340B Specialist

Job Description:

 The MISSION of SpendMend Pharmacy, is to focus on 340B compliance and optimization, so that hospitals and clinics can focus on their patients and to help covered entities improve their 340B program by sharing our experiences and expertise. 

This position requires knowledge of 340B Program compliance, and the use and management of 340B software systems, and spreadsheet work in general.

The 340B Specialist will: Be expected to conduct oneself in a professional manner representing SpendMend Pharmacy directives utilizing best practice standards as set forth by Apexus and HRSA. 340B Specialist will trouble shoot issues that may arise and report any potential problems to SpendMend’s leadership. 340B Specialist is expected to work independently within the first 3 months.

340B Drug Program Monthly Audits: 

• Perform remote monthly audits independently.
• Apply appropriate risk-stratification criteria to prioritize monthly administered drug and retail sample audits.
• Audit patient records to determine if prescription written is from an eligible clinic or hospital location, by a covered entity provider, and the prescription is related to the care received at the covered entity and documented in the EHR.
• Monitor ordering/purchasing processes, and analyze invoices, shipping, and inventory processes related to 340B drugs. 
• Provide other monthly related 340B tasks as outlined in client’s statement of work (e.g., updating provider lists, monitoring Walgreen’s self-disclosure report, reviewing Medicaid Carve-out or carve-in compliance, conducting clean-site audits, reviewing high and negative accumulation).
• Clearly and concisely communicate the results of the audit to the client site, including a written audit summary which demonstrates the professionalism and expertise of the SpendMend team.
• Complete audit summary report by the end of the month.
• Provide education to pharmacy staff and/or other 340B compliance staff as needed. 
• Participate in corrective action planning with clients post audit as needed.

340B Referral Capture:

• Conduct monthly review of non-qualified prescriptions to determine potential referral capture opportunities.
• Assess EHR documentation to identify eligible prescriptions under the client's policy and procedure.
• Document referral capture notes needed for qualification. 
• Identify opportunities and implement a coordination of care referral note where needed. 
• Update client policy and procedures with referral capture language. 
• Work with TPAs to move non-qualified prescriptions to 340B qualified. 
• Provide monthly report to covered entity summarizing qualified 340B prescriptions and increased 340B savings. 

SpendMend Pharmacy Compliance Participation, Monitoring, And Development:

• Participate in development of company.
• Participate in weekly team meetings.
• Maintain an up to date calendar.
• Understand OPAIS and resources available on the HRSA website.
• Review the 340B Health general discussion group weekly.
• Review the NACHC Manual and any updates
• Maintain knowledge of changing rules and regulations.
• Participate in policy and procedure development.
• Participate in development of tools, standards, documentation, and other communications.
• Expand professional development through related classes and seminars, current publications, and regional/national association membership participation.
• Monitor state Medicaid processes.

Evaluation And Process Improvement:

• Annual performance reviews will be conducted along with goal setting.
• Provide recommendations on process improvements.

340B Compliance Training Requirements:

• Begin 340B Advanced Certificate Program within first 3 months of hire and complete within 9 months of hire.
• Participate in quarterly staff education.

Desired Education And Experience Requirements:

• 2 years’ experience in 340B related operations.
• Pharmaceutical purchasing/inventory experience.
• Previous experience as a compliance analyst, auditor, or similar 340B role. 
• Proficiency with at least one split billing vendor/platform.
• Possess in-depth understanding of contract pharmacy operations.
• Knowledge of the healthcare environment, electronic health records, and 340B program in general.
• Knowledge of state and federal laws and regulations related to 340B and associated billing practices
• Experience presenting to management staff and C-suite leadership.

Interpersonal Skills:

• Excellent verbal and written communication skills
• Customer focused with strong personable, social, and communication skills
• Able to identify and resolve issues
• Flexible and able to collaborate within a group and with clients
• Proficient in Microsoft office, includes MS Word, Excel, and PowerPoint
• Self-directed and ability to work independently
• Accuracy, timeliness, and attention to detail

Job Location: 

• Remote office
• Occasional travel may be requested such as to annual company events, 340B Coalition Conferences etc.