POSITION SUMMARY: 

Analyzes and interprets financial data to advise and support Pharmacy strategic decision-making and achieve Pharmacy business objectives, financial optimization, and 340B program compliance, across retail pharmacy, 340B contract pharmacy, and clinical medication dispensaries.  Monitor 340B compliance across all business lines thru the coordination, and completion of Pharmacy internal auditing according to auditing standards and regulatory requirements. Tracks variances between financial projections and actual results to identify and troubleshoot differences and recommend adjustments or improvements.

CORE JOB RESPONSIBILITIES:

Pharmacy Data Analysis

• Performs routine and ad-hoc pharmacy data analysis utilizing data from Mosaic’s electronic medical record, insurance claims, 340B partners and Mosaic’s retail pharmacy to optimize 340B program performance.
• Maintains thorough understanding of data sources, information architecture, and documentation workflows for pharmacy programs.
• Analyzes and interprets financial data to advise and support strategic decision-making and achieve organization pharmacy financial objectives.
• Utilizes tools such as Tableau, Alteryx, SQL, Business Objects, Epic Reporting Workbench, and Excel to answer ad hoc medication, 340B, and retail pharmacy data requests.
• Provides internal stakeholders with actionable pharmacy data, participates in relevant workgroups and project teams supporting data availability and quality and understanding.
• Coordinates with external partners to ensure bi-directional secure, reliable and accurate data file transmission.
• Monitor and maintain data transmission of Electronic Health Record encounter files to contracted third-party agencies.
• Reviews 340B referral prescriptions weekly to determine eligibility for 340B savings.

Pharmacy Reporting and Financial Analysis

• Optimize net revenue and cash flow across all lines as well as conducting 340B referral prescription capture.
• Creates and routinely monitors monthly and annual reports for pharmacy and 340B that clearly document utilization, savings, problem areas, and exceptions or discrepancies, to be passed on to pharmacy leadership and administrati
• Develops routine reports that are a by-product of the inventory process and software, allowing for concise information to be communicated to the leadership responsible for 340B inventory management.
• Ensures that reporting meets organizational, regional, national, state, and federal requirements/guidelines.

Pharmacy Auditing

• Conducts and documents internal audits that follow current regulatory compliance Reports and reviews any audit findings to the Pharmacy Operations Manager. These audits include, but are not limited to: 
  • Internal contract Pharmacy audits
  • Internal monthly audits of all 340B-eligible locations to verify adherence with the 340B Program guidelines
  • Internal patient record audits to assure patient eligibility for 340B medications including clinic eligibility, eligible provider and appropriate EMR documentation
  • Internal 340B purchasing and utilization audits or compliance assessments
  • Quarterly reviews of the new 340B pricing list to search for and quickly address costly change
• Collaborates with the Pharmacy Operations Manager to process data requests and prepare reports for external auditors or regulatory bodies.
• Monitors and reports 340B compliance and risk management activities and findings to Pharmacy Operations Manager. Reviews data to identify trends, incidents, problems, and areas of noncompliance.
• Reviews internal processes, transactions, documentation, and systems to validate compliance, evaluate effectiveness, identify issues, and prepare reports and recommendations for remediation.

Education and Advising

• Serves as internal consultant for identifying potential data sources and developing new performance opportunities for Pharmacy programs.
• Uses data to assist improvement teams in developing change strategies and evaluate improvement efforts for Pharmacy programs.
• Provides access to and interpretation of business intelligence for monitoring Pharmacy performance, compliance and developing business strategy.
• Presents summaries of trends in writing, graphically, and orally.

SUPPORTING JOB RESPONSIBILITIES:

• Participates in relevant committees and work groups.
• Attends meetings and assigned trainings.
• Addresses in a timely manner, correspondence which includes but is not limited to Outlook, EHR encounters, in-basket, etc.
• Utilizes resources to remain informed of organizational communication (i.e. Mosaic Share, organization newsletter, etc.)
• Complies with all policies, procedures, guidelines, and workflows.
• Performs safe work practices to protect the health and safety of employees and patients per OSHA regulation.
• Protects individually identifiable health information per HIPAA regulation.
• Proper and timely documentation in EMR.
• Completes all required compliance training within the established timeline.
• Utilizes the incident reporting system as needed.

COMPETENCIES:

Accountability:  Takes ownership for delivering on commitments; owns mistakes and uses them as opportunities for learning and development; openly discusses his/her actions and their consequences both good and bad; has an ability to identify strengths and developmental opportunities and leverages insight to make adjustments to improve their effectiveness; courage to have the difficult conversation.

Adapting to Change:  Accepts and adapts to change in a professionally appropriate and thoughtful manner.  Is willing to offer a different perspective or approach and yet knows when and how to stand down graciously and accept a well-thought-out decision. Embraces change.

Championing Customer Needs:  Provides timely and professional service to both internal and external customers; is responsive to customer needs and requests; is always courteous to the customer and considers the needs of the customer when making decisions.

Communicating Effectively:  Shares information. Listens and involves others. Clearly conveys ideas in a manner that engages others and helps them understand and retain the message.

Teamwork: Meets all team deadlines and responsibilities, listens to others and values opinions, helps team leader to meet goals, welcomes newcomers and promotes a team atmosphere.

Decision Making/Judgment:  Approaches problems and decisions methodically and objectively; involves others as needed; uses sound judgment in making decisions and understanding the impact to themselves, customers, their team, and the organization; conducts the appropriate analysis to identify the symptoms and root cause of issues; makes timely decisions.

Delivering High Quality Work:  Makes sure responsibilities central to the role meet all requirements and expectations. Finishes tasks promptly and critically reviews work to ensure quality and accuracy. Considers impact of work to others and takes steps to mitigate. Seeks additional work after finishing tasks.

Demonstrating Initiative: Takes action on his/her own without being prompted; handles problems independently; able to resolve issues without relying on extensive help from others; does more than is expected or asked.

Results Orientation:  Is focused on outcomes and accomplishments; follows through on commitments; can be counted upon to successfully execute on goals; motivated by achievement and a need for closure; has an attention to detail and is both efficient and effective in achieving a high level of measurable outcomes; persists in achieving goals despite obstacles.

Supporting Mosaic Mission:  Actively supports Mosaic’s mission and values; uses individual skills to add value to the mission; aligns actions around organizational goals; gives priority to organizational mission and value when making decisions.

 QUALIFICATIONS:

Work Experience:  Three years of relevant experience required. Data analysis and audit experience required. Pharmacy and 340B program experience preferred.

Education, certification and licensure:  High school diploma or equivalent required. Bachelor’s degree preferred. Pharmacy Technician certification preferred.

Skills & Knowledge: Developing complex spreadsheets, custom charts, referential dashboards, and advanced formulas. Advanced skills with relational databases, preferably using Microsoft Access or Crystal Reports. Knowledge of prescription drugs and electronic health records. Must have excellent communication skills and ability to interact with a diverse population and professionally represent Mosaic Medical, strong team working and collaborative skills, ability to multi-task, attention to detail, excellent organizational skills, and customer service.  Intermediate ability and experience in computer applications, specifically electronic medical records system, Excel, Power Point and MS Office.

*candidates must reside in Central Oregon

About Mosaic Community Health

https://mosaicch.org/

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