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TriHealth · 5 hours ago

Pharmacy Compliance Auditor – 340B Program

Norwood, OH

Full-time

Onsite

Entry, Mid Level

2+ years exp

TriHealth is a healthcare organization committed to providing affordable medications for underserved communities. The Pharmacy Compliance Auditor – 340B Program will conduct audits and monitor compliance within the 340B Drug Pricing Program, ensuring adherence to regulations and identifying opportunities for improvement.

Health CareService IndustryWellness

Responsibilities

Accurately and efficiently performs 340B audits on a scheduled basis, including contract pharmacy, mixed use pharmacy, and outpatient pharmacy, and ensures compliance to the 340B Program

Addresses any reconciliations that arise

Monitors and audits state Medicaid claims

Uses Excel, to filter out non-eligible transactions

Evaluates patient eligibility for qualified and non-qualified patients in mixed-use areas and clinics

Maintains and audits the Prescriber file provided by Medical Staffing Office

Assists with external audits, as assigned

Maintains easily retrievable copies of audits and reports for compliance and audit purposes

Review’s findings, issues, and steps taken to reconcile the issue with the Pharmacy Compliance Coordinator

Ensures that reporting meets organizational, regional, national, state, and federal requirements/guidelines

Routinely monitors industry publications and websites, and that organization has latest updates and information

Signs up for 340b webinars

Audits Contract Pharmacy matches and analyzes the causes of incorrect accumulations and reverses incorrect matches

Identifies and accumulates eligible matches from suspects

Maintains auditable records of purchases sent to Contract Pharmacies and payments made to the Covered Entity

Audits Outpatient Pharmacy matches and analyzes the causes of incorrect accumulations and reverses incorrect matches

Audits whether correct pricing plan was applied to Medicaid/Managed Medicaid

Audits the sub-clarification code 20 application to all FFS and MCO Medicaid claims, as well as verifying that the 08 code was applied

Identifies and accumulates eligible matches from suspects

Responsible for loan-borrow tracking

Maintains auditable records and facilitates inventory reconciliations

Compiles purchasing information, such a list of TriHealth purchasing accounts

Provides the Pharmacy Buyers with information needed to place orders using the appropriate accounts to replenish inventory in the mixed-use inventory setting

Verifies data integrity within 340B software and wholesaler/vendor purchase reports to after corrections and rebills are made and approves the order review in the queue

Provides root cause analysis and corrections of NDCs

Identifies and submits Individual wastes

Qualification

340B program administrationNational Pharmacy Technician CertificationApexus 340B UniversityTechnical PharmacyHospital PharmacyPharmacy purchasingMicrosoft OfficeEMR systemsRetail pharmacy systemsCommunication skillsTeam collaboration

Required

High School Diploma or GED (required)

Minimum of 2–3 years of experience in one or more of the following areas (required): Technical Pharmacy, Hospital Pharmacy, Pharmacy purchasing, 340B program administration

Ability to successfully complete Apexus 340B University within six (6) months of hire (required)

Ability to successfully earn the 340B Operations Certificate within one (1) year of hire (required)

National Pharmacy Technician Certification (CPhT) is required. Accepted certifications include: Pharmacy Technician Certification Board (PTCB), ExCPT Certification through the National Healthcareer Association (NHA)

Must be currently registered as a Certified Pharmacy Technician with the Ohio Board of Pharmacy (required)