Pharmacy Program Audit Specialist

4 days ago

Chicago, Illinois, United States The University of Chicago Medicine Full time
Job Description:

Be a part of a world-class academic healthcare system, UChicago Medicine, as a Pharmacy 340B Program Audit Analyst.

In this role, you will be responsible for conducting audits and supporting third-party audits of the pharmacy 340B program for all qualified entities within the organization, including retail and contract pharmacy relationships.

This is a remote/hybrid position.

Key Responsibilities:
  • Conduct audits to ensure qualifications for the program are met and maintained
  • Audit to ensure that related records are complete and accurate
  • Audit to ensure all primary objectives as defined by leadership are consistently achieved
Primary Objectives:
  • Compliance Audits - Assure all use of 340B throughout the institution (including retail and contract pharmacies) is fully compliant with all federal regulations and related interpretations for the program
  • Maximum Participation Audits - Assure the institution is achieving maximum utilization of 340B pricing through full participation in all qualified areas with all applicable products, including inpatient contracts, to ensure greatest cost savings returns throughout the institution
  • Efficiency of 340B Processes Audits - Assure that all policies, procedures, and related approaches to 340B include the most efficient use of resources
Essential Job Functions:
  • Be a member of an audit team responsible for being an institutional compliance expert or authority on 340B regarding everything from qualifications to the details, policies, and procedures of the virtual inventory processes required for mixed areas
  • Strong emphasis on retail and contract pharmacy transactional and operational compliance (audits) and recommendations
  • Attend 340B conferences, routinely monitor Apexus, 340B Health, OPA, and other industry-related publications and websites as well as the professional media, literature, and peers to assure the institution has the latest information regarding interpretations, rulings, suggestions, and advanced ideas for ensuring audit activities are comprehensive and align with compliance objectives
  • Routinely audit and monitor all points of service (e.g., retail, specialty, emergency department, contract, etc.) where 340B participation occurs to insure policies and procedures are followed, entities qualify, and all patients qualify as covered patients
  • Routinely audits utilization records and 340B purchasing accounts to insure software or tools are working properly and accurately, performing audits or compliance assessments internally as needed; also supports external compliance assessments where appropriate with outside firms to validate internal processes
  • Assists in developing and routinely monitoring monthly and annual audit reports on 340B participation which clearly documents audit findings, problem areas, and exceptions or discrepancies, to be passed to pharmacy leadership and administration for final resolution
  • Provide insight into consistent policies and procedures for 340B that assure productivity and efficiency so that long-term management of the program does not hamper operations and/or create unnecessary costs
  • Support proper implementation that assures full compliance without additional steps, paperwork, or manpower, including the proper use of software or related tools to manage a virtual inventory
Requirements:
  • Bachelor's degree in finance, business, or accounting with exposure or limited experience with 340B program experience including 340B Prime Vendor Certification
  • Minimum three years of experience in business analysis in a healthcare environment
  • Teamwork and strong collaboration skills
Preferred Qualifications:
  • IL tech license preferred
  • Epic experience preferred
Work Environment:

This is a remote/hybrid position with some onsite requirements.

The days of the week that you are scheduled will rotate during the week, Monday-Friday.

We anticipate that you will generally work approximately 40 hours per week.

We anticipate that you will generally be scheduled to work the day shift, from approximately 8:00am-4:30pm, you will be scheduled to be on-call one day a week.

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