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Pharmacy Analyst - FT - Days - External Pharmacy - INTEGRIS

Company: INTEGRIS Health
Location: Oklahoma City
Posted on: May 7, 2021

Job Description:

340B Pharmacy Analyst

Job Code: 8657

Position Summary:

Under the direction of the 340B Compliance Director, the 340B Analyst I and II assists with the overall audit development and coordination support for all INTEGRIS 340B covered entities including contract pharmacy. The 340B Analyst key areas of responsibility will include, but not limited to: oversight of 340B drug purchasing, inventory processes, monthly reporting, split-billing software maintenance, audits, contract pharmacy programs, and all areas of regulatory compliance. The roles require extensive detailed review of data collection and analysis to detect deficient controls.

All applicants will receive consideration regardless of membership in any protected status as defined by applicable state or federal law, including protected veteran or disability status. INTEGRIS Health is an Equal Opportunity/Affirmative Action Employer.

Essential Functions:

The 340B Analyst I responsibilities include, but are not limited to, the following:

* Develop a thorough understanding of the 340B Program and improve the overall efficiency, value and internal support of the 340B program

* Develop a thorough understanding of the split billing/third party administrator systems and the functions to be performed.

* Provides regulatory oversight of INTEGRIS Health 340B program through internal audit functions to include compliance auditing, deficiency identification, and written compliance recommendations to address the controls of the 340B drug program.

* Develops, implements, and maintains processes to ensure compliance with State and Federal regulations.

* Develops and maintains internal relationships (billing, IT, legal, etc.) and external relationships (wholesalers, manufacturers, contract pharmacies, split-billing software vendor, etc.) to ensure sound operations of INTEGRIS Health 340B program.

* Works closely with the 340B Compliance Director with audit results and recommends changes to improve 340B integrity and compliance.

* Actively participates in audit preparation and is accountable for audit interactions as a face-to-face member of the facility audit team during actual audits.

340B Mixed-use Functions:

* Ensures mixed-use pharmacies are being monitored with scrutiny for diversion through the routine auditing of medication orders.

* Evaluates patient eligibility for qualified and non-qualified patients in mixed-use areas by reviewing patient medical records, insurance plans, location, provider eligibility, and hospital status.

* Prepares detailed reports on mixed-use audit findings on a routine basis and conveys information regarding audit results to 340B Oversight Compliance team on a regular basis.

* Resolve any reconciliation issues as they arise during the monitoring/auditing process and report to 340B Compliance Director.

* Ensure compliance with 340B Program requirements for qualified patients, drugs, and locations.

* Update the package size/BUPP for covered entities.

* Reviews the split billing software system and performs transaction reviews to ensure that 340B eligible dispensations are accurately reflected in the system.

* Monitors and audits State Medicaid claims for compliance and prevention of duplicate discount rebates.

* Develops, implements, and monitors systems to ensure all computer systems supporting the mixed-use area of the 340B Program are working appropriately.

* Assesses the definitions of an eligible provider specific to the covered entity and reviews physicians, nurse practitioners, residents, physician assistants, and medical residents who write 340B prescriptions.

* Review and recommend changes to the OPAIS database quarterly.

Accountability:

Reports to assigned leader

Required Physical Demands (Subject to Reasonable Accommodation):
Keyboarding/Dexterity: Frequently; activity exists from 1/3 to 2/3 of the time
Standing/Walking: Occasionally; activity exists up to 1/3 of the time
Strength (Lift/Carry/Push/Pull): Sedentary (exerting up to 10 pounds of force occasionally)
Talking (Must be able to effectively communicate verbally): Yes
Seeing: Yes
Hearing: Yes
Color Acuity (Must be able to distinguish and identify colors): Yes

This position may have additional or varied physical demand and/or respiratory fit test requirements. Please consult the Physical Demands Project SharePoint site or contact Risk Management/Employee Health for additional information.

Environmental Conditions:

Normal office environment

Qualifications:

* Bachelors Degree in Accounting, Finance, or related field or 4 years of equivalent experience

* 4 years of accounting or pharmacy experience

* Audit and/or compliance experience preferred

* Previous work experience using various software applications

* Must be able to communicate effectively in English

Keywords: INTEGRIS Health, Oklahoma City , Pharmacy Analyst - FT - Days - External Pharmacy - INTEGRIS, Healthcare , Oklahoma City, Oklahoma

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