potential alternatives and possible additional savings as a result of GPO formulary.

21. Maintains system databases to reflect changes in the drug formulary or product specifications.

22. Performs thorough quarterly reviews of the new 340B pricing list to search for and quickly address costly changes.

23. Establishes a routine approach to updating the CDM/crosswalk for new products and product changes to ensure both the accuracy of the utilization report and the efficiency and accuracy of the charge process.

24. Ensures split-billing software integrity and reviews applicable reports for areas of improvement.

25. Periodically performs spot audits or compliance assessments in specific areas and specific products to ensure that the CDM is accurate, charges are coming across accurately, and the utilization numbers are translating accurately into report for 340B reorders.

26. Maintains professional growth and development through seminars, workshops, and professional affiliations to keep abreast of latest trends in field of expertise.

27. Participates in meetings, committees and department projects as assigned.

28. Performs other related projects and duties as assigned.

Essential Job functions are marked with an asterisk “*”. 

REQUIRED KNOWLEDGE, SKILLS AND ABILITIES:

1. Knowledge of medical, nursing and pharmaceutical terminology.

2. Knowledge of data management, statistical analysis and informatics.

3. Knowledge of quality improvement principals and methods.

4. Knowledge of computer hardware equipment and software applications relevant to work functions.

5. Skill in reasoning to solve practical problems and deal with a variety of variables in situations with limited documentation.

6. Ability to accurately perform data entry functions and produce spreadsheets.

7. Ability to communicate effectively both verbal and written.

8. Ability to exercise courtesy and professionalism when receiving calls and visitors to the department and establish effective working relationships with all personnel.

9. Ability to prioritize work demands and work with minimal supervision.

10. Ability to maintain confidentiality relative to sensitive information.

11. Ability to organize and maintain filing systems.

12. Ability to create statistical reports and/or tally logs.

13. Ability to maintain regular and punctual attendance.

EDUCATION AND EXPERIENCE:

High school diploma or equivalency required. Must be at least 18 years of age. Minimum of one (1) year experience in an institutional pharmacy environment (hospital or health care facility with admitted patients), retail pharmacy environment, or hospital required. Experience with 340B program preferred.

OTHER CREDENTIALS / CERTIFICATIONS:

Registration as a Pharmacy Technician in the State of Nebraska required. Pharmacy Technician Certification from a State of Nebraska approved certification agency required. Examples include: ptcb, ExCPT, UNMC (NE-CPhT).

PHYSICAL REQUIREMENTS:

(Physical Requirements are based on federal criteria and assigned by Human Resources upon review of the Principal Job Functions.)

(DOT)—Characterized as light work requiring exertion up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects.