Audit associate Jobs in Kent, WA

Job Description : JOB DESCRIPTION

The position description is a guide to the critical duties and essential functions of the job, not an all-inclusive list of responsibilities, qualifications, physical demands, and work environment conditions. Position descriptions are reviewed and revised to meet the changing needs of the organization.

TITLE : Pharmacy 340B Compliance and Audit Specialist

JOB OVERVIEW : The Pharmacy 340B Compliance and Audit Specialist supports the accuracy, compliance, and operational effectiveness of the organization's 340B program. This role is responsible for conducting detailed reviews of 340B claims for eligibility, maintaining program integrity, and assisting with 340B operations within the pharmacy department at Valley Medical Center.

DEPARTMENT : Pharmacy Services

WORK HOURS : Typically, Monday - Friday; Hours may vary based on department needs.

REPORTS TO : Supervisor Pharmacy 340B Program

PREREQUISITES :

High school diploma or equivalency (GED) required. Associates degree in business, healthcare, or related field preferred.

Must hold a Pharmacy Technician credential in the State of Washington and be in good standing as of hire date.

Minimum 2 years of pharmacy practice experience required.

Experience with pharmacy operations in a health care / hospital environment and 340B program, preferred.

QUALIFICATIONS :

Professional and effective verbal and written communication skills.

Demonstrated ability to multitask, set priorities, and work accurately and independently, as well as functioning as part of a coordinated team.

Ability to perform duties with a high attention to detail and accuracy.

Ability to communicate with all levels of internal and external customers including but not limited to clinical personnel, support and technical staff, external customers, third-party administrators, and regulatory agencies.

Ability to learn all compliance, regulatory, quality assurance and control aspects of the 340B program.

General knowledge of pharmacy operations including purchasing and inventory processes.

Knowledge of basic medical terminology and data management.

Ability to maintain confidentiality; with full and complete access to patient medical records, quality assurance and risk management data and information, maintaining the utmost integrity to safeguard patients and the organization.

Advanced computer skills with MS Office applications including Excel and Outlook.

UNIQUE PHYSICAL / MENTAL DEMANDS, ENVIRONMENT AND WORKING CONDITIONS :

Ability to work at a computer for an extended period of time. Requires the ability to work in an environment of constant interruptions. Ability for limited travel out-of-state for conferences, training, and meetings related to the 340B program. Ability to work irregular hours for regulatory and compliance audits, program goals, and deadlines. Ability to lift and move items weighing up to 70 pounds repeatedly using proper tools and safe work practices, including lifting boxes from a table or counter onto a dolly or cart and transporting them as needed.

PERFORMANCE RESPONSIBILITIES :

A. Generic Job Functions : See Generic Job Description for Administrative Partner.

B. Essential Responsibilities and Competencies :

Maintain a current working knowledge of the rules and regulations that govern the 340B program, and the organization's 340B policy and procedures.

Prepares quality assurance audit reports for review by the 340B Oversight Committee.

Perform other quality assurance audits and prepare reports with recommendations for improvement as described in performance responsibilities.

Assists with 340B drug receiving and shipping in the inpatient pharmacy on a weekly schedule.

Maintain a general working knowledge regarding the Drug Supply Chain Security Act (DSCSA).

Maintain a general understanding of Medicare's Maximum Fair Price (MFP) program, and the Health Resources and Services Administration's (HRSA) 340B rebate pilot program.

Assists with team efforts in developing solutions to difficult or complex situations identified to ensure that goals and objectives are met.

Responsible for maintaining competency with pharmacy regulatory requirements and departmental policies and procedures.

Evaluate qualified and non-qualified claim identification by reviewing patient medical records, prescription records, and other 340B eligibility criteria.

Evaluate 340B inventory replenishment for each pharmacy to confirm that accumulation, reduction, and reconciliation are occurring as expected.

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

Performs other quality assurance / compliance audits and prepare reports and recommendations for any operational changes as assigned.

Assist with external compliance assessments with outside firms, where appropriate, to validate internal processes.

Assists with pharmacy charge work queues to validate accuracy of patient charges which impacts 340B.

Work with the Pharmacy Willow IT team to ensure the electronic medical record charging is accurately reflecting the medications being purchased and dispensed for purposes of 340B compliance.

Manages and tracks 340B drug inventory, including proper replenishment.

Routinely monitors utilization records and 340B purchasing accounts to ensure that software or tools are working properly.

Reviews and monitors wholesale purchasing statements to ensure accuracy and assists accounts payable with resolving any discrepancies or concerns.

Monitors and audits 340B rebates and Medicare refunds through multiple third-party platforms and prepare reports for pharmacy leadership and finance related to rebate / refund monitoring.

Other duties as assigned.

Created : 11 / 19

Revised : 11 / 25

Grade : NC-07

FLSA : NE

CC : 7176

Job Qualifications : PREREQUISITES :

High school diploma or equivalency (GED) required. Associates degree in business, healthcare, or related field preferred.

Must hold a Pharmacy Technician credential in the State of Washington and be in good standing as of hire date.

Minimum 2 years of pharmacy practice experience required.

Experience with pharmacy operations in a health care / hospital environment and 340B program, preferred.

QUALIFICATIONS :

Professional and effective verbal and written communication skills.

Demonstrated ability to multitask, set priorities, and work accurately and independently, as well as functioning as part of a coordinated team.

Ability to perform duties with a high attention to detail and accuracy.

Ability to communicate with all levels of internal and external customers including but not limited to clinical personnel, support and technical staff, external customers, third-party administrators, and regulatory agencies.

Ability to learn all compliance, regulatory, quality assurance and control aspects of the 340B program.

General knowledge of pharmacy operations including purchasing and inventory processes.

Knowledge of basic medical terminology and data management.

Ability to maintain confidentiality; with full and complete access to patient medical records, quality assurance and risk management data and information, maintaining the utmost integrity to safeguard patients and the organization.

Advanced computer skills with MS Office applications including Excel and Outlook.