Job Description

Location:

Work from home (Pennsylvania)

Shift:

Days (United States of America)

Scheduled Weekly Hours:

40

Worker Type:

Regular

Exemption Status:

Yes

Job Summary:

The 340B Third Party Administrator (TPA) Program Specialist works under the 340B Program Director. to ensure the 340B Program is running optimally and compliantly while maximizing 340B opportunities. Responsibilities include but are not limited to routinely conducting reviews of systems and claims to ensure processes are working as expected; monitoring and analyzing 340B program financials; creating and communicating 340B processes, procedures, work plans and training programs; optimizes qualification processes performance by reviewing data feeds and supporting other various 340B activities. The 340B Program Specialist will monitor changes program requirements and facilitate changes to Enterprise Pharmacy technology, processes and policy to meet such changes, while ensuring data integrity.

Job Duties:

• Provides proactive support of the 340B program, including the identification of potential errors in the processes and methodologies to ensure adequate compliance with all regulatory and auditing requirements.
• Develops new site assessments in conjunction with finance and IT.
• Optimizes purchasing opportunities in conjunction with the Pharmacy Procurement team.
• Acts as a subject matter expert on audits and supports the auditing team assists in the remediation of findings and feedback to auditors as needed. Assesses opportunities for cost savings and system improvements to yield higher compliance.
• Works with Channel Consultants to develop 340B strategies for external partners
• Develops and maintains internal relationships (accounting, legal, national) and external relationships (wholesalers, manufacturers, contract pharmacies, split-billing software vendors, employee benefit pharmacy benefits managers (PBMs), and third-party administrator (TPA) vendors) as needed.
• Actively engages with senior leadership and participates in decision-making processes related to the implementation of new 340B processes.
• Ensures split-billing software integrity and reviews applicable reports for areas of improvement.
• Maintains current knowledge of all pharmacy systems to understand the interface between the 340B split billing and accumulation software and those pharmacy systems.

Work is typically performed in a non-clinical environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. Additional competencies and skills outlined in any department-specific orientation will be considered essential to the performance of the job related to that position

Position Details:

Education:

Bachelor's Degree- (Required)

Experience:

Minimum of 5 years-Related work experience (Required)

Certification(s) and License(s):

340B ACE Certificate Within 1 year - Apexus

Skills:

Computer Literacy, Financial Analysis, Healthcare Regulatory Environment, Waterfall Model

OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities.

• KINDNESS: We strive to treat everyone as we would hope to be treated ourselves.
• EXCELLENCE: We treasure colleagues who humbly strive for excellence.
• LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow.
• INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.
• SAFETY: We provide a safe environment for our patients and members and the Geisinger family.

We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, we encourage an atmosphere of collaboration, cooperation and collegiality.

Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, pregnancy, genetic information, disability, status as a protected veteran, or any other protected category under applicable federal, state, and local laws.