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Company: MedStar Medical Group
Location: Washington, DC
Career Level: Associate
Industries: Not specified

Description

General Summary of Position
This position conducts monitoring, analysis, investigations and special projects on behalf of the MedStar Specialty Pharmacy program, in order to ensure compliance with 340B regulations. Primary responsibility includes positive validation of specialty pharmacy claims for 340B eligibility. Under the oversight from the MedStar Corporate 340B Manager, and in collaboration with the Director of Specialty Pharmacy Services, the analyst assists with development of monitoring protocols and efficient and effective internal controls for the 340B operations of the Pharmacy, and performs audits that meet the government agencies' requirements to self-audit (OPA and HRSA). These functions are to be performed in accordance with all applicable laws and regulations of MedStar Health's philosophy, policies, procedures and standards. This position relies on strong analytical skills, ability to multi-task, problem solve and communicate effectively across various disciplines, levels and segments of the organization.


Primary Duties and Responsibilities

  • Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards, and safety standards. Complies with governmental and accreditation regulations.
  • Ensures compliance with 340B program requirements as well as optimization of the 340B program in the Specialty Pharmacy setting, on behalf of MedStar covered entities. In collaboration with hospital and system 340B resources, performs transactional self-audits and reports results to System 340B Manager. Represents the Specialty Pharmacy and covered entities in 340B related audits and inquiries.
  • Obtains, analyzes, and reports data to identify and evaluate the system of control in the 340B Drug Program. Reports on financial performance to system Director of Specialty Pharmacy and Finance. Monitors GPO spend. Documents analytical findings in accordance with department standards. Identifies opportunities for improvement, analyzes the effect of the weaknesses, researches causes, and formulates recommendations. Identifies opportunities for 340b optimization.
  • Reads regulations/ journals/articles related to compliance and analysis of the Specialty Pharmacy program and financial performance. Participates in conferences and/or webinars pertinent to the 340B Drug Program. Attends education/training events (internal and external).
  • Monitors virtual accumulations for negative accumulations and buy back opportunities, to ensure compliance and optimization on the purchasing side. Works with Pharmacy Techs / Buyer to resolve discrepancies and realize opportunities.
  • Communicates in writing in the form of memos, reports, and emails. Written communication should be clear, concise, using explicit and unambiguous terminology, and convey a professional tone and rational logic at all times. Strong presentation skills: analyst must be able to present their findings and answer questions in a group setting. Tactful and respectful communication is essential and non-verbal communication should be professional and demonstrate respect and tolerance. Provides communication of analytical findings to department or corporate leadership as directed by management.
  • Assists the System 340B Manager in the implementation and management of split-billing software in the Specialty Pharmacy setting.
  • Demonstrates the ability to manage multiple projects often with the same deadlines.
  • Advanced ability in team participation. The analyst is a strong team member and works collaboratively with other team members to make appropriate contributions. Participates on the 340B Steering Committee.
  • Advances MedStar's profile and reputation in the area of 340B. Represents MedStar at relevant external meetings and on relevant external committees, taskforces, and organizations.
  • Assists the Director of Specialty Pharmacy and other members of the Pharmacy team as assigned.
  • Participates in meetings and on committees and represents the department and hospital in community outreach efforts.
  • Participates in multi-disciplinary quality and service improvement teams.
  • Performs other duties as assigned.

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    Minimum Qualifications
    Education

    • Bachelor's degree required

    Experience

    • 3-4 years experience working in hospital or retail pharmacy environments and 2 of those in 340B required.

    Licenses and Certifications

    • CPhT preferred

    Knowledge, Skills, and Abilities

    • Experienced with data analysis and reporting.
    • Knowledge of pharmacy billing and reimbursement, especially including experience with the 340B Drug Discount Program.
    • Understanding of evolving State and Federal regulations; familiarity with the requirements of prominent specialty pharmacy accrediting organizations.
    • Ability to effectively utilize key software programs and applications, such as pharmacy dispensing and clinical therapy management systems, as necessary for operations.
    • Knowledge of general accounting principles.
    • Proficiency with Microsoft applications, data and evidence analysis, financial statement analysis, oral and written communication skills.


    This position has a hiring range of $58,656 - $98,384

     


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