Job Objective :
Under the direction of the Assistant Director and Director of Pharmacy, in close collaboration with the leadership and staff of the Pharmacy Department, with some latitude for independent judgment and action, serves as the expert on 340B program details, policies, and procedures.
Duties and Responsibilities:
- Policy and Procedure Development
1. Ensures policies and procedures are developed, implemented, and maintained on 340B purchasing processes
2. Develop systems and processes to limit program liabilities and provide proper audits to identify risk and prevent duplicate discounts and diversion.
3. Review 340B Program policies and procedures on an ongoing basis and offer contributions and changes to ensure 340B compliance.
B.
Education
1. Develop proper 340B quality assurance training for employees as appropriate.
2. Provide proactive and ongoing education to staff on policies and procedures related to inventory management and 340B procedures.
3. Assist in precepting pharmacy students, residents, and others in training.
4. Expand professional development through related classes and seminars, current publications, and regional/national association membership participation.
5. Regularly communicates with all staff involved with the 340B Program to be sure that processes remain efficient and to address any problems or suggestions for improvement.
C.
Audits
1. Be involved in all 340B Program audits.
2. Perform audits on a daily basis; may involve presenting and resolving reconciliation issues as they arise during the monitoring and reconciliation process.
3. Perform 100% claims eligibility monitoring for contract pharmacies.
4. Perform monthly self-audits of 340B pharmacy operations.
5. Ensure compliance with 340B Program requirements for qualified patients, drugs, and locations.
6. Monitor and audit state Medicaid claims to ensure compliance to prevent potential duplicate discount rebates.
7. Using Excel or a comparable data management program, filter out non-eligible transactions, including, but not limited to, drugs used to treat patients during inpatient care, drugs provided free by manufacturers, those provided at non-eligible locations, or prescriptions written by non-eligible providers.
8. Evaluate patient eligibility for qualified and non-qualified patients in mixed-use areas and clinics by reviewing patient medical records, insurance plans, and, if applicable, hospital status.
9. Ensure that facilities maintain adherence to 340B Program regulations and guidelines.
10. Develop and foster working relationships with internal working counterparts (IT, internal audit, results, accounting, and others) to facilitate productive exchanges of information to improve program efficiency and promote program compliance. Provide data, information, and reports as needed for other business units within the organization
- Program Enhancement/Optimization
1. Develop a thorough understanding of the 340B Program and improve the overall efficiency, value, and internal support of the 340B Program.
2. Assess opportunities for cost savings and system improvements to yield higher compliance.
3. Continue to build knowledge of the health care and pharmacy services industry; use that knowledge to identify ways, and make recommendations, to improve the 340B Program.
4. Evaluate and implement cost savings opportunities.
5. Assist all customers to clarify requirements and propose sourcing options; evaluate and recommend the best sourcing solution.
1. Develop reports that can be used to educate staff and assist management in tracking the overall financial impact to the organization. Build other reports, as appropriate, to monitor and improve 340B Program compliance and performance.
2. Maintain copies of reports for compliance and audit purposes.
3. Use provided tools to monitor prescription data, patient data, hospital data, payer data, site of care, and, if required, ICD-10 codes. Summarize and report results to the appropriate individuals.
4. Monitor, report, and analyze contract pharmacy 340B activities; provide financial reports to hospitals or other covered entities relative to financial impact and liabilities; make recommendations that would improve efficiency.
5. Track financial impact over time, identify root causes of adverse trends, and make recommendations to improve the program’s financial stability.
6. Review and refine monthly 340B cost savings reports detailing purchasing and replacement practices, as well as dispensing patterns
1. Develop a thorough understanding of the split-billing/third party administrator systems and the functions to be performed.
2. Educate others involved in the purchasing process to ensure proper operation and compliance.
3. Provide each buyer with information needed to place orders using the appropriate accounts (e.g., WAC, GPO, and 340B and non-340B) to replenish inventory in the mixed-use inventory setting.
Non-Essential Duties:
· Other duties as assigned.
Knowledge, Skills and Abilities:
Knowledge
· Knowledge of pharmacy systems
· Thorough knowledge of and can apply all state and federal laws and regulations related to the practice of pharmacy.
· Demonstrate knowledge and proficiency regarding special needs and behaviors of age or ethnic specific groups.
Skills
· Must possess excellent written and verbal communication skills.
· Demonstrates strong analytical skills in gathering information from users, defining work problems and designing a system of procedures to resolve problems.
Abilities
· Able to effectively train and educate staff both in Pharmacy and other departments.
· Ability to adhere with AVMC Policies and Procedures and demonstrate knowledge and understanding of corporate compliance rules and regulations.
· Ability to adhere to safety rules and regulations and maintain the confidentiality of patient, hospital, and department information.
· Ability to conform to AVMC Standards of Excellence and supports the values and mission statement established by the AVMC Board of Directors.
· Ability to conform with and support hospital quality assurance and improvement guidelines
· Demonstrated ability to collaborate with other health care professionals.
· Ability to work independently and demonstrate effective decision making skills.
· Ability to perform all the duties of a Pharmacy Technician III.
Education and Experience:
Education
· High School diploma or equivalent is required.
· Associate of Arts or Bachelor Degree in related field is preferred.
· 340B University Certification preferred.
Experience
· Minimum 5 years acute care pharmacy practice as a pharmacy technician.
· Must have experience at a senior pharmacy technician level.
Required Licensure and/or Certifications:
· Must have a current State of California Pharmacy Technician License
Physical Requirements and Working Conditions:
· Works primarily in an office environment.
· Requires ability to stand, sit or walk around department and facility most of the day.
· Some bending, lifting less than 20 lbs and reaching above the shoulder.
· Typing, answering phones and working around automated equipment.
· Potential for exposure to dangerous or toxic medications.
· May need PPE depending on environment working in or task being performed.
A detailed description of the physical requirements of this job is maintained in the Employee Health Department .