Compliance Analyst, 340B Program

Job Details:

Job Summary:

The 340B Program Compliance Analyst is responsible for maintaining regulatory compliance within the 340B Program across all WMCHealth entities. This role ensures adherence to HRSA guidelines, monitors program performance, conducts audits, and collaborates with internal stakeholders to optimize savings while maintaining compliance.

Responsibilities:

• Program Compliance & Stakeholder Collaboration
  • Serve as an internal liaison to key stakeholders, ensuring proper utilization of the 340B program and compliance with all regulatory requirements in conjunction with the 340B Program Manager.
  • Maintain current knowledge of 340B program requirements, assessing regulatory changes and their impact on workflows, processes, and systems.
  • Collaborate with Finance, IT, and other departments to ensure 340B billing requirements are properly set up and maintained.

• Software & Data Management
  • Maintain, test, and audit split-billing software and associated data feeds, ensuring accuracy and compliance.
  • Develop and refine claims qualification logic and data feeds for contract pharmacy relationships.
  • Assist in the implementation of new software programs and support necessary business practice changes.
  • Ensure acquisition pricing updates are correctly reflected in the Pharmacy Information System on a monthly basis.

• Auditing & Compliance Oversight
  • Develop and maintain a 340B audit compliance program, executing self-audits and implementing corrective action plans.
  • Conduct ongoing self-audits of all 340B-eligible locations and contract pharmacies to verify compliance with HRSA and internal policies.
  • Review and monitor all points of 340B participation, including covered entity eligibility, provider eligibility, and patient eligibility.
  • Prepare and present audit findings and corrective action plans to the 340B Steering Committee.
• Contract Pharmacy & Cost-Saving Initiatives
  • Evaluate contract pharmacy relationships, including contract language, fee structures, and data setup, ensuring compliance with 340B requirements.

• • Assess cost-saving opportunities and system improvements to maximize program efficiency and financial benefits.
  • Monitor internal and contract pharmacy purchasing activity, ensuring all software and tracking systems function properly.

• Regulatory & External Audit Support
  • Assist in responses to 340B-related inquiries or on-site audits from pharmaceutical manufacturers, HRSA, and other regulatory bodies.
  • Maintain an up-to-date list of eligible providers and ensure accurate reporting for HRSA recertifications and regulatory submissions.

• Education:

  • Required:
    • High school diploma or equivalent
  • Preferred:
    • Bachelor’s degree in related field and/or equivalent training/experience

• Experience:

  • Required:
    • Strong proficiency in data entry and pharmacy software systems
    • Excellent verbal and written communication skills
    • Strong financial background
    • Minimum of two years of experience in a hospital pharmacy setting
  • Preferred:
    • Pharmacy management experience
    • Understanding of inpatient, outpatient, retail, or specialty pharmacy operations
    • 3-5 years of experience in 340B compliance

• Skills & Certification:
  • Required:
    • 340B University (in person or on demand)
    • 340B Apexus Advanced Certification (ACE) within 6 months of hire
    • Demonstrated accomplishments in 340B, pharmacy and/or hospital billing.
    • Extensive knowledge of the 340B regulations and compliance requirements.
    • Demonstrate strong presentation skills and analytical techniques.
    • Ability to communicate clearly in all formats and apply a high degree of analytical, interpretive and evaluative skills.
    • Ability to operate healthcare information systems and analytical software.
    • Solid understanding of audit standards, techniques, and practices.
    • Solid understanding of financial concepts.
    • Demonstrate leadership and team building skills and interact with all clients/customers (internally and externally).
    • Initiate problem solving and conflict resolution skills to foster an effective working relationship with peers.

• Reports to: Network Director, Pharmacy Business Operations
• Schedule: Full-time, day shift
• Opportunities for Growth and Collaboration: This role provides opportunities to develop expertise in 340B program compliance, data analytics, and regulatory auditing while collaborating with pharmacy leadership, finance, IT, and compliance teams. The analyst will gain experience in policy development, system optimization, and cross-functional projects that enhance program integrity and financial performance.

About Us:

WMC Advanced Physician Services PC

Benefits:

We offer a comprehensive compensation and benefits package that includes:

• Health Insurance
• Dental
• Vision
• Retirement Savings Plan
• Flexible Savings Account
• Paid Time Off
• Holidays
• Tuition Reimbursement