Business Operations Specialist-Pharmacy 340B

J  o  b    D  e  s  c  r  i  p  t  i  o  n

JOB INFORMATION

Effective Date:

7/1/2024

Entity:

Wisconsin

Job Code:

300095

Job Title:

Business Operations Specialist-Pharmacy 340B

FLSA Exemption Status:

Exempt

Management Level:

Individual Contributor

JOB SUMMARY

The Business Operations Specialist - Pharmacy 340B is responsible for maintaining a high performing, highly compliant, 340B program. The incumbent's main focus will be conducting audits and assuring the ongoing success of the 340B program. The incumbent may be asked to participate in the development of policies and procedures, education to internal stakeholders, program changes, program and optimization projects.

ESSENTIAL DUTIES

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Regularly communicates with all staff involved with the 340B program to ensure that processes remain efficient and to address any problems or suggestions for improvement.

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Participate in training of newly hired staff as designated by manager or director.

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Assist with the development and maintenance of 340B policies and procedures.

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Review 340B Program policies and procedures on an ongoing basis and offer contributions and changes to ensure 340B compliance.

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Conducts ongoing monthly and quarterly audits to assure the 340B program is compliant.

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Performs 340B purchasing and utilization audits or compliance assessments internally, as needed to ensure compliance with all applicable regulations. This includes but not limited to: self-audits of 340B processes, annual audit of contract pharmacies, and monthly audits of 340B eligible locations.

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Coordinates the remediation of findings as they arise during scheduled monitoring..

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Routinely reviews data and related reports from all points of service at which 340B participation occurs to ensure that policies and procedures are followed, entity eligibility requirements are met, and all patients meet patient definition requirements.

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Using Excel or a comparable data management program, filter out non-eligible transactions, including, but not limited to, drugs used to treat patients during inpatient care, Medicaid patients, drugs provided free by manufacturers, those provided at non-eligible locations, or prescriptions written by non-eligible providers.

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Evaluate patient eligibility for qualified and non-qualified patients in mixed-use areas and clinics by reviewing patient medical records, insurance plans, and, if applicable, hospital status.

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Develop and foster working relationships with internal working counterparts (IT, internal audit, results, accounting, and others) to facilitate productive exchanges of information to improve program efficiency and promote program compliance.

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Provide data, information, and reports as needed for other business units within the organization.

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Assess opportunities for system improvements to yield higher compliance.

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Ensures that leadership is aware of any potential opportunities that are identified.

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Assist with implementation and monitoring.

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Participates in the day-to-day compliance review and operations of clinic-administered medications in eligible locations, mixed-use areas managed by split-billing software, outpatient prescriptions fulfilled by an owned pharmacy, and outpatient prescriptions fulfilled by a contract 340B pharmacy.

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Participate in interviews, selection, orientation, and training of new employees

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Provide input on staff performance including providing feedback for performance evaluations.

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Participate in staff meetings to communicate changes and address issues that need to be discussed.

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Assist in the implementation of policies and procedures.

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Establishes a routine approach to updating the CDM/crosswalk for new products and product changes to ensure both the accuracy of the utilization report and the efficiency and accuracy of the charge process.

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Develop a thorough understanding of the split-billing/third party administrator systems and the functions to be performed.

As needed, additional responsibilities reasonably within the scope of duties and physical requirements may be assigned.  ALL DUTIES AND REQUIREMENTS MUST BE PERFORMED CONSISTENT WITH THE UW HEALTH PERFORMANCE STANDARDS AND RESPECT FOR PEOPLE COMMITTMENTS.

X

Non-Clinical

JOB REQUIREMENTS

Bachelor's Degree

in business administration, finance, accounting, supply chain, or another relevant field

Required

Experience may be considered in lieu of a degree in addition to the experience listed below

1 year

of healthcare, accounting, business administration, finance, or related experience

Required

1 year

of experience as a Pharmacy Technician, Buyer, Analyst, or Auditor

Preferred

2 years

of experience in progressively advanced analytic and project leadership roles in healthcare or equivalent advanced education

Preferred

Advanced 340B Operations Certificate (340B ACE)

Preferred

LICENSE, CERTIFICATIONS, AND REGISTRATIONS MUST BE MAINTAINED PER UW HEALTH POLICY. 

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Excellent verbal and written English communication skills.

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Excellent organizational and time management abilities.

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Effective interpersonal skills, including the ability to effect collaborative alliances, promote teamwork and ensure a high degree of internal and external customer satisfaction.

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Ability to work as a team player or autonomously with strong organizational skills, project management skills and attention to detail.

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Ability to work with vendors and other departments to keep multiple tasks on track and bring projects successfully to completion.

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Strong skills in standard Microsoft Office applications (Excel, Word, Outlook, Access)

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Ability to initiate and follow through on complex programs of both short- and long-term duration.

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Highly developed problem-solving skills including the ability to identify and resolve complex problems

PHYSICAL REQUIREMENTS/WORKING CONDITIONS

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Sedentary: Ability to lift up to 10 pounds maximum and occasionally lifting and/or carrying such articles as dockets, ledgers and small tools. Although a sedentary job is defined as one, which involves sitting, a certain amount of walking and standing is often necessary in carrying out job duties. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Up to 10#

Negligible

Negligible

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Light: Ability to lift up to 20 pounds maximum with frequent lifting and/or carrying of objects weighing up to 10 pounds. Even though the weight lifted may only be negligible amount, a job is in this category when it requires walking or standing to a significant degree.

up to 20#

Up to 10# or requires significant walking or standing or requires pushing/pulling of arm/leg controls.

Negligible or constant push/pull of items of negligible weight

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Medium: Ability to lift up to 50 pounds maximum with frequent lifting and/or carrying objects weighing up to 25 pounds.

20-50#

10-25#

Negligible-10#

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Heavy: Ability to lift up to 100 pounds maximum with frequent lifting and/or carrying objects weighing up to 50 pounds.

50-100#

25-50#

10-20#

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Very Heavy: Ability to lift over 100 pounds with frequent lifting and/or carrying objects weighing over 50 pounds.

Over 100#

Over 50#

Over 20#

Other - list any other physical requirements or bona fide occupational qualifications not indicated above:

Over 50 lbs.

UW Health does not require, nor does it expect that its employees lift more than 50 lbs unassisted. Objects in excess of 50 lbs should be lifted or moved with mechanical means or through a team lift. Employees in patient care areas are expected to utilize mechanical lifts and adhere to the "Use of Mechanical Lifts (Liko)" policy in the Patient Services Policy and Procedure Manual.

Note: The purpose of this document is to describe the general nature and level of work performed by personnel so classified; it is not intended to serve as an inclusive list of all responsibilities associated with this position.

THE EMPLOYEE MUST BE ABLE TO COMPLETE ALL PHYSICAL REQUIREMENTS OF THE JOB WITH OR WITHOUT AN APPROVED ACCOMODATION. Note: The purpose of this document is to describe the general nature and level of work performed by personnel so classified; it is not intended to serve as an inclusive list of all responsibilities associated with this position.