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WVU Medicine · 18 hours ago

WVU-340B Audit & Compliance Analyst - Remote -88472

United States

Full-time

Remote

Mid Level

3+ years exp

WVU Medicine is seeking a 340B Audit & Compliance Analyst to assist with the coordination of the 340B Drug Pricing Program. The role involves reviewing compliance procedures, conducting audits, and ensuring adherence to regulatory requirements to maintain program effectiveness and excellence.

Health CareHospitalMedical

Responsibilities

Develops systems and processes to limit program liabilities and provides proper audits to identify risk and prevent duplicate discounts and diversion

Reviews and monitors utilization records and 340B purchasing accounts to ensure software or tools are working properly and accurately, performing audits or compliance assessments to validate processes

Monitors monthly and annual reports on 340B Program participation which clearly documents utilization, savings, problem areas and exceptions or discrepancies

Performs monthly compliance audits of contract pharmacies, hospital owned retail pharmacies, specialty pharmacies and hospital mixed use pharmacy to ensure that all 340B HRSA regulations are upheld

Performs monthly compliance audits of patient eligibility, provider eligibility, and location eligibility

Monitors purchasing records where 340B participation occurs, clearly documenting utilization, savings, problem areas and exceptions or discrepancies, to be shared with pharmacy leadership, Finance and Administration

Maintains 340B Program software to ensure appropriate products are mapped to the appropriate charge code and in the correct ratio as well as maintain system when new charge codes are created

Responsible for daily maintenance of the 340B Split Billing Software. Responsible for the testing and validation of the 340B Split Billing Software and it’s communication with the pharmacy software

Monitors purchases for contract compliance, 340B compliance, and accurate pricing

Assists WVUHS covered entities with reporting, data requests and other inquiries as necessary

Responsible for uploading purchase data to 340B Split Billing Software on a monthly basis for all purchases made outside of the wholesaler

Performs monthly audit to verify mapping is correct in the 340B Split Billing Software

Provides purchaser(s) throughout the system with information and assistance needed to place orders using the appropriate accounts to maximize the 340B benefit

Reviews product accumulation is split-billing software to ensure proper accumulations and identify negative trends

Reviews ineligible claim data to ensure maximum benefit and identification of third-party administrator claim processing issues

Responsible for single dose vial reporting and monthly input of single dose vial waste into split-billing software

Responsible for updating any changes to charge code billing units from Epic into the split-billing software for accuracy and consistency

Creates ad hoc reports to support program optimization and compliance

Performs targeted audits, negative audits, referral process development and reviews suspect pending claims to find additional eligibility

Completes accumulator reviews and targeted audits to ensure compliance

Qualification

Apexus Advanced 340B Operations Certificate340B Drug Pricing Program experienceData analysisAudit processHealthcare experienceAnalytical skillsMS Office proficiencyEffective communicationProblem-solving skillsTeamwork