Job Description

• Ensure Regulatory Compliance: Maintain strict compliance with Federal Drug Pricing Program and HRSA requirements, continuously monitor program integrity, and advise internal stakeholders on necessary changes based on the HRSA OPAIS website
• Prevent Fraud and Waste: Ensure all claims are reviewed and processed with the appropriate inventory to prevent diversion and duplicate discounts
• Conduct Audits and Maintain Records: Perform pharmacy prescription and EHR audits to verify eligibility and collect or track required medical documentation from external providers to maintain complete audit readiness
• Manage Systems and Data: Utilize and troubleshoot EHR and pharmacy operating systems to build compliant patient profiles and accurately track eligibility and utilization
• Drive Financial Optimization: Track and analyze monthly savings, variance trends, and purchasing patterns, and generate comprehensive reports for leadership visibility, budget forecasting, and audits
• Develop Policies and Stay Informed: Create and update program-related policies and procedures and stay current on federal regulations by attending relevant trainings, webinars, and conferences
• Collaborate with Stakeholders: Establish strong relationships with internal staff and external providers, maintain regular communication to support efficient workflows, and participate in meetings regarding process improvement and quality
• General Support: Perform other duties as assigned to support the team

• Registered or certified pharmacy technician required.
• High School Diploma required.
• Associate’s or Bachelor’s degree preferred.

• Experience with the federal drug pricing program.
• Ability to proficiently use EHR and pharmacy operating system(s).
• Quality assurance experience, such as medical chart reviews or auditing, is preferred. 
• Exceptional organization skills.
• Ability to work independently.
• Strong attention to detail, spelling, and numerical differences.
• Proficient with Excel.
• Exemplary written and verbal communication skills.
• Knowledge of healthcare terminology.

• Equal investment and support for our people and patients.
• A fun and ambitious growing environment with a culture that takes on important things, takes risks, and learns quickly.
• The ability to demonstrate creativity, innovation, and conscientiousness, and find joy in working together.
• A team of highly skilled, incredibly kind, and welcoming employees, every one of whom has something unique to offer.
• We know that the overall success of our business is a collaborative effort, and we strive to provide ongoing opportunities for our employees to learn and grow, both personally and professionally.
• Full-time employees are eligible to participate in our benefits package which includes Medical, Dental, Vision Insurance, Paid time off, Short- and Long-Term Disability, 401k match and more.