Description
POSITION DESCRIPTION: The 340B Program Analyst is responsible for the day-to-day administration, compliance monitoring, and data audit activities of the organization's 340B Drug Pricing Program. This dual-scope role oversees compliance across both in-house clinical dispensing environments and our external contract pharmacy network, including dedicated channels with WellPartner, Walgreens and Accredo. The Analyst serves as the primary data custodian, utilizing the Intergy EHR platform alongside the third-party administrator (TPA) software to perform regular audits, reconcile inventory, prevent duplicate discounts, and ensure ongoing adherence to Health Resources and Services Administration (HRSA) guidelines. Adheres to Corporate Compliance program, by reporting improper or unethical conduct, violation of applicable laws, regulations or program requirements.
DETAILED DUTIES AND RESPONSIBILITIES:
Data Auditing & Compliance Management
- Intergy & WellPartner Audits: Conduct routine audits of 340B claims by cross-referencing patient clinical data from Intergy EHR with encounter records processed via the WellPartner TPA platform.
- Contract Pharmacy Oversight: Monitor, review, and validate qualified 340B prescriptions flowing through external contract pharmacy partners, specifically focusing on specialized Walgreens and Accredo data streams.
- In-House Dispensing Monitoring: Track internal clinical encounters and inventory to verify accurate identification of 340B-eligible treatments dispensed within in-house clinics.
- Compliance Enforcement: Actively identify and flag potential diversion or duplicate discount violations (specifically regarding Medicaid managed care and fee-for-service claims) prior to regular submissions.
Inventory Control & TPA Optimization
- Inventory Reconciliation: Reconcile physical inventory and virtual drug replenishment counters across all internal and contract pharmacy accounts.
- System Maintenance: Maintain, update, and test clinical data filters, provider files, and location maps within WellPartner and Intergy to minimize script capture exceptions and optimization gaps.
- Accumulation Monitoring: Track WAC and 340B accumulation accounts to ensure clean ordering practices and prevent cross-contamination of drug stocks.
Reporting, Audits & Collaboration
- Reporting: Compile, structure, and deliver regular performance metrics and compliance scorecards to the 340B Compliance Administrator and C-Suite.
- Audit Preparation: Aggregate and package verifiable historical data logs to support internal reviews and formal HRSA or manufacturer compliance audits.
- Cross-functional Collaboration: Collaborate with internal IT, clinical teams, and account contacts at WellPartner, Walgreens, and Accredo to resolve technical data disparities or workflow blocks.
Requirements
KNOWLEDGE, SKILLS AND ABILITIES:
- Good interpersonal skills.
- Ability to conduct oneself professionally.
- Strong analytical and problem-solving skills.
- Advanced capabilities in Microsoft Excel (VLOOKUPs, pivot tables, data cleaning formulas) to manage large data extracts from multiple vendors.
- Hands-on experience navigating the Intergy EHR system or similar electronic health record platforms for auditing clinical eligibility.
- Strong attention to detail and ability to identify discrepancies and trends.
- Ability to manage multiple priorities and meet established deadlines.
- Excellent written and verbal communication skills.
- Ability to maintain confidentiality and handle sensitive financial, operational, and compliance information.
- Demonstrate a commitment to ongoing professional development and maintaining current knowledge of 340B regulations, industry best practices, and emerging technologies.
TRAINING AND EXPERIENCE:
- Associate's or Bachelor's degree in Healthcare Administration, Information Technology, Finance, Business, or a closely related field preferred.
- Current Pharmacy Technician Certification (CPhT) or equivalent clinical/administrative licensure is highly advantageous.
- Minimum of 1-2 years of direct experience analyzing or handling 340B program data, hospital pharmacy purchasing, or healthcare data compliance operations.