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MAHEC01 MAHEC
340B Auditor - Pharmacy - Biltmore Campus
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Based on North Carolina data
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What they do
A Compliance Auditor examines records and procedures to determine adherence to regulatory guidelines of an organization. Inspects accounting, IT or security, prepares reports on the compliance with required regulations and risk management procedures.
$90,053 / year median in North Carolina
+4% projected growth
Job Description
JOB SUMMARY
MAHEC is seeking to fill a full time and benefitted 340B Program Auditor who is responsible for auditing MAHEC's 340B Pharmacy Program. This position is responsible for ensuring compliance with state and federal requirements of a 340B program. This role will train in person and remote/hybrid work environment may be available after the initial training period. The ideal candidate will be regionally located .SPECIFIC RESPONSIBILITIES
All required audits / reports for the 340B Pharmacy Program are completed monthly per HRSA guidelines. R e v i e w 340B Program p o li c i es and p r o ce d u r es o n an o n g o i n g b a s i s a n d o f f e r co n tr i b u t i o n s a n d ch a n g es t o e n s u r e 3 4 0B comp li a n ce. Develop a thorough understanding of the split-billing / third party administrator systems and the functions to be performed. Audit prescription data, patient da ta, hospital data, payer data, site of care, and, if required , ICD-10 codes. Summarize and report results to the Compliance Officer and the Director of the 340B Program. Audit the purchasing process to ensure proper operation and compliance. Audit invoices, shipping, and inventory processes. P e r f o r m m o n t h l y a u d i t s o f co n tr a c t p h a r m ac i es. P e r f o r m m o n t h l y audits o f 3 4 0B p h a r m acy o p era t i o n s. Audit for c o m p li a n ce w i t h 340B Program r e q u i r e m e nts f or q u al i f i ed p a t i e n t s, dr u g s, a n d l o c a t i o n s. A ud i t s t ate M e d i ca i d cl ai m s t o e n su r e co m p li a n ce t o p r e v e n t p o t e n t i al d u p li cate d i sco u nt r e b ate s . U s i ng E x cel or a c o m p a r a bl e da t a m a n a g e m e n t p r o g r a m , f il t er o u t n o n- e li g i b l e t r a n sa c t i o n s , i nc l u di n g , b u t n o t li m i t ed t o , d r u g s us e d t o t r e a t p a ti e n t s d u r i ng i n p ati e n t c a r e, M e di c a i d pa t i e n t s , d r u g s p r o v i d e d fr ee by m a n u f a c t u r er s , t h ose pro v i d e d at n o n
- e li g i b l e l o cati o ns, o r p r es c r i p t i o n s w r i tt en by n o n
- e li g i b l e pro v i d e r s. Audit data regarding pa t i e n t e li g i b ili t y f o r q u al i f i ed a n d n o n
- q u a li f i ed p a t i e n t s i n m i x e d
- use a r e a s a n d c li n i cs by r e v i e w i ng p a t i e n t m e di c a l r ec o r d s , i ns u r a n ce p l a n s , a n d , if applicable, h o sp i t al s t a t us.
KEY COMPETENCIES
Communication Skills Effectively and respectably communicate with other individuals, whether it be a colleague, patient, or patient's family member and appropriately enumerate information in a manner easily understood by all parties. We do this to foster a culture of understanding between all parties, especially in complex and difficult situations , to ultimately provide the best care possible to our patients and their families. Decision Making Ability to make the most appropriate decision in a given situation and then taking the next steps to ensure appropriate and timely completion. This requires conflict resolution skills, critical thinking skills , confidence in your ability to make the right decision in most situations. This also includes ability to prioritize your workday appropriately to ensure the most important tasks are completed on time. HealthCare Knowledge Having the drive to keep yourself abreast and up to date on the new breakthroughs in your area of expertise and communicating them to the rest of the team, as appropriate . This also includes keeping up with your licensure and yearly training requirements within your area exp ertise along with MAHEC's organizational training. Finally, the ability to apply the depth of knowledge maintained and gained through this process in real life scenarios as appropriate . Interpersonal Skills Showing the ability to meet difficult situations with grace, professionalism, and understanding. Within your area of expertise, showing respect and showing empathy where appropriate with your colleagues, patients, and their family at all times, even when its most difficult to do so. This is done, in part, by effective listening, being your authentic self, showing responsibility and dependability, and being patient with others. Organizational Values Adherence to MAHEC's founding principles and incorporating them every day. This includes, among others, having integrity and accountability, reverence for other cultures and equitable practices, ability to manage change, and displaying a clear understanding of organizational dynamics. Doing these things creates a culture where people want to do the best for each other and gives personal ownership towards the goal of helping people in their time of need. Problem Solving Having an analytical mind and ability to work autonomously to solve complex problems that may arise. The wherewithal to think logically through a difficult problem and come to an appropriate resolution for a given issue. This helps to drive continuous improvement by thinking through where we can improve in a novel way. Measures success by understanding where we are currently and where we want to go and then applying those new ideas to affect positive change.SPECIFIED SKILLS COMPUTER
Must have advanced computer skills including Microsoft Office Suite.FOREIGN LANGUAGE
Spanish speaking skills preferred.PHYSICAL DEMANDS
Light- Moderate energy level: Lift and carry 25
- 35 lbs , Push/Pull 50
- 100 lbs (empty bed, stretcher, etc.
Physical Activity :
Occasional ( 0- 33 % of Workday)
SUPERVISORY RESPONSIBILITIES
Not Applicable.EDUCATION AND EXPERIENCE MINIMUM QUALIFICATIONS
Associate's Degree in healthcare or equivalent work experience and/or a minimum of three (3) years of auditing experience .PREFERRED QUALIFICATIONS
340B Pharmacy Program experience and/or Federally Qualified Healthcare Organization (FQHC) experience strongly preferred. Allscripts PM/EMR Pro software experience preferred.DESIRED LICENSES / CERTIFICATIONS
: Certified Pharmacy Tech (CPhT). Registered Health Information Technic ian (RHIT) . Certified Professional Medical Auditor (CPMA).SCHEDULE
Regular attendance on-site is an essential function of this position. Typical business hours are Monday- Friday, 8:00 am to 5:00 pm (or flexed to best meet the needs of the clients and/or the Division); 40 hours per workweek ; Work hours will need to be flexible in order to respond to special work assignments, or evening activities, as requested by the team leader.