Analyst

St. Mary's Campus - 89 Genesee St

Full time

REQ_242106

Job Title: 340B Analyst Department: 340B PharmacyLocation: Hybrid (Onsite & Remote), 89 Genesee Street, Rochester, NY 14611, United States of America, Tuesday and Thursdays in office. Hours Per Week: 40 Schedule: Full-Time, Dayshift, Monday to Friday, (8 am -4:30 pm)

Position Summary: Provides 340B program regulatory oversight for the all 340B contract pharmacies to include compliance auditing, deficiency identification, and written compliance recommendations for program. Assist the Director of Operations in Maximizing 340B Revenue. Proficiency in data management and Microsoft Office are essential to this role, along with the ability to work independently thru task completion. Key Responsibilities:

• Develops and updates documents, processes, and procedures for daily operations and monthly financial reporting.

• Prepares reports regarding the Contract Pharmacy business operations revenue and expenses.

• Audits for compliance with OPA/HRSA and other regulatory bodies relating to 340B contracted pharmacies and provider administrated drugs.

• Review Pharmacy Benefit Management dashboards to audit data and interact with pharmacies as needed.

• Interact with purchasing/pharmacy to obtain 340B pricing on administered drugs in the office and relay this information to RGMG billing department.

• Audits contract pricing to ensure accuracy and manages the drug returns process for the retail pharmacies for out of date drugs.

• Maintains all files and records such that the information processed and produced reflects the pharmacy information system up to date processes.

• Tracks, trends, and reports 340B pharmaceutical sales and purchases data to insure provider/physician and patient eligibility and review ineligibility reports.

• Coordinates payment and compliance audits by contracted plans and/or regulatory agencies. Makes recommendations as to whether the third party audit findings are in compliance with reimbursement regulations.

• Collaborates with finance, compliance, and other partners to ensure the 340B Program is utilized to its fullest potential; making/recommending necessary changes to the program as needed.

• Performs moderately complex statistical, cost, and financial analysis of data.

• Through the use of analysis, audit and investigative means, identifies and acts upon reimbursement and revenue opportunities. Ensures revenue optimization through the implementation of charge capture and charge reconciliation tools.

• In a collaborative effort, works with medical, clinical and support staff regarding reimbursement issues related to but not limited to; coding, documentation, payer requirements and audit results

• Assists in the investigation of charging and/or billing opportunities for existing and future revenue projects while determining reimbursement potential.

• Identifies trends and monitors utilization for the purpose of data analysis and projection.

• Utilizes all necessary software and applications to investigate, analyze, report, educate as well as develop procedural improvements related to all components of the 340B Program.

• Manages projects independently, prepares governmental disclosures and facilitates external audits by regulatory agencies while working with Administration and Management.

• Develops reports reflecting audit results and reports findings to Compliance Director, Administration and management.

• Demonstrated analytical (critical thinking) skills are essential.

• Strong interpersonal communication skills and organizational skills.

• Consistently demonstrates ability to respond to changing priorities and situations in a flexible manner in order to meet current needs.

• Demonstrated ability to manage and prioritize tasks with attention to detail.

• Ability to work in a team environment, use a computer for communication, writing and research.

• Proficient with Microsoft Office including Word, Excel, PowerPoint, and Outlook.

Minimum Qualifications:

• Bachelor’s degree preferred, preferably in a Science, Technology, Business, Math Degree. Equivalent combination of education and/or experience may substitute when experiences are closely related to the duties of the job.

• Retail Pharmacy experience desired.

Required Licensure/Certification Skills:

• None

Rochester Regional Health is an Equal Opportunity / Affirmative Action Employer. Minority/Female/Disability/Veteran

EDUCATION:

BS (Required)

LICENSES / CERTIFICATIONS:

PHYSICAL REQUIREMENTS:

Sedentary - Sedentary roles are primarily office-based and require prolonged sitting (67–100% of the workday) with minimal physical effort and lifting limited to under 10 lbs. Fine motor skills are necessary for computer work, writing, and telephone use, supported by clear visual and auditory ability. Cognitive and emotional demands are high due to extended concentration, frequent interruptions, independent decision-making, and information processing. Although physical exposure is low, administrative areas within healthcare environments may occasionally involve contact with infectious agents. Some roles may require flexible hours, TB screening, or a valid driver’s license.

For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements.

Any physical requirements reported by a prospective employee and/or employee’s physician or delegate will be considered for accommodations.

PAY RANGE:

$62,400.00 - $67,000.00

CITY:

Rochester

POSTAL CODE:

14611

The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.

Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.

Rochester Regional Health is an integrated health services organization serving the people of Western New York, the Finger Lakes, St. Lawrence County, and beyond. The system includes nine hospitals; primary and specialty practices, rehabilitation centers, ambulatory campuses and immediate care facilities; innovative senior services, facilities and independent housing; a wide range of behavioral health services; and Rochester Regional Health Laboratories and ACM Global Laboratories, a global leader in patient and clinical trials. It’s vision is to lead the evolution of healthcare to enable every member of the communities it serves to enjoy a better, healthier life.