Pharmacy Credentialing Regulatory Specialist

Established in 1980, the Greater Lawrence Family Health Center (GLFHC) is a multi-site mission-driven non-profit organization employing over 700 staff whose primary focus is providing the highest quality patient care to residents throughout the Merrimack Valley. Nationally recognized as a leader in community medicine (family practice, pediatrics, internal medicine, and geriatrics), GLFHC has clinical sites throughout the service area and is the sponsoring organization for the Lawrence Family Medicine Residency program.

GLFHC is currently seeking a Pharmacy Operations, Credentialing and Regulatory Specialist. Under the direction of the Pharmacy Director, supports Pharmacy Operations, Credentialing and Regulations functions. Works collaboratively with Legal and Compliance department to ensure and support adherence to pharmacy requirements, performance monitoring and process improvement activities for all regulatory agencies as it pertains to the pharmacy. Provide business and financial analysis assistance. The Pharmacy Operations, Credentialing and Regulatory Specialist will be responsible for inventory reporting, co-pays, compliance audits, management of the contract process and support for inventory management of the Pharmacies. This position works closely with pharmacy management and Finance and will provide financial and market analysis to assist in financial planning and business development projects with regard to 340B. It will also assist the department in evaluating/negotiating/auditing contracts with regard to PBM's, drug procurement, new technology, and new contract pharmacy arrangements/services.

• Ensure pharmacies are compliant with all regulatory agencies such as, but not limited to, CMS, OPA, DEA, Mass. Board of Pharmacy, and HRSA 340b program.

• Coordinate staff training oversight as required by Mass Board of Pharmacy.

• Track Fraud, Waste and Abuse trainings and attestations.

• Monitor HIPAA procedures.

• Maintain and secure all pharmacy licensing as needed and conduct routine audits of licenses and certifications.

• Monitor OPA database for accuracy and 340B compliance.

• Develop and conduct error prevention training as required by Mass Board of Pharmacy.

• Ensure Compliance with all 3rd party requirements (signature logs, FWA, partial fill).

• Ensure compliance with the Federal 340B drug pricing program as it pertains to, policies and procedures, duplicate discounts, patient eligibility, and inventory.

• Provides direction for site in maximizing revenues and minimizing operating costs/expenses by periodically reviewing prescription billing and compliance.

• Maintains a working knowledge of applicable federal, state, and local laws and regulations governing pharmacy and especially the 340B HRSA program.

• Develop and perform compliance audits to ensure all sites are fulfilling all requirements.

• Travels to various sites as needed to provide help with compliance, education, or support as directed.

• Coordination and management of health plans, other payers and affiliates.

• Complete, documents, files any inquiries regarding pharmacy applications to insurance carriers

• Regularly communicates on a regular basis to obtain required information from C-suite and/or Board of Directors necessary to the credentialing process

• Recommend process improvements to improve operational efficiency and cost-effectiveness.

Qualifications

Experience

• Ten to fifteen years' progressive pharmacy experience required.

• At least ten must consist of regulatory agencies and their requirements.

• Knowledge of the 340B regulations and compliance requirements.

• Strong presentation, analytical techniques, and computer skills.

• Proficiency in Excel, Word and other databases required.

• Demonstrate leadership and team building skills and interact with all clients/customers throughout the Health System (internally and externally).

Education

• Bachelor's degree from a four-year college or university. Relevant experience may be considered in lieu of education.

• Pharmacy-Based Immunization Certification preferred.

• BLS certification preferred.

GLFHC offers a great working environment, comprehensive benefit package, growth opportunities and tuition reimbursement.