Compliance Analyst

Assist the System 340B Manager with daily 340B program operations and compliance activities. Lead and support 340B-related projects as needed, while collaborating with internal and external stakeholders to enhance program efficiency, ensure regulatory compliance, and support ongoing program optimization. Develop and maintain effective working relationships across the organization to promote successful program outcomes and compliance standards.ESSENTIAL DUTIES AND RESPONSIBILITIESPolicy and Procedure DevelopmentMaintain up-to-date policies and procedures on 340B purchasing processes.Develop systems and processes to limit program liabilities and provide proper audits to identify risk and prevent duplicate discounts and diversion.Review 340B Program policies and procedures on an ongoing basis and offer contributions and changes to ensure 340B compliance.EducationDevelop proper 340B quality assurance training for employees as appropriate.Assign staff training based on their role/responsibility.Provide proactive education to staff on policies and procedures related to inventory management and 340B procedures.Expand professional development through related classes and seminars, current publications, and regional/national association membership participation.Self-AuditsBe involved in any and all 340B Program audits.Perform audits on a scheduled basis; may involve presenting and resolving reconciliation issues as they arise during the monitoring and reconciliation process.Perform monthly audits of contract pharmacies.Perform monthly self-audits of 340B pharmacy operations.Ensure compliance with 340B Program requirements for qualified patients, drugs, and locations.Monitor and audit state Medicaid claims to ensure compliance to prevent potential duplicate discount rebates.Using Excel or a comparable data management program, filter out non-eligible transactions, including, but not limited to, drugs used to treat patients during inpatient care, Medicaid patients, drugs provided free by manufacturers, those provided at non-eligible locations, or prescriptions written by non-eligible providers.Evaluate patient eligibility for qualified and non-qualified patients in mixed-use areas and clinics by reviewing patient medical records, insurance plans, and, if applicable, hospital status.Ensure that facilities maintain adherence to 340B Program regulations and guidelines.Develop and foster working relationships with internal working counterparts (IT, internal audit, results, accounting, and others) to facilitate productive exchanges of information to improve program efficiency and promote program compliance. Provide data, information, and reports as needed for other business units within the organization.Program Enhancement/OptimizationDevelop a thorough understanding of the 340B Program and improve the overall efficiency, value, and internal support of the 340B Program.Assess opportunities for cost savings and system improvements to yield higher compliance.Continue to build knowledge of the health care and pharmacy services industry, and use that knowledge to identify ways and make recommendations to improve the 340B Program.Evaluate and implement cost savings opportunities.Assist all customers to clarify requirements, propose sourcing options; evaluate and recommend the best sourcing solution.ReportingDevelop reports that can be used to educate staff and assist management in tracking the overall financial impact to the organization. Build other reports, as appropriate, to monitor and improve 340B Program compliance and performance.Maintain copies of reports for compliance and audit purposes.Collaborate with the Pharmacy, Compliance, and 340B Oversight council to develop monthly, quarterly, and yearly audit metrics.Construct appropriate financial metrics to assess areas of improvement.Develop and update 340B Program reporting packages detailing volume, financial value, and other reporting metrics as needed.Use provided tools to monitor prescription data, patient data, hospital data, payer data, site of care, and, if required, ICD-10 codes. Summarize and report results to the appropriate individuals.Monitor, report, and analyze contract pharmacy 340B activities; provide financial reports to hospitals or other covered entities relative to financial impact and liabilities; make recommendations that would improve efficiency.Perform covered entity-specific gross financial analysis and make recommendations to improve program performance. Track financial impact over time, identify root causes of adverse trends, and make recommendations to improve the program’s financial stability.Review and refine monthly 340B cost savings reports detailing purchasing and replacement practices, as well as dispensing patterns.Purchasing/Inventory DutiesOversee all aspects of the inventory purchasing process for applicable pharmacies.Procure supplies, equipment, services, and merchandise; request price quotes; facilitate purchasing proposals and contract negotiations.Process requisitions and issue purchase orders; expedite deliveries; resolve receiving and invoicing issues or problems.Manage existing contracts and supplier relations.Manage drug selection, procurement, and inventory control.Manage purchasing, receiving, and inventory control processes,Continually monitor product par levels to effectively balance product availability and cost- efficient inventory control,Ensure appropriate safeguards and system integrity.Perform annual inventory and monthly cycle counts.Monitor ordering processes, integrating the most current pricing from wholesalers.Analyze invoices, shipping, and inventory processes.Comply with all track-and-trace legal requirements of the Drug Supply Chain Security Act for purchasing and distribution of drug products.Split-Billing or Third Party Administrator DutiesDevelop a thorough understanding of the split-billing/third party administrator systems and the functions to be performed.Educate others involved in the purchasing process to ensure proper operation and compliance.Provide each buyer with information needed to place orders using the appropriate accounts (e.g. WAC, GPO, and 340B and non-340B) to replenish inventory in the mixed-use inventory setting.Coordinate purchasing for dual or multiple split inventories within pharmacies.EDUCATION AND/OR EXPERIENCEAssociate degree (Bachelor's preferred) in a related field. ;In lieu of a degree, one to two years related experience and/or training; or equivalent combination of education and experienceCERTIFICATION/LICENSURENo certification or licensure requiredPAY RANGE:$58,797.66 - $85,256.61Mercyhealth is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identify, national origin, disability, or protected veteran status.Mercyhealth offers competitive pay and a comprehensive benefits package including:Medical, Dental, VisionLife & Disability InsuranceFSA/HSA OptionsGenerous, accruing paid time offPaid Parental and caregiver leaveCareer advancement and educational opportunitiesTuition and certification reimbursementCertification ReimbursementWell-being ProgramsEmployee DiscountsOn-Demand PayFinancial EducationAnnual recognition/awards eventsPartner appreciation daysFamily entertainment/attractions discountCommunity service/improvement opportunitiesClick here for more details regarding Mercyhealth Careers Benefit Information.At Mercyhealth, we don’t simply hire people, we empower employee-partners who are passionate about making lives better. As an integrated health system, we deliver exceptional, coordinated across seven hospitals, 85 primary and specialty clinics, and a team of over 7,500 professionals serving northern Illinois and southern Wisconsin.Mercyhealth has been nationally recognized for our commitment to our people and culture, including:#1 in the nation on AARP's Best Employers for Workers Over 50One of Working Mother magazine's 100 Best Companies for Working MothersA Top 50 Company and Top 10 Nonprofit for Executive Women #J-18808-Ljbffr