340B Compliance Auditor

Job Description: • Responsible for achieving in-depth knowledge of the 340B Program and providing expert audit direction to staff and management regarding the 340B Program. • Maintains up-to-date knowledge of Geisinger’s 340B eligible locations, contract pharmacy network, procedures on 340B purchasing processes, and provides accurate and efficient audits to identify risk and prevent duplicate discounts and diversion. • Routinely reviews 340B Program policies and procedures and offers contributions and changes to ensure 340B compliance. • Ensures compliance with 340B drug purchasing, monthly auditing, split-billing software maintenance, contract pharmacy and mixed-use audits, and all areas of program compliance. • Performs audits on a scheduled basis; to ensure compliance with the federal regulations of the 340B program. • Evaluates patient eligibility for qualified and non-qualified patients by reviewing patient medical records, insurance plans, and hospital admission status. • Performs chart and medical record review to verify necessary patient, provider, and medication information to ensure proper claim submission, and maintain accurate documentation of records related to 340B program. • Ensures standard operating procedures are being followed and monitor all drug purchases on the GPO, WAC, and 340B accounts. • Monitors compliance across points of service where 340B participation occurs. • Develop a thorough understanding of split-billing systems and performs basic crosswalk maintenance. • Performs spot audits and compliance assessments to confirm accuracy of charge descriptions, utilization data, and reorder reporting. Requirements: • High School Diploma or Equivalent (GED)- (Required) • Bachelor's Degree- (Preferred) • Minimum of 4 years-Related work experience (Required) • Minimum of 1 year-Healthcare (Required) • Skills: Business Analysis, Critical Thinking, Healthcare Industry Benefits: • Healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners.