340B Account Specialist (Finance)
Overview
The 340B Account Specialist is responsible for managing the compliance and optimization of the 340B program for the assigned client. This involves completing routine audits of prescriptions, tracking findings and communicating with the covered entity as needed to improve compliance and savings. This position will also coordinate with internal departments for account reporting, data issues and resolution, and coordinate the facilitation between the internal data systems and the controlled entities' identified resources.
Responsibilities
To perform this job successfully, an individual must be able to perform the following satisfactory. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Essential Duties and Responsibilities:
• Perform analysis of 340B program elements to understand areas for potential improvement;
• Participate in Account Reports with Covered Entity to accurately represent audit findings and suggest improvements;
• Follow industry trends and makes recommendations as applicable to the Covered Entity 340B Program;
• Address areas of deficiency in the entity's 340B Policy and Procedures by working with entity to draft revisions and obtaining approval from the entity's appropriate committees (P&T, Med Exec, etc);
• Utilize financial metrics to assess areas of improvement.
• 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.
• Monitor and audit state Medicaid claims to ensure compliance to prevent potential duplicate
• discount rebates.
• 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.
• Perform audits on a scheduled basis; may involve presenting and resolving reconciliation issues
• as they arise during the monitoring and reconciliation process.
• Communicate audit deficiencies and improvement opportunities internally, to the client, and to 340B processor;
• Track documentation required to improve 340B qualifying criteria through provider referrals;
• Identify deficiencies in processing of 340B qualifications, and work with client and 340B processor to resolve;
• Prepare 340B contract pharmacy service agreements for review and submission;
• Serve as the primary point of contact internally and externally for 340B contract pharmacy implementation; and
• Develop systems and processes to limit program liabilities and provide proper audits to identify risk and prevent duplicate discounts and diversion
• Continue to build knowledge of the health care and pharmacy services industry, and use
• that knowledge to identify ways and make recommendations to improve the 340B Program.
• Other duties as assigned.
Qualifications
Competencies: Analytical - Synthesizes complex or diverse information; uses intuition and experience to complement data.
Problem Solving - Identifies and resolves problems in a timely manner; gathers and
analyzes information skillfully; develops alternative solutions; works well in group problem solving situations.
Job Knowledge - Competent in required job skills and knowledge; exhibits ability to learn and apply new skills; displays understanding of how job relates to others; uses resources effectively. Expands professional development through related trainings. Develops knowledge and maintains awareness of current regulations, trends, and issues pertaining to the 340B program.
Communication - Expresses ideas and thoughts verbally and in written form; exhibits good listening and comprehension; keeps others adequately informed; selects and uses appropriate communication methods.
Dependability - Responds to requests for assistance; follows instructions, responds to management direction; commits to doing the best job possible; meets attendance and punctuality expectations.
Professionalism - Approaches others in a tactful manner; reacts well under pressure; treats others with respect and consideration regardless of their status or position; accepts responsibility for own actions; follows through on commitments; looks for ways to improve and promote quality; exudes professionalism consistent with company standards, in dress, personal appearance, and grooming; displays courtesy and sensitivity; maintains confidentiality
Quality - Demonstrates accuracy and thoroughness; displays commitment to excellence; looks for ways to improve and promote quality; applies feedback to improve performance; monitors own work to ensure quality.
Ethics - Treats people with respect; works with integrity and ethically; upholds organizational values, policies, and procedures; manages financial resources in prudent manner, compliant with all applicable regulations.
Safety and Security - Observes safety and security procedures; reports potentially unsafe conditions.
Attendance/Punctuality - Consistently at work and on time.
Qualifications: Education/Experience - Associate's degree (AA) or equivalent from two-year college or technical school; or six months to one-year related experience and/or training; or equivalent combination of education and experience required. Pharmacy experience, medical billing, or financial auditing preferred.
Language Ability - Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization.
Mathematical Ability - Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent, and to draw and interpret bar graphs.
Reasoning Ability - Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
Computer Skills - Proficient personal computer skills including electronic mail, record keeping, routine database activity, word processing, spreadsheet, graphics, etc.
Why Should You Choose VytlOne
VytlOne offers a culture that promotes teamwork and where employees are valued as the Company's best asset. We work hard, but we make sure to have fun along the way, too. Competitive hourly pay, plus a great benefits package are available including:
- $850 individual, annual medical deductible
- $25 office visit copays;
- Low biweekly premiums;
- Company paid basic life/AD&D, Short and Long-term disability insurance;
- Rx, dental, vision, short-term disability, and FSA
- Employer-matched 401k Plan
- Industry Leading PTO Plan
- Pharmacy Technician Career Laddering Program
- And more!
To Apply: please go online at https://careers-maxor.icims.com/
VytlOne is an EOE, including disability/vets
