Compliance Manager - 340B Program
- - Compliance & Quality Assurance
- Indianapolis, Indiana, IN, USA
- Full Time
Compliance Manager - 340B Program
Damien Pharmacy and Quality Teams
Damien Center empowers communities and persons affected by HIV/AIDS in the state of Indiana by being a leading resource, provider, and advocate for comprehensive HIV/AIDS care, prevention, education, and related services. Damien Center, Damien Cares and Damien Pharmacy provide client-centered social services focused on care coordination, clinical and pharmacy services, mental health, housing, and nutrition to the Indianapolis community.
The 340B Program Compliance Manager maintains the agency's standards of equitable and inclusive care by ensuring compliancy with all 340B regulations and guidelines, while striving to optimize 340B utilization to best meet the needs of clients and providers. This position completes various responsibilities related to maximizing compliant 340B claim capture. The Manager facilitates, maintains, and expands relationships with all external 340B stakeholders, including but not limited to contract pharmacy vendors, drug wholesalers, program auditors, and Electronic Medical Records (EMR) Specialists. The Manager is also responsible for communicating program performance measures and forecasting to all internal stakeholders including the pharmacy, finance department and President & CEO. The Manager conducts regular meetings with the 340B Internal Committee to discuss quality improvement measures and development related to the program.
Duties and Responsibilities:
This job description describes the general nature and level of work performed by employees assigned to this position. It should not be construed as an exhaustive list of all required duties, responsibilities, and skills.
- Coordinates with Damien Pharmacy, Cares, and Center to ensure strict compliance with federal 340B guidelines and procedures.
- Creates, implements, and maintains 340B policies and procedures according to organizational, state, and federal requirements and guidelines.
- Diligently monitors for guidance and/or rule changes, including legislative and policy adjustments, and provides regular updates to leadership.
- Maintains the OPAIS database for the covered entity and reviews periodically for necessary updates or changes.
- In collaboration with the 340B Analyst, obtains and analyzes prescription claim data monthly. Ensures compliance of all prescriptions, both internally and externally, to prevent diversion or duplicate discounts.
- Provides training, education, and guidance for all employees involved with the 340B program, creating comprehensive training materials, and establishing clear lines of communication for queries or concerns.
- In collaboration with the 340B Analyst, develops and executes self-audits of the 340B process at all 340B eligible locations, performs audits of all contract pharmacies, and documents results/follow-up on any findings.
- Prepares for external audits by ensuring strict adherence to 340B regulations, maintaining utilization records, and monitoring all points of contact where 340B participation occurs.
- Coordinates annual external review of policies, procedures, and claims and vets and adopts recommended changes based on the review results.
- Maintains working knowledge of state Medicaid laws and regulations as they pertain to the 340B program and makes changes to entity's 340B policies and procedures as necessary.
- Maintains relations with contract pharmacies while identifying and evaluating potential contract opportunities. Reviews and negotiates new or developing contracts.
- Collaborates with marketing and direct service staff to develop 340B marketing, promotions, and increased patient access.
- Continually identifies opportunities to improve 340B utilization, save costs, and better serve clients and providers.
- Works with pharmacy management to monitor all purchase records related to 340B participation and. tracks 340B drug inventory
- Maintains excellent proficiency of the EMR and pharmacy systems, including but not limited to patient eligibility tracking and reporting, and all other reporting features.
- Coordinates with providers to ensure efficient and compliant facilitation of prescriptions from writing to dispensing.
- Maintains and reviews contract pharmacy database management systems.
- In conjunction with the 340B Analyst, facilitates the build and transfer of patient eligibility files to all contract pharmacies, per their individual file specifications.
- Completes and submits wholesaler applications for 340B accounts, overseeing their implementation and maintenance.
- Reviews wholesaler invoicing for both in-house and contract pharmacies for purposes of self-auditing.
- Tracks, records, and reports 340B program income per designation, per vendor, and per contract pharmacy.
- Oversees and coordinates all 340B Internal Committee meetings and projects, including completing and tracking all educational program requirements.
- Assists with implementation of the Damien Quality Management plan
- Performs special assignments and other work, on an as-needed basis
Education and/or Experience
High school diploma required. Bachelor's Degree from an accredited college or university preferred. One to three years of experience in data management preferred. Experience with pharmacy, including familiarity with 340B program and laws preferred. Experience with data analytics, problem solving, decision-making, data forecasting, quality assurance, and communications preferred. Excellent proficiency with Microsoft Office Suite, eClinicalWorks, and OPAIS preferred.
*Work experience may substitute for education requirements on a case-by-case basis.
Knowledge, Skills, and Abilities:
Possess superior organizational and administrative skills. Excellent interpersonal and communication abilities. Excellent computer skills in a Microsoft Windows environment. Ability to work independently and achieve high standards of productivity, achieving deadlines and with superior product results. Strong calendaring, organizational, and document management skills required. Proactive approach to solving problems and communicating to leadership. Knowledge of office management systems, procedures, and office equipment required. Excellent time management skills and ability to prioritize work.
To perform this job successfully, an individual must be able to perform each essential job function satisfactorily. The requirements listed are representative of the basic knowledge, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The individual in this role must display the highest level of integrity and confidentiality. The individual should have effective communication skills, attention to detail and organization, and flexibility and adaptability. The individual will also maintain knowledge of trends in their area of responsibility.
The physical demands described here are general representations of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- While performing the duties of this job, the employee is regularly required to sit, reach with hands and arms, talk, and hear. The employee frequently is required to use hands to touch and handle objects. The employee frequently stands or walks.
- The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Office setting, remote, or a hybrid schedule are all possible options for this role. Location will be determined and/or approved as needed by the agency.
- Sustained use of a computer.
- The noise level in the office environment is minimal to moderate.
- Maintains personal/professional competency and works to create an environment of courtesy, respect, enthusiasm, and a positive attitude in all interactions both internal and external to the organization.
- FLSA Status: Exempt, Salaried, Full-Time,
- Benefits: Complete Benefits Package Available
- Leader: Quality Improvement Director
Damien Center is an Equal Opportunity Employer
Please apply at www.damien.org/job-opportunities
This position description does not constitute a contract of employment or guarantee of any terms or conditions of employment. Damien Center employees are employed on an at-will basis. Nothing in this position description restricts Damien Center's right to assign or reassign duties and responsibilities to this position at any time.