Account Specialist

Boulo is recruiting for a 340B Pharmacy Program Account Specialist to join our client, a pharmacy program and solution firm located in Birmingham, Alabama.

Job Type: Full-time

Pay: $48,000 - $65,000

Flexibility: In-office

Benefits: Health, dental and vision insurance, STD and LTD, 401K with match, PTO and paid vacations

The 340B Account Specialist is responsible for managing the compliance and optimization of the 340B program for the assigned client. This involves completing routine audits of prescriptions, tracking findings and communicating with the covered entity as needed to improve compliance and savings. This position will also coordinate with internal departments for account reporting, data issues and resolution, and coordinate the facilitation between the internal data systems and the controlled entities’ identified resources.

Responsibilities:

• Perform analysis of 340B program elements to understand areas for potential improvement;
• Participate in Account Reports with Covered Entity to accurately represent audit findings and suggest improvements;
• Follow industry trends and makes recommendations as applicable to the Covered Entity 340B Program;
• Address areas of deficiency in the entity’s 340B Policy and Procedures by working with entity to draft revisions and obtaining approval from the entity’s appropriate committees (P&T, Med Exec, etc);
• Utilize financial metrics to assess areas of improvement;
• Make recommendations to improve program performance;
• Track financial impact over time, identify root causes of adverse trends, and make recommendations to improve the program’s financial stability;
• Monitor and audit state Medicaid claims to ensure compliance to prevent potential duplicate discount rebates;
• Evaluate patient eligibility for qualified and non-qualified patients in mixed-use areas and clinics by reviewing patient medical records, insurance plans, and hospital status;
• Perform audits on a scheduled basis; may involve presenting and resolving reconciliation issues as they arise during the monitoring and reconciliation process;
• Communicate audit deficiencies and improvement opportunities internally, to the client, and to 340B processor;
• Track documentation required to improve 340B qualifying criteria through provider referrals;
• Identify deficiencies in processing of 340B qualifications, and work with client and 340B processor to resolve;
• Utilize a contract template to prepare 340B contract pharmacy service agreements for supervisor’s review;
• Serve as the primary point of contact internally and externally for 340B contract pharmacy implementation;
• Develop systems and processes to limit program liabilities and provide proper audits to identify risk and prevent duplicate discounts and diversion;
• Continue to build knowledge of the health care and pharmacy services industry, and use that knowledge to identify ways and make recommendations to improve the 340B Program.

Requirements:

• Strong communication skills.
• 340B experience required.
• Self-motivated, collaborative, and strong problem-solving skills.
• Pharmacy experience, medical billing, or financial auditing preferred.
• Education/Experience – Associate's degree (AA) or equivalent from two-year college or technical school; or six months to one-year related experience and/or training; or equivalent combination of education and experience required.
• Proficient personal computer skills including electronic mail, record keeping, routine database activity, word processing, spreadsheet, graphics, etc.