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Role Description

Reports to the Manager, 340B Program. Serves as a member of the 340B Team to effectively achieve and optimize 340B program goals in assigned areas, while ensuring that related records are complete, accurate, auditable, and that primary objectives as defined by hospital leadership are met. Responsible for remote services which includes day-to-day compliant medication procurement, billing, auditing, and inventory management to ensure compliance standards are being upheld and that financial returns are being realized. Assists with implementation of and adherence to 340B related policies and procedures. Assists in multiple areas of 340B program participation including mixed use, grantees, and contract pharmacy, as needed. This position is 100% remote.

Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another.

In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include:

• Instill Trust and Value Differences
• Patient and Community Focus and Collaborate

Responsibilities

• Establishes and maintains compliance with Brown University Health’s Flexible Work Arrangement Guidelines and Forms.
• Shares expertise and assists with training, education, and communication to new 340B Team members, hospital pharmacy staff, and external departments regarding updates to 340B policies and procedures.
• Actively utilizes computerized systems, including but not limited to electronic medical records, vendor portals, and specialized equipment and technologies utilized in operations related to the 340B program.
• Collaborates with Manager, 340B Program; Lifespan Pharmacy Information Technology (IT) and Lifespan Information Services (IS), along with external vendors, to report deficiencies.
• Remotely audits pharmacy claims data where 340B participation occurs to ensure compliance with the 340B program statute requisites for patient definition, diversion, and duplicate discounts, as delineated in existing hospital and pharmacy department policies and procedures.
• Maintains auditable records on a common shared drive.
• Inputs audit results into applicable Third-Party Administrators (TPA) portal systems and internal 340B artificial intelligence (AI) dashboards.
• Works in partnership with pharmacy IT and Lifespan IS teams to develop, manage, and maintain AI dashboards related to 340B metrics.
• Reports claims eligibility corrections to 340B TPAs and tracks status on reversal data sheet.
• Monitors subsequent refills are not captured in error and requests corrections as needed.
• Remotely meets with Manager, 340B Program at established intervals to review reversal data sheet(s) in assigned areas for appropriate escalation to wholesalers or manufacturers for resolution.
• Reviews drug accumulations and 340B purchasing records to ensure TPA software systems are correctly reflecting all purchase orders and shipped drug quantities.
• Communicates issues to the applicable TPA for correction.
• Manages purchase reviews and activity relating to active manual accumulators.
• Performs audits and compliance assessments of specific areas and products, on a routine basis as assigned, assuring accurate charging, billing, and revenue collection.
• Monitors monthly activity to verify consistent processes are followed.
• Collaborates with hospital billing and pharmacy finance to review and determine variances in monthly financial reporting as assigned.
• Reviews select system data crosswalks to ensure internal data points are accurate and 340B compliant.
• Works with pharmacy IT and Lifespan IS teams to ensure data extracts are compiled and received by third parties, contract pharmacies, and 340B third party administrators.
• Performs business analysis reviews for potential 340B expansion opportunities as assigned and within assigned areas.
• Helps identify vendors that offer 340B or equivalent pricing and develop strategies to participate.
• Communicates with drug wholesalers and manufacturers to secure 340B drug pricing on various hospital and bill to/ship to purchasing accounts.
• Verifies wholesaler pricing by comparing vendor portal systems against Apexus Prime Vendor pricing lists, and escalates discrepancies as needed for resolution.
• Identifies and communicates compliance risks to Manager, 340B Program, assists with implementation of corrective action plans to address 340B compliance deficiencies, as needed.
• Monitors TPA software operations to ensure alignment with established policies and procedures and applicable contracts.
• Identifies trends and opportunities to improve program design, information system/software functionality, and compliance automation.
• Attends 340B vendor calls, providing updates on program operations for their assigned areas, and, where applicable, serves as the primary point of contact for assigned meetings.
• Attends, and prepares assigned content for, quarterly 340B Steering Committee meetings.
• Effectively and continually maintains open lines of communication with staff and management involved with the 340B program.
• Provides timely and accurate communication, both written and verbal as appropriate, regarding changes and continuous quality improvement activities, including goals and objectives of the 340B program.
• Reports identified compliance deficiencies in a timely manner to facilitate appropriate follow-up and resolution in accordance with established policies and procedures.
• Participates in continuous quality assessment and performance improvement (QAPI) initiatives.
• Performs other duties as required.

Qualifications

• Bachelor of Science or Bachelor of Arts degree in business or health related field or current unrestricted licensure as a Pharmacy Technician in the state where they are residing and nationally recognized pharmacy technician certification (CPhT).
• Excellent interpersonal and presentation skills.
• Ability to provide targeted communication, both verbal and written to internal and external constituents.
• Proficient in the use of computers and a variety of spreadsheet and database applications, including Microsoft Office Word, Excel, and Access as well as presentation software including PowerPoint.
• Knowledge and ability to download, import, and merge information from a variety of sources, platforms, and programs.
• Proven analytical and process redesign skills, including but not limited to problem solving, quantitative reasoning, and workflow processes.
• 2 years 340B Drug Pricing Program experience in healthcare or with a healthcare provider.
• 340B Apexus Certified Expert (ACE) certification preferred.

Requirements

• Extended periods of time spent sitting.
• Requires the visual and manual dexterity to operate a computer.
• Employee will be responsible to establish a secure workspace environment to protect the confidentiality of sensitive information.
• Sensitive information includes confidential information, protected health information (PHI), and protected identifiable information (PII).
• Employee will be responsible for costs associated with setting up, furnishing, and managing their remote employee workspace and for costs of maintaining appropriate internet connectivity to access Lifespan Information Services resources.
• Performs independently within department policies and practices.
• Refers specific complex problems to Manager where clarification of departmental policies and procedures may be required.

Benefits

• Pay Range: $71,136.00-$117,353.60
• Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.

Location

Remote-Rhode Island - N/A Providence, Rhode Island 02901

Work Type

M-F 8:00AM-4:30PM

Work Shift

Day

Daily Hours

8 hours

Driving Required

No