Pharmacy Program Analyst - LifeLong Medical Care

Overview

LifeLong Medical Care is looking for a Pharmacy Program Analyst in Berkeley, CA. Manages 340B compliance with HRSA, pharmacy regulations, and LifeLong policies and procedures. Coordinates 340B internal reviews and audits as well as planning.

This is a full time, 40 hrs/wk, benefit eligible position.

LifeLong Medical Care is a large, multi-site, Federally Qualified Health Center (FQHC) with a rich history of providing innovative healthcare and social services to a wonderfully diverse patient community. Our patient-centered health home is a dynamic place to work, practice, and grow. We have over 15 primary care health centers and deliver integrated services including psychosocial, referrals, chronic disease management, dental, health education, home visits, and much, much more. LifeLong Medical Care is an equal opportunity employer. We strongly encourage applications from women, people of color, and bilingual and bicultural individuals and members of the lesbian, gay, bisexual, and transgender communities. Applicants shall not be discriminated against because of race, religion, sex, national origin, ethnicity, age, disability, political affiliation, sexual orientation, gender identity, color, marital status, or medical condition.

Benefits

Compensation: $25 - $32/hour. We offer excellent benefits including: medical, dental, vision (including dependent and domestic partner coverage), generous leave benefits including ten paid holidays, Flexible Spending Accounts, 403(b) retirement savings plan.

COVID-19 Vaccine Policy

In accordance with LifeLong Medical Care's commitment to provide and maintain a workplace that is free of known hazards, we have adopted a Mandatory COVID-19 Vaccine Policy to safeguard the health of our employees and their families; our patients and visitors; and the community at large from infectious diseases, that vaccinations may reduce. This policy will comply with all applicable laws and is based on guidance from the Centers for Disease Control and Order of the California State Public Health Officer. Unless a reasonable medical or religious accommodation is approved, all employees must receive COVID-19 vaccinations.

