Director, BILH 340B Compliance

Job Type: Regular

Time Type: Full time

Work Shift: Day (United States of America)

FLSA Status: Exempt

When you join the growing BILH team, youre not just taking a job, you’re making a difference in people’s lives.

Job Profile Summary

Reporting to the Assistant Vice President of Regulatory and Compliance, this position is responsible for leading and overseeing the 340B Program. Responsible for 340B Program activities, including analysis, monitoring, and reporting of 340B activities, as well as growth of various components of the overall 340B Program including split-billing activities. In a regulatory capacity, coordinates and assists in identifying and evaluating 340B issues and developing and implementing corrective actions across all 340B programs at BILH. Works with various internal and external stakeholders to develop plans and priorities to achieve 340B program targets and address service and operational challenges. Develops and oversees 340B program compliance. Serves as a resource on issues regarding 340B regulations, trends, and issues.

Job Description:

Job Description

Primary Responsibilities:

1. Oversight of the Pharmacy system 340B program for split-billing. Serves as primary internal and external coordinator and liaison for all 340B split-billingrelated matters. (essential)

2. Leads operations for BILH’s 340B program to maximize savings and revenue as well as ensure compliance with HRSA/Office of Pharmacy Affairs and manufacturers policy. Evaluates and implements opportunities for growth of the 340B Program related to addition of child sites. Participates in internal, external, Federal and State audits. (essential)

3. Ensures policies and procedures are developed and implemented according to organizational, regional, national, state and federal requirements and guidelines. Full oversight of program compliance and establishes consistent policies and procedures for 340B that ensure productivity and efficiency. (essential)

4. Serves as the chairs for steering and operations committees at covered entities

Reviews and oversees the implementation of cost savings initiatives associated with contract opportunities for 340B via various organizations. Fully knowledgeable of the GPO exclusion rule and when to utilize WAC and 340B when appropriate. (essential)

5. Oversees and implements 340B software for the internal 340B program. Maintains 340B software integrity and reviews applicable 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. (essential)

6. Oversees 340B Program compliance including all internal and external auditing. Implements and oversees 340B monitoring and auditing program that assures compliance with HRSA regulations and BILH 340B policies.

7. Periodically performs spot audits or compliance assessments in specific areas and specific products to ensure that the CDM is accurate, charges are coming across accurately, and the utilization numbers are translating accurately into report for 340B reorders. (essential)

8. Partners with federal and state governmental entities on advocacy efforts regarding the 340B Program. (essential)

9. Provides ongoing training, education and communication required for the 340B Program. Develops training and competency materials for staff and leaders who work with the 340B program. Conducts ongoing 340B program training for staff. (essential)

10. 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. Responsible for ensuring registration of any new child site within the allowable time frame. (essential)

11. Tracks and reports program savings and revenue on a regular basis; communicates to the leadership team on an ongoing basis. Participates in the development and implementation of reports generated on the 340B Program that outline savings, utilization, exceptions and discrepancies. Ensures that reporting meets organizational, regional, national, state and federal requirements/guidelines. (essential)

12. Responsible for 340B related contracts including pricing agreements with manufacturers. (essential)

13. Has the authority to direct and support employees daily work activities. Has the direct responsibility to undertake the following employment actions: hiring, termination, corrective action and performance reviews. Direct Reports: More than 7 Indirect Reports: 1-5 Assists in planning, monitoring and/or managing budget in functional area of department. Leverages program opportunities including reduction in prescription leakage

Required Qualifications:

1. Bachelors degree required. Masters degree preferred.

2. Advanced 340B Operations Certificate preferred.

3. 5-8 years related work experience required and 3-5 years supervisory/management experience required Advanced 340B Operations Certificate.

4. Possess a working expertise for 340B split-billing software and a well-rounded understanding of medications, dosage forms and strengths, therapeutic equivalents, formulary workings, and pharmacy law. Fully understand 340B compliance (Federal) so as to comply with all regulations that pertain to the 340B program.

5. Advanced skills with Microsoft applications which may include Outlook, Word, Excel, PowerPoint or Access and other web-based applications. May produce complex documents, perform analysis and maintain databases.

Competencies:

Decision Making: Ability to make decisions with significant, broad implications for the management and operations of a major department or multiple departments. Participates in decisions on overall strategy and direction of the organization.

Problem Solving: Ability to address problems that are highly varied, complex and often non-recurring, requiring staff input, innovative, creative, and Lean diagnostic techniques to resolve issues.

Independence of Action: Ability to set goals and priorities for functional area. May make recommendations for department policies, practices and programs. Manager or Director provides broad guidance and overall direction.

Written Communications: Ability to communicate complex information in English effectively in writing to all levels of staff, management and external customers across functional areas.

Oral Communications: Ability to verbally communicate complex concepts in English and address sensitive situations, resolve conflicts, negotiate, motivate and persuade others.

Knowledge: Ability to demonstrate broad and comprehensive knowledge of theories, concepts, practices and policies with the ability to use them in complex and/or unprecedented situations across multiple functional areas.

Team Work: Ability to act as a team leader for small projects or work groups, creating a collaborative and respectful team environment and improving workflows. Results may impact the operations of one or more departments.

Customer Service: Ability to lead operational initiatives to meet or exceed customer service standards and expectations in assigned unit(s) and/or across multiple areas in a timely and respectful manner.

Social/Environmental Requirements:

Work requires periods of close attention to work with out interruption. Concentrated effort of up to 4 hours without break may be required.

Work routine is fairly consistent, but employee needs to be able to use judgment to respond to events several times a week.

No substantial exposure to adverse environmental conditions

Health Care Status: NHCW: No patient contact.- Health Care Worker Status may vary by department

Sensory Requirements:

Close work (paperwork, visual examination), Visual monotony, Visual clarity <3 feet, Hot/Cold, Smell, Conversation, Monitoring Equipment, Telephone.

Physical Requirements:

Sedentary work: Exerting up to 10 pounds of force occasionally in carrying, lifting, pushing, pulling objects. Sitting most of the time, with walking and standing required only occasionally

This job requires constant sitting, frequent walking, standing.

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) and COVID-19 as a condition of employment. Learn more (https://www.bilh.org/newsroom/bilh-to-require-covid-19-influenza-vaccines-for-all-clinicians-staff-by-oct-31) about this requirement.

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Equal Opportunity Employer/Veterans/Disabled