340B AUDITOR en Meadville Medical Center

JOB SUMMARY

To support the 340B program and the organization in internal and/or manufacturer audits and to maintain compliance with the 340B program. This role requires extensive detailed review of data collection and analysis to detect deficient controls, and to optimize compliance with 340B regulations, policies and procedures. This individual must be a self-starter and capable of planning and performing longitudinal operational, financial, and compliance audits of moderate difficulty and complexity with minimum supervision. They must demonstrate analytical and critical thinking skills, excellent computer and data management skills and knowledge of billing systems. Under the direction of the 340B Coordinator assists in any audits internally for the organization either with Meadville Medical Center or Titusville Area hospital, as well as the contract pharmacies for either. Reports directly to the 340B Coordinator.

JOB DUTIES

Understand and be familiar with current hospital 340B policies and procedures on 340B purchasing processes under the coordination of the 340B coordinator and Compliance Officer.

Expand professional development through related classes, publications or membership participation. Utilize hospital’s third party administrator program to audit eligible versus non-eligible transactions in order to filter out those 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.

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

Assists the 340B Coordinator and 340B Administrator in ensuring compliance with the 340B Program requirements for qualified patients, drugs and locations.

Auditing duties within the hospital’s split billing program and for contract pharmacies under the direction of the 340B Coordinator to prevent duplicate discounts and program diversion.

Use provided tools to monitor prescription data, patient data, hospital data, payer data, site of care and if required ICD-10 codes. Summarize and report results to appropriate individuals.

Monitor report and analyze contract pharmacy 340B activities; make recommendations that would improve efficiency.

Performs other duties as assigned.

 SPECIFIC JOB DEMANDS

Strength: Light Work - Lifting, Carrying, Pushing, Pulling 20 Lbs. occasionally, frequently up to 10 Lbs., or negligible amount constantly.

Can include walking and or standing frequently even though weight is negligible. Can include pushing and or pulling of arm and or leg controls.

Reaching: Frequently - Extending hand(s) or arm(s) in any direction.

Handling: Frequently - Seizing, holding, grasping, turning, or otherwise working with hand or hands. Fingers are involved only to the extent that they are an extension of the hand, such as to turn a switch or shift automobile gears.

Fingering: Frequently - Picking, pinching, or otherwise working primarily with fingers rather than with the whole hand or arm as in handling.

Talking: Frequently - Expressing or exchanging ideas by means of the spoken word to impart oral information to clients or to the public and to convey detailed spoken instructions to other workers accurately, loudly, or quickly.

Hearing: Frequently - Perceiving the nature of sounds by ear.

Near Acuity: Frequently - Clarity of vision at 20 inches or less.

Accommodation: Frequently - Adjustment of lens of eye to bring an object into sharp focus. This factor is required when doing near point work at varying distances from the eye.

Color Vision: Frequently - Ability to identify and distinguish colors.

MINIMUM EDUCATION, KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED

The position requires a high school diploma

Prior pharmacy tech experienced preferred but not required

Possess problem-solving aptitude, the ability to identify and resolve complex issues.

Knowledge and ability to perform basic mathematics is required.

Knowledge of medical terminology, principles of drug distribution and good communication skills will also be required for retention.

On the job training will include familiarization with 340B program.

Familiarity with computers and other medication related software functions or ability to learn is required.

 WORKING CONDITIONS

The working conditions are an office or pharmacy environment both requiring extensive use of computers.

DISCLOSURE

MMC commits to review, under the intent of this standard, and in coordination with medical professional opinion’s and physical demands job analysis performed by certified professionals, an individual’s ability to be reasonably accommodated within the role they are responsible and qualified to perform.

MMC is committed to complying with the Americans with Disabilities Act (“ADA”) and providing equal opportunity employment for qualified persons with disabilities. All employment practices and activities are conducted on a nondiscriminatory basis. Meadville Medical Center will follow any state or local law that provides individuals with disabilities greater protection that the ADA.

Every effort has been made to make your job description as complete as possible. However, this in no way states or implies that these are the only duties you will be required to perform. The omission of specific tasks does not exclude them from the position if the task is similar, related, or is a logical assignment to the position, or is imperative for patient care and to meet emergency situations.