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Federal Drug Pricing Program Auditor

AndHealth

divh2Pharmacy Compliance Analyst/h2pAndHealth is on a mission to radically improve access and outcomes for the most challenging chronic health conditions, with the goal of making world-class specialty care accessible and affordable to all. We partner with health systems, community health centers and independent specialists to remove barriers to care to ensure all people have access to the care they deserve. We are looking for a Pharmacy Compliance Analyst that will play an important role at AndHealth./ppWhat youll do in the role:/pulliEnsure Regulatory Compliance: Maintain strict compliance with Federal Drug Pricing Program and HRSA requirements, continuously monitor program integrity, and advise internal stakeholders on necessary changes based on the HRSA OPAIS website./liliPrevent Fraud and Waste: Ensure all claims are reviewed and processed with the appropriate inventory to prevent diversion and duplicate discounts./liliConduct Audits and Maintain Records: Perform pharmacy prescription and EHR audits to verify eligibility and collect or track required medical documentation from external providers to maintain complete audit readiness./liliManage Systems and Data: Utilize and troubleshoot EHR and pharmacy operating systems to build compliant patient profiles and accurately track eligibility and utilization./liliDrive Financial Optimization: Track and analyze monthly savings, variance trends, and purchasing patterns, and generate comprehensive reports for leadership visibility, budget forecasting, and audits./liliDevelop Policies and Stay Informed: Create and update program-related policies and procedures and stay current on federal regulations by attending relevant trainings, webinars, and conferences./liliCollaborate with Stakeholders: Establish strong relationships with internal staff and external providers, maintain regular communication to support efficient workflows, and participate in meetings regarding process improvement and quality./liliGeneral Support: Perform other duties as assigned to support the team./li/ulpEducation Licensure Requirements:/pulliRegistered or certified pharmacy technician required./liliHigh School Diploma required./liliAssociates or Bachelors degree preferred./li/ulpOther Skills or Qualifications:/pulliExperience with the federal drug pricing program./liliAbility to proficiently use EHR and pharmacy operating system(s)./liliQuality assurance experience, such as medical chart reviews or auditing, is preferred./liliExceptional organization skills./liliAbility to work independently./liliStrong attention to detail, spelling, and numerical differences./liliProficient with Excel./liliExemplary written and verbal communication skills./liliKnowledge of healthcare terminology./li/ulpHeres what wed like to offer you:/pulliEqual investment and support for our people and patients./liliA fun and ambitious growing environment with a culture that takes on important things, takes risks, and learns quickly./liliThe ability to demonstrate creativity, innovation, and conscientiousness, and find joy in working together./liliA team of highly skilled, incredibly kind, and welcoming employees, every one of whom has something unique to offer./liliWe know that the overall success of our business is a collaborative effort, and we strive to provide ongoing opportunities for our employees to learn and grow, both personally and professionally./liliFull-time employees are eligible to participate in our benefits package which includes Medical, Dental, Vision Insurance, Paid time off, Short- and Long-Term Disability, 401k match and more./li/ulpWe are an equal opportunity and affirmative action employer. We embrace diversity and are committed to creating an inclusive environment for all employees. Applicants will be considered for employment without regard to race, religion, gender, gender identity, sexual orientation, national origin, age, disability, or veteran status./p/div

AndHealth
Vacancy posted 3 days ago
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