340B Billing Compliance Analyst

Position Summary / Career Interest:

The 340B compliance analyst is responsible for maintenance, audit, and optimization of the 340B Drug Pricing Program for the health system. Regular maintenance includes regular monitoring of the 340B split billing software to ensure accuracy. Audits must be completed in accordance to the hospital 340B policy. All activities are to be performed as part of the 340B compliance team with direction from the 340B Oversight Committee.


Responsibilities and Essential Job Functions

• Assist the 340B Manager with any 340B Drug Pricing Program pharmacy operations -
• Demonstrates the ability to serve as a project leader for the 340B Drug Pricing Program functions
• 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.
• Utilizing a 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.
• Perform audits on a scheduled basis; may involve presenting and resolving reconciliation issues as they arise during the monitoring and reconciliation process.
• Through financial analysis, strive to recognize the value opportunity of the 340B Drug Pricing Program.
• Assess opportunities for cost savings and system improvements to yield higher compliance.
• Develop a thorough understanding of the 340B Drug Pricing Program.
• Strive to consistently improve the overall efficiency, value, and internal support of the 340B program.
• Collaborate with the 340B Oversight Committee to develop monthly, quarterly, and yearly audit metrics.
• Perform hospital- or other covered entity-specific gross financial analysis and make recommendations to improve program performance.
• Track financial impact over time, identify root causes of adverse trends, and make recommendations to improve the program’s financial stability. – similar to “C” - Develop a thorough understanding of the split-billing system and the functions to be performed. Educate others involved in the purchasing process to ensure proper operation and compliance.
• Manage any manual or non-automated 340B data within the split billing software. Provide each buyer with information needed to place orders using the appropriate accounts (e.g., WAC, GPO, and 340B) to replenish inventory in the mixed-use inventory setting
• Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.
• These statements are intended to describe the essential functions of the job and are not intended to be an exhaustive list of all responsibilities. Skills and duties may vary dependent upon your department or unit. Other duties may be assigned as required.

Required Education and Experience

• Bachelors Degree in Business, Information Systems or Finance/Accounting.
• 3 or more years of prior experience in a pharmacy retail or hospital setting

Knowledge Requirements

• Prior knowledge and training in the 340B Drug Pricing Program.

We are an equal employment opportunity employer without regard to a person’s race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, ancestry, age (40 or older), disability, veteran status or genetic information.