This hands-on position will be responsible for managing 340B related functions of the organization. The role requires the individual to support the organization through internal and/or HRSA/OPA, manufacturer, 3rd party insurance audits. Requires extensive review of data collection and analysis to detect deficient controls, and to optimize compliance with 340B regulations, and policies and procedures. This individual must be a self-starter and capable of planning and performing longitudinal operational, financial, and compliance audits of moderate difficulty and complexity with minimum supervision. This individual will also work with the pharmacy and other stakeholders to ensure that the organization meets all 340B requirements. The position reports directly to the CEO, and is a member of Senior Management Staff.
Duties and Responsibilities
Provides vigilant oversight of the organizations’ 340B program through internal audit functions that address controls of the 340B drug
Provides guidance and oversight on the day-to-day operation of the 340B program including, but not limited to, 340B purchasing, contracting, pricing, billing, system maintenance and inventory
Performs business process walkthroughs, inquiries, claims, and documentation reviews to assess whether procedures and internal controls exist to comply with the 340B program
Monitors vendor software and contract pharmacy replenishments to ensure that the 340B drugs are utilized in a compliant and consistent manner with scrutiny for diversion and duplicate discounts through the routine auditing of
Reviews contract pharmacy claims for all registered contract pharmacies of the covered entity and provides detailed reports of audits to the 340B oversight
Reviews 340B Office of Pharmacy Affairs Information Systems (340B OPAIS) database monthly to ensure database entries are complete, accurate, and
Assesses the definitions of an eligible provider specific to the covered entity and reviews physicians, nurse practitioners, residents, physician assistants, and medical residents who write 340B
Prepares detailed reports on audit findings on a routine basis and conveys information regarding audit results effectively to the 340B oversight team
Accountable to oversee inventory control related to 340B at all qualified pharmacy sites.
Stays informed and up to date of the ever-changing 340B regulations and guidelines.
Reviews all claims from all 340B registered ID and all contract pharmacies to ensure all claims are valid, accurate, and accounted
Works with PBM and TPA to resolve issues, reverse claims, to resolve credit/rebill issues, and ensure all necessary identifier codes are
Works with CFO and COOs to ensure all needed documentation is occurring and present for each claim in the E.H.R., CAREWare and case management
Works with outside providers and referral agencies and physicians to ensure compliance documentation is
Maintains the Policy and Procedure manual for 340B business operations. Addresses any changes to those policies with CEO and ensures policies and procedures are
Ensures auditable records are available at all
Engage and participate in all 340B regulatory calls, webinars and
Particiapte in all 340B conferences and trainings. Successfully complete all trainings offered by the primevendor
Assists in developing and ensures compliance with training materials, resources and workflows.
Attend and actively participate in all legislative activity, political information and education surrounding the importance of
Performs all other duties as
This job description is not intended to be all-inclusive; an employee also will perform other reasonably related job responsibilities as assigned by immediate supervisor and other management as required.
This organization reserves the right to revise or change job duties as the need arises. This job description does not constitute a written or implied contract of employment.
Qualification and Requirements:
A BS/BA degree is required, preferably in accounting, pharmacy management, or business
A minimum of two (2) years of internal auditing, pharmacy operations, and/or public accounting experience is
Experience with analyzing and reporting data to identify issues, trends, or exceptions.
Experience with organizing and managing multiple priorities, including demonstrable experience in workflow management systems and/or service
Good oral and written communications, including familiarity with Microsoft Office (Word, Excel, PowerPoint) and healthcare software
Requires knowledge of online technology and healthcare IT
Strong knowledge of Ryan White and STD Section 318 grants and the Federal 340B Drug Program is
Understanding of contract pharmacy software systems is a plus.
Internal Number: 3401
About Big Bend Cares
Originally known as Tallahassee AIDS Support Services (TASS), our organization was formed in 1985 by volunteers in order to provide supportive services to local individuals with HIV/AIDS.At that time, telephone calls were coming in from people who were infected with HIV or who were worried about the disease. Some of these individuals had been hospitalized and TASS began to recognize the need for home and hospital visits, as well as telephone counseling and group meetings. Although the Panhandle had only a few cases of AIDS by the beginning of 1986, the numbers were clearly increasing.By January 1987, the number of individuals asking for help was increasing rapidly, and the group decided to call an organizational meeting to recruit more volunteers. It was at this meeting that one of the more experienced individuals present suggested that the organization pursue incorporation. TASS became a non-profit corporation on July 1, 1987.In October 1991, TASS changed its name to Big Bend Comprehensive AIDS Resources, Education & Support, Inc. (Big Bend CARES), in order to more accurately reflect our range of services and our provision area. The new name was chosen by the board from entries su...bmitted in a volunteer contest to rename the organization.In 2017, Big Bend Cares expanded by opening Care Point Health and Wellness. The vision for Care Point was to be a one-stop-shop for all your healthcare needs. A place where clients and community members can receive primary care, radiology, dental, prescription refills, and lab work all in one location.Big Bend Cares provides assistance to people living with HIV and conducts HIV prevention and education programs to the general community. Big Bend Cares is the only AIDS Service Organization (ASO) in the eight counties of Area 2B and serves HIV positive individuals in all 8 counties.Today, Big Bend Cares’ mission is to provide education and comprehensive support to people infected with or affected by HIV/AIDS.