The work involves developing, maintaining and performing audit processes and procedures related to participation in and compliance with the guidelines of the Federal 340B drug pricing program in the Compliance Department at the Erie County Medical Center Corporation. The 340B program was created in 1992 as part of the Public Health Service Act that requires drug manufacturers to provide outpatient drugs to eligible health care organizations and covered entities at significantly reduced prices for distribution to eligible Medicaid patients.
The incumbent audits the distribution and tracking of drugs on matters related to proper labeling, usage, dosage, billing, etc. The incumbent develops reports and make presentations on matters related to the 340B program and its administration at ECMCC. Work is performed under the general supervision of the Director Corporate Compliance.
Supervision is not a function of this position. Does related work as required.
TYPICAL WORK ACTIVITIES:
Performs internal audits and participates in external audits of ECMCC departments and/or contracted pharmacies utilizing 340B program for dispensing and prescribing drugs;
Determines an audit schedule utilizing available 340B program resources in collaboration with applicable Compliance, Pharmacy and Ambulatory Services personnel;
Documents findings of compliance and non-compliance with program guidelines; develops recommendations for corrective actions based on internal audits and adverse findings from external audits; prepares such in reports and presents to applicable ECMCC personnel and/or external agencies;
Collaborates with colleague position on developing, formalizing and presenting on matters such as uniform findings, reports and training programs;
Maintains a library of audit reports for use internally, by auditors and as mandated by regulatory agencies for their review;
Evaluates patient eligibility for participating in 340B program in accordance with established guidelines;
Monitors Pharmacy billing practices for compliance with program guidelines; receives and reviews billing issues and develops corrective actions;
Reviews billing accounts related to 340B program for determining effectiveness of electronic applications responsible for performing split-billing and other compliance controls;
Participates in and may organize meetings, committees, trainings, in-services, conferences, etc.
FULL PERFORMANCE KNOWLEDGE, SKILLS, ABILITIES AND PERSONAL CHARACTERISTICS: Thorough knowledge of hospital pharmacy operations and billing practices; thorough knowledge of pharmaceutical and medical terms, abbreviations and symbols; thorough knowledge of applicable laws, rules, regulations and accreditation standards as they relate to hospital pharmacy operations and 340B program administration; thorough knowledge of electronic applications utilized at ECMCC and available otherwise for maintaining 340B program compliance; ability to perform audits compliant with 340B program guidelines; ability to comprehend, interpret and explain instances of compliance and non-compliance with 340B guidelines; ability to prepare, present and store audit reports; ability to communicate effectively, both orally and in writing; ability to establish and maintain effective working relationships with a diverse constituency; ability to utilize a variety of electronic software applications; capable of performing the essential functions of the position with or without reasonable accommodation.
Graduation from high school or possession of a high school equivalency diploma and four (4) years of pharmacy experience, of which one (1) year was in a hospital.
Possession of Certified Pharmacy Technician (CPhT) certification as issued by the Pharmacy Technician Certification Board (PTCB) at time of appointment and maintenance throughout duration of appointment.
NOTE: Verifiable part-time and/or volunteer experience will be pro-rated toward meeting the full-time experience requirements.
University Emergency Medical Services, Inc.