Responsibilities

• Coordinates 340B compliance in clinics and communicates compliance requirements, identifies risk points and facilitates corrective of actions.
• Provides 340B contract pharmacy adjudication and program support.
• Ensures that policies and procedures are developed, implemented, and maintained according to organizational, regional, national, state, and federal requirements and guidelines and are approved by the institution’s legal department.
• Establishesconsistent policies and procedures for 340B that ensure productivity and efficiency so that long-term management of the program does not hamper operations or create unnecessary cost
• Providesongoing training, education, and communication required for the 340B Program at the organizati
• Developstraining/competency materials for all employees who work with the 340B Program.
• Mayassist in the development, implementation, or promotion of programmatic resources/tools to support staf
• Regularly communicates with all staff involved with the 340B Program to be sure that processes remain efficient and to address any problems or suggestions for improvement.
• Monitors and assesses 340B guidance and/or rule changes, including, but not limited to HRSA/OPA rules and Medicaid changes. Attends regular 340B trainings and shares lessons and hot topics with staff.
• Routinely monitors industry publications and websites as well as the professional media, literature, and peers to ensure that the institution has the latest information regarding interpretations, rulings, suggestions, and advanced ideas for improving participation.
• Ensures that the 340B pharmacy program is continuously compliant with 340B federal regulations.
• Provides expertise on all 340B Program legislation and policy changes from HRSA and OPA, informing and collaborating with legal and compliance teams.
• Collaborates with the Prime Vendor Program, pharmacy leadership, and other 340B institutions to determine the most appropriate use of the 340B Program staff.
• Responsible for ensuring that the annual HRSA recertification is completed within the allowable time frame.
• Responsible for ensuring that the HRSA 340B OPAIS is accurate for all organization entities.
• Responsible for ensuring registration of any new associated sites are within the allowable time frame.
• Manages relationships, billing services, and compliance with contracted 340B pharmacies.
• Evaluates all current and future contract pharmacy opportunities, including contract language, fee structure, data setup, and internal and independent external auditing.
• Assesses opportunities for cost savings and business improvements in 340B contract pharmacy utilization.
• Assesses opportunities for cost savings and system improvements to yield higher compliance.
• Oversees the 340B contract pharmacy marketing program to attract and retain qualified retail pharmacy contracts and serve eligible patients.
• Analyzes utilization of the program and existing software to identify ways to compliantly use the 340B Program to its fullest extent to meet the needs of underserved patients.
• Works directly with manufacturers as well as wholesalers to develop strategies for appropriate use of the program.
• Develops business plans to prioritize and implement programs related to program services and contract pharmacy agreements.
• Develops action plans to close identified gaps in collaboration with organizational leadership.
• Implements business plans in coordination with organizational pharmacy leadership to help use 340B savings to expand and improve care provided to underserved and vulnerable populations.
• Provides oversight for the implementation of process improvement initiatives and creates an environment that places an emphasis on continuous monitoring and improvement.
• Routinely monitors monthly and annual reports on 340B participation that clearly document utilization, savings, problem areas, and exceptions or discrepancies, to be passed on to pharmacy leadership and administration.
• Develops routine reports that are a by-product of the inventory process and software, allowing for concise information to be communicated to the leadership responsible for 340B inventory management.
• Constructs appropriate financial metrics to assess areas of improvement.
• Prepares and assists in the monitoring and various tracking and reporting measurements to ensure compliance with the program.
• Coordinates monthly financial reporting and analysis, including, but not limited to, metric reporting, scorecards, and variance analysis and reporting.
• Ensures that reporting meets organizational, regional, national, state, and federal requirements/guidelines.
• Maintains records related to job function and contributes to reports.
• Routinely communicates any questions, issues, or discrepancies with the appropriate authority.
• Reports monthly savings opportunities.
• Ensures appropriate documentation and audit trail across areas of responsibility.
• Monitors purchasing records for each 340B participant; clearly documents utilization, savings, problem areas, and exceptions or discrepancies. Relays results to pharmacy leadership.
• Monitors for 340B pricing exclusions or shortages and establishes appropriate alternative products that are included when possible, including work with medical staff and formulary to ensure proper position and related use.
• Participates with the Prime Vendor and routinely reviews 340B formulary pricing and potential alternatives.
• Manages and tracks 340B drug inventory, including proper replenishment.
• Tracks, trends, and reports 340B pharmaceutical sales and purchases data to ensure provider/physician and patient eligibility.
• Continuously monitors product min/max levels to effectively balance product availability and cost- efficient inventory control.
• Maintains system databases to reflect changes in the drug formulary or product specifications.
• Ensures compliance with regulations related to 340B purchasing.
• Routinely monitors utilization records and 340B purchasing accounts to ensure that software or tools are working properly.
• Performs thorough quarterly reviews of the new 340B pricing list to search for and quickly address costly changes.
• Maintains 340B TPA software integrity and reviews reports to identify areas for improvement.
• Assists in implementing new software packages and other changes in business practice based on changing regulations and policies.
• Is responsible for maintenance and testing of tracking software.
• Works with pharmacy management and informatics teams to ensure that the organization’s clinical information system is coordinated and integrated into the work with the 340B Program. This shall include the electronic interfaces between the EMR and the virtual accumulator and any interfaces between the organization and contract pharmacy providers and/or administrators.

Qualifications

• Demonstrated effective professional communication and writing skills.
• Demonstrated proficiency with Microsoft Windows and Office software applications (particularly Excel and Word), plus experience with DAP, ePrescribing, and prescription adjudication software.
• Demonstrated excellent critical thinking skills and be able to work independently.
• Knowledge of eligibility for public healthcare programs such as Medi-Cal, Medicare, and CMSP.
• Knowledge of medication management regulations and requirements.
• Knowledge of 340B program compliance.
• Excellent organizational skills, close attention to detail, an independent drive within a teamwork setting.
• Requires a valid driver’s license, access to personal vehicle, proof of insurance, and light to moderate lifting ability.

Job Requirements

• Current 340B ACE Certificate. Or
• Able to obtain 340B ACE Certificate within 90 days of hiring if with previous experience in the field.
• Two years’ accounting experience, including experience managing 340B compliance.

Job Preferences              

• Four year degree with two or more years of experience in a human services setting, pharmacy, or health-related field.