Shift: Full-Time 40-hour work week
Eligible: Full-Time Benefits
Performs a wide variety of financial, database, auditing and compliance reporting analyses to ensure HFHS entities to reinforce eligibility, integrity and compliance for the 340B Federal Discount Program. Provides program support for both the financial and compliance operations of the 340B program through investigating, analyzing and reporting accurate data related to the 340B billing and contract pharmacy operations.
Utilizes multiple data sources and business intelligence tools to analyze statistical and financial information in order to recommend strategies for optimizing 340B program initiatives while ensuring compliance with all applicable regulations. Maintains database to reflect changes in drug formularies, assures system integrity, analyzes purchasing data and monitors ordering processes and documentation related to pharmacy supply chain compliance with state and federal regulations.
PRINCIPLE DUTIES AND RESPONSIBILITIES:
Oversight and responsibility for overall compliance, auditing and financial analytics for the 340B Pharmacy Program within Henry Ford Health System (HFHS)
Conducts regular audits of claims data to ensure 340B program compliance. Evaluates all eligibility criteria for qualified and non-qualified patients. Performs chart and medical record review.
Utilizing multiple data sources and business strategies for optimizing 340B program initiatives while ensuring compliance with all applicable regulations.
Performs a variety of financial and compliance reporting and auditing. Maintains accurate tracking of financial and productivity data related to 340B and purchasing program.
Reviews trends, creates forecasts and develops predictive models. Analyzes data reports for trends and discrepancies while assessing cost savings opportunities for maximum optimization and compliance.
Monitors and tracks all payments received by contract pharmacies. Acts as a liaison between the covered entity and contract pharmacy when payment discrepancies occur.
Validates necessary patient, provider and medication information to ensure proper claims submission, and to maintain accurate documentation of records related to 340B and purchasing program.
Continually monitors product levels to effectively balance product availability and cost-efficient inventory control factoring in 340B utilizing Retail Usage Ratios.
This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and duties. It should be understood, therefore, that employees may be asked to perform job-related duties beyond those explicitly described above.
Bachelor's Degree in Business, Finance, Healthcare or related field -or- equivalent related work experience required.
Prior Pharmacy operations experience preferred.
Working knowledge of 340B program, including eligibility and compliance requirements.
General working knowledge in areas of compliance, finance, supply chain and database tools.
Proficient working knowledge and/or experience with Microsoft Office products Excel, Assess, Word, PowerPoint, Team, etc., along with relational database and other analytical tools such as Tableau.
Effective verbal, written and interpersonal communication skills to interact effectively and cooperatively with all internal and external customers.
Must possess excellent project planning and time management skills. Ability to work independently while managing multiple tasks and meeting established deadlines.
CERTIFICATIONS/LICENSURES REQUIRED :
340B Apexus Certified Expert (ACE) certification required within one year of employment (highest 340B certification currently available
Organization: Community Care Services
This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described above.
Under the leadership of President and CEO Robert G. Riney, Henry Ford Health is a $6 billion integrated health system comprised of six hospitals, a health plan, and 250+ sites including medical centers, walk-in and urgent care clinics, pharmacy, eye care facilities and other healthcare retail. Established in 1915 by auto industry pioneer Henry Ford, the health system now has 32,000 employees and remains home to the 1,900-member Henry Ford Medical Group, one of the nation's oldest physician groups. An additional 2,200 physicians are also affiliated with the health system through the Henry Ford Physician Network. Henry Ford is also one of the region's major academic medical centers, receiving between $90-$100 million in annual research funding and remaining Michigan's fourth largest NIH-funded institution. Also an active participant in medical education and training, the health system has trained nearly 40% of physicians currently practicing in the state and also provides education and training for other health professionals including nurses, pharmacists, radiology and respiratory technicians. visitHenryFord.com.
Whether it's offering a new medical option, helping you make healthier lifestyle choices or making the employee enrollment selection experience easier, it's all about choice. Henry Ford Health has a new approach for its employee benefits program - My Choice Rewards. My Choice Rewards is a program as diverse as the people it serves. There are dozens of options for all of our employees including compensation, benefits, work/life balance and learning - options that enhance your career and add value to your personal life. As an employee you are provided access to Retirement Programs, an Employee Assistance Program (Henry Ford Enhanced), Tuition Reimbursement, Paid Time Off, Employee Health and Wellness, and a whole host of other benefits and services. Employee's classified as contingent status are not eligible for benefits.
Equal Employment Opportunity/Affirmative Action Employer
Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health is committed to the hiring, advancement and fair treatment of all individuals without regard to race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height, weight, marital status, family status, gender identity, sexual orientation, and genetic information, or any other protected status in accordance with applicable federal and state laws.