Description
Job Title: 340B Analyst
Department: 340B Pharmacy
Location: Hybrid (Onsite & Remote), 89 Genesee Street, Rochester, NY 14611, United States of America, Tuesday and Thursdays in office.
Hours Per Week: 40
Schedule: Full-Time, Dayshift, Monday to Friday, (8 am -4:30 pm)
Position Summary:
Provides 340B program regulatory oversight for the all 340B contract pharmacies to include compliance auditing, deficiency identification, and written compliance recommendations for program. Assist the Director of Operations in Maximizing 340B Revenue. Proficiency in data management and Microsoft Office are essential to this role, along with the ability to work independently thru task completion.
Key Responsibilities:
Develops and updates documents, processes, and procedures for daily operations and monthly financial reporting.
Prepares reports regarding the Contract Pharmacy business operations revenue and expenses.
Audits for compliance with OPA/HRSA and other regulatory bodies relating to 340B contracted pharmacies and provider administrated drugs.
Review Pharmacy Benefit Management dashboards to audit data and interact with pharmacies as needed.
Interact with purchasing/pharmacy to obtain 340B pricing on administered drugs in the office and relay this information to RGMG billing department.
Audits contract pricing to ensure accuracy and manages the drug returns process for the retail pharmacies for out of date drugs.
Maintains all files and records such that the information processed and produced reflects the pharmacy information system up to date processes.
Tracks, trends, and reports 340B pharmaceutical sales and purchases data to insure provider/physician and patient eligibility and review ineligibility reports.
Coordinates payment and compliance audits by contracted plans and/or regulatory agencies. Makes recommendations as to whether the third party audit findings are in compliance with reimbursement regulations.
Collaborates with finance, compliance, and other partners to ensure the 340B Program is utilized to its fullest potential; making/recommending necessary changes to the program as needed.
Performs moderately complex statistical, cost, and financial analysis of data.
Through the use of analysis, audit and investigative means, identifies and acts upon reimbursement and revenue opportunities. Ensures revenue optimization through the implementation of charge capture and charge reconciliation tools.
In a collaborative effort, works with medical, clinical and support staff regarding reimbursement issues related to but not limited to; coding, documentation, payer requirements and audit results
Assists in the investigation of charging and/or billing opportunities for existing and future revenue projects while determining reimbursement potential.
Identifies trends and monitors utilization for the purpose of data analysis and projection.
Utilizes all necessary software and applications to investigate, analyze, report, educate as well as develop procedural improvements related to all components of the 340B Program.
Manages projects independently, prepares governmental disclosures and facilitates external audits by regulatory agencies while working with Administration and Management.
Develops reports reflecting audit results and reports findings to Compliance Director, Administration and management.
Demonstrated analytical (critical thinking) skills are essential.
Strong interpersonal communication skills and organizational skills.
Consistently demonstrates ability to respond to changing priorities and situations in a flexible manner in order to meet current needs.
Demonstrated ability to manage and prioritize tasks with attention to detail.
Ability to work in a team environment, use a computer for communication, writing and research.
Proficient with Microsoft Office including Word, Excel, PowerPoint, and Outlook.
Minimum Qualifications:
Bachelor’s degree preferred, preferably in a Science, Technology, Business, Math Degree. Equivalent combination of education and/or experience may substitute when experiences are closely related to the duties of the job.
Retail Pharmacy experience desired.
Required Licensure/Certification Skills:
None
Rochester Regional Health is an Equal Opportunity / Affirmative Action Employer. Minority/Female/Disability/Veteran
EDUCATION:
- BS (Required)
PHYSICAL REQUIREMENTS: Sedentary - Sedentary roles are primarily office-based and require prolonged sitting (67–100% of the workday) with minimal physical effort and lifting limited to under 10 lbs. Fine motor skills are necessary for computer work, writing, and telephone use, supported by clear visual and auditory ability. Cognitive and emotional demands are high due to extended concentration, frequent interruptions, independent decision-making, and information processing. Although physical exposure is low, administrative areas within healthcare environments may occasionally involve contact with infectious agents. Some roles may require flexible hours, TB screening, or a valid driver’s license.
PAY RANGE: $62,400.00 - $67,000.00
The listed base pay range is a good faith representation of current potential base pay for successful applicants. It may be modified in the future. Pay is determined by factors including experience, clinical licensure date, relevant qualifications, specialty, internal equity, location, and contracts.
