JOB SUMMARY:
MAHEC is seeking to fill a full time and benefitted 340B Program Auditor who is responsible for auditing MAHEC’s 340B Pharmacy Program. This position is responsible for ensuring compliance with state and federal requirements of a 340B program. This role will train in person and remote/hybrid work environment may be available after the initial training period. The ideal candidate will be regionally located.
SPECIFIC RESPONSIBILITIES:
All required audits / reports for the 340B Pharmacy Program are completed monthly per HRSA guidelines.
Review 340B Program policies and procedures on an ongoing basis and offer contributions and changes to ensure 340B compliance.
Develop a thorough understanding of the split-billing / third party administrator systems and the functions to be performed.
Audit prescription data, patient data, hospital data, payer data, site of care, and, if required, ICD-10 codes. Summarize and report results to the Compliance Officer and the Director of the 340B Program.
Audit the purchasing process to ensure proper operation and compliance.
Audit invoices, shipping, and inventory processes.
Perform monthly audits of contract pharmacies.
Perform monthly audits of 340B pharmacy operations.
Audit for compliance with 340B Program requirements for qualified patients, drugs, and locations.
Audit state Medicaid claims to ensure compliance to prevent potential duplicate discount rebates.
Using Excel or a comparable data management program, filter out non-eligible transactions, including, but not limited to, drugs used to treat patients during inpatient care, Medicaid patients, drugs provided free by manufacturers, those provided at non-eligible locations, or prescriptions written by non-eligible providers.
Audit data regarding 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.
Audit to ensure that MAHEC Pharmacies maintain adherence to 340B Program regulations and guidelines.
Compile reports, as appropriate, to monitor and improve 340B Program compliance.
Maintain copies of reports for compliance and auditing purposes.
This role description is a general description of the essential job functions. It is not intended to describe all the duties the 340B Program Auditor may perform.
KEY COMPETENCIES:
Communication Skills
Effectively and respectably communicate with other individuals, whether it be a colleague, patient, or patient’s family member and appropriately enumerate information in a manner easily understood by all parties. We do this to foster a culture of understanding between all parties, especially in complex and difficult situations, to ultimately provide the best care possible to our patients and their families.
Decision Making
Ability to make the most appropriate decision in a given situation and then taking the next steps to ensure appropriate and timely completion. This requires conflict resolution skills, critical thinking skills, confidence in your ability to make the right decision in most situations. This also includes ability to prioritize your workday appropriately to ensure the most important tasks are completed on time.
HealthCare Knowledge
Having the drive to keep yourself abreast and up to date on the new breakthroughs in your area of expertise and communicating them to the rest of the team, as appropriate. This also includes keeping up with your licensure and yearly training requirements within your area expertise along with MAHEC’s organizational training. Finally, the ability to apply the depth of knowledge maintained and gained through this process in real life scenarios as appropriate.
Interpersonal Skills
Showing the ability to meet difficult situations with grace, professionalism, and understanding. Within your area of expertise, showing respect and showing empathy where appropriate with your colleagues, patients, and their family at all times, even when its most difficult to do so. This is done, in part, by effective listening, being your authentic self, showing responsibility and dependability, and being patient with others.
Organizational Values
Adherence to MAHEC’s founding principles and incorporating them every day. This includes, among others, having integrity and accountability, reverence for other cultures and equitable practices, ability to manage change, and displaying a clear understanding of organizational dynamics. Doing these things creates a culture where people want to do the best for each other and gives personal ownership towards the goal of helping people in their time of need.
Problem Solving
Having an analytical mind and ability to work autonomously to solve complex problems that may arise. The wherewithal to think logically through a difficult problem and come to an appropriate resolution for a given issue. This helps to drive continuous improvement by thinking through where we can improve in a novel way. Measures success by understanding where we are currently and where we want to go and then applying those new ideas to affect positive change.
SPECIFIED SKILLS
COMPUTER
Must have advanced computer skills including Microsoft Office Suite.
FOREIGN LANGUAGE
Spanish speaking skills preferred.
PHYSICAL DEMANDS
Light - Moderate energy level: Lift and carry 25 - 35 lbs, Push/Pull 50 - 100 lbs (empty bed, stretcher, etc.)
Physical Activity: Occasional (0 - 33% of Workday)
SUPERVISORY RESPONSIBILITIES:
Not Applicable.
EDUCATION AND EXPERIENCE
MINIMUM QUALIFICATIONS:
Associate’s Degree in healthcare or equivalent work experience and/or a minimum of three (3) years of auditing experience.
PREFERRED QUALIFICATIONS:
340B Pharmacy Program experience and/or Federally Qualified Healthcare Organization (FQHC) experience strongly preferred.
Allscripts PM/EMR Pro software experience preferred.
DESIRED LICENSES/ CERTIFICATIONS:
Certified Pharmacy Tech (CPhT).
Registered Health Information Technician (RHIT).
Certified Professional Medical Auditor (CPMA).
SCHEDULE:
COMPENSATION:
At MAHEC, we strive to equip all team members with Total Rewards (pay + benefits) to honor their service, support their health, manage their financial security, build their career, and thrive.
MAHEC is a qualifying employer for the Public Service Loan Forgiveness (PSLF) Program. Employees who meet federal requirements may be eligible to have remaining student loan balances forgiven after 10 years of qualifying payments while working full-time at MAHEC.
If you are interested in this role, and you have related experience and qualifications, we encourage you to apply or reach out to [email protected] for support in your job search process. You could be the talent we are seeking for this or other opportunities
All MAHEC employees and learners will be required to receive the Flu vaccine or have an approved exemption.
MAHEC does not provide employment-based US visa sponsorship, now or in the future. All new employees must provide valid, original I-9 documents on their first day of work.
MAHEC Talent Management is located at 121 Hendersonville Road, Asheville, NC 28803. Equal Opportunity Employer.
Job details are sourced from the employer's original posting.
Open job postingAbout the company
MAHEC Community pharmacies provide pharmacy services. Responsibilities may include providing direct patient care services related to medication access and clinical coordination.