Align is looking for a WVU-340B Audit & Compliance Analyst to support the WVU Medicine Health System's participation in the 340B Drug Pricing Program. In this role, you will be responsible for reviewing operational procedures and regulatory controls to ensure compliance with all program requirements and maintain eligibility.
What You'll Do
- Develop systems and processes to limit program liabilities and conduct audits to identify risk and prevent duplicate discounts and diversion.
- Review and monitor utilization records and 340B purchasing accounts to ensure software tools are functioning accurately, performing compliance assessments as needed.
- Monitor monthly and annual reports on 340B Program participation, documenting utilization, savings, problem areas, and exceptions.
- Perform monthly compliance audits of contract pharmacies, hospital-owned retail pharmacies, specialty pharmacies, and hospital mixed-use pharmacies to uphold HRSA regulations.
- Perform monthly compliance audits of patient, provider, and location eligibility.
- Monitor purchasing records for 340B participation, documenting findings to share with pharmacy leadership, Finance, and Administration.
- Maintain 340B Program software to ensure proper product mapping to charge codes and correct ratios, updating for new charge codes.
- Handle daily maintenance, testing, and validation of the 340B Split Billing Software and its communication with pharmacy systems.
- Monitor purchases for contract compliance, 340B compliance, and accurate pricing.
- Assist WVUHS covered entities with reporting, data requests, and other inquiries.
- Upload purchase data to the 340B Split Billing Software monthly for all non-wholesaler purchases.
- Perform monthly audits to verify correct mapping within the split-billing software.
- Provide system purchasers with information and assistance to place orders using appropriate accounts to maximize the 340B benefit.
- Review product accumulation in split-billing software to ensure proper accumulations and identify negative trends.
- Review ineligible claim data to ensure maximum benefit and identify third-party administrator processing issues.
- Manage single dose vial reporting and monthly input of single dose vial waste into split-billing software.
- Update charge code billing unit changes from Epic into the split-billing software for accuracy.
- Create ad hoc reports to support program optimization and compliance.
- Perform targeted audits, negative audits, develop referral processes, and review suspect pending claims to find additional eligibility.
- Complete accumulator reviews and targeted audits to ensure compliance.
What We're Looking For
- High School Diploma or Equivalent.
- Apexus Advanced 340B Operations Certificate.
- Three (3) years of healthcare, finance, or pharmacy experience.
- One (1) year of 340B or finance experience.
Nice to Have
- Associate’s or Bachelor’s degree in Information Technology, Business Management, or Hospital Administration.
- Nationally Certified Pharmacy Technician through the Pharmacy Technician Certification Board.
- 340B Drug Pricing Program experience.
- Experience in data analysis, audit process and reporting.
- Hospital or retail pharmacy experience.
Technical Stack
- MS Office applications including Word, PowerPoint, Excel and Outlook.
- 340B Split Billing Software.
- Epic.
Work Mode
This is a fully remote position.
Align is an equal opportunity employer.
