Position located at Trinity Health System Office in Livonia, Michigan.
Provides oversight for the coordination, integration, and analysis of the system-wide 340B program across Trinity Health. Leverages information technology, process design, change management, and industry evidence to enable improvements in the quality, financial, and regulatory and compliance goals of the Trinity Health 340B Program. Oversees individual ministry 340B programs through the development and refinement of split-billing software and other technology setups, implementations and enhancements of new programs, analytic reporting, internal audit and compliance programs, program stewardship, and advocacy.
1. Policy and Procedure Development:
Maintains up-to-date policies and procedures for 340B purchasing processes.
Develops systems and processes to limit program liabilities and provides proper audits to identify risk and prevent duplicate discounts and diversion.
Reviews 340B Program policies and procedures on an ongoing basis and offer contributions and changes to ensure 340B compliance.
Assists in development of proper 340B quality assurance training for employees as appropriate.
Provides proactive education to staff on policies and procedures related to inventory management and 340B procedures.
Expands professional development through related classes and seminars, current publications, and regional/national association membership participation.
Leads and assists Covered Entities in 340B audits.
Evaluates patient eligibility for qualified and non-qualified patients in mixed-use areas and clinics by reviewing patient medical records, insurance plans, and hospital status.
Ensures that facilities maintain adherence to 340B Program regulations and guidelines.
Performs audits on a scheduled basis; may involve presenting and resolving reconciliation issues as they arise during the monitoring and reconciliation process.
Performs audits of contract pharmacies.
Performs self-audits of 340B pharmacy operations.
Ensures compliance with 340B Program requirements for qualified patients, drugs, and locations.
4. Program Enhancement/Optimization:
Through financial analysis, recognizes the value opportunity of the 340B Program.
Assesses opportunities for cost savings and system improvements to yield higher compliance.
Develops a thorough understanding of the 340B Program. Consistently improves the overall efficiency, value, and internal direction of the 340B Program.
Builds knowledge of the health care and pharmacy services industry, and use that knowledge to identify ways and make recommendations to improve the 340B Program.
Evaluates and implements cost savings opportunities.
Assists all customers to clarify requirements, propose sourcing options; evaluate and recommend the best sourcing solution.
Develops reports utilizedto educate staff and assist management in tracking the overall financial impact to the organization. Builds other reports, as appropriate, to monitor and improve 340B Program compliance and performance.
Maintains copies of reports for compliance and audit purposes.
Collaborates with the 340B Steering Team and Forum to develop monthly, quarterly, and yearly audit metrics.
Assists with the construction of appropriate financial metrics to assess areas of improvement.
Develops and updates 340B Program reporting packages detailing volume, financial value, and other reporting metrics as needed.
Uses provided tools to monitor prescription data, patient data, hospital data, payer data, site of care, and, if required, ICD-10 codes. Summarizes and reports results to the appropriate individuals.
Monitors, reports, and analyzes contract pharmacy 340B activities; provides financial reports to hospitals or other covered entities relative to financial impact and liabilities; makes recommendations that would improve efficiency.
Coordinates Covered Entities in gross financial analysis and make recommendations to improve program performance. Tracks financial impact over time, identifies root causes of adverse trends, and makes recommendations to improve the program’s financial stability.
Reviews and refines monthly 340B cost savings reports detailing purchasing and replacement practices, as well as dispensing patterns.
6. Purchasing/Inventory Duties:
Directs Covered Entities in the inventory purchasing process for the applicable inpatient and outpatient pharmacies.
Assists Covered Entities in resolving receiving and invoicing issues or problems.
Complies with all GPO Prohibition rules for applicable covered entities: DSH, PED, and CAN.
Complies with all track-and-trace legal requirements of the Drug Supply Chain Security Act for purchasing and distribution of drug products.
7. Split-Billing Duties:
Develops a thorough understanding of the split-billing system and the functions performed.
Educates others involved in the purchasing process to ensure proper operation and compliance.
Provides covered entities with information needed to place orders using the appropriate accounts (e.g., WAC, GPO, and 340B) to replenish inventory in the mixed-use inventory setting.
Serves as a project leader for the 340B Program functions.
Develops and fosters working relationships with internal working counterparts (IT, internal audit, results, accounting, and others) to facilitate productive exchanges of information to improve program efficiency and promote program compliance. Provides data, information, and reports as needed for other business units within the organization.
An in-depth advanced base of knowledge of healthcare operations, the 340B program, and the pharmacy industry as normally obtained through a Bachelor's degree in assigned specialty area and five (5) or more years of related specialized experience; or an equivalent combination of education and experience.
Three (3) or more years of experience in leading performance/business process improvement activities including analyzing workflow processes through continuous process improvement methodologies.
Leadership and management experience in a specialized setting with responsibility for managing people, projects and assignments.
Familiarity with information systems, clinical software and other computer applications. Prior experience and knowledge of EHR functionality required.
Excellent organizational, advanced analytical, presentation, interpersonal, written and verbal communication skills. Highly professional manner and appearance.
Ability to interact effectively with all levels of the organization system-wide.
A personal presence characterized by a sense of honesty, integrity and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals and values of Trinity Health.
PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONS
Must be able to set and organize own work priorities, and adapt to them as they change.
Must be able to travel to attend some planned conferences, site visits, and/or conduct RHM work sessions, as needed (up to 20%).
The above statements are intended to describe the general nature and level of work being performed by persons assigned to this classification. They are not to be construed as an exhaustive list of duties so assigned.
Additional Salary Information: competitive compensation and excellent benefits
Internal Number: 00122052
About Trinity Health
Let Trinity Health introduce you to a well-rounded career in a community environment with all the advantages of working at one of the nation's premier Catholic health systems. Trinity Health operates acute-care hospitals, outpatient facilities, long-term care facilities, hospice programs. Our health services are located in 22 states. We are steadfast in our commitment to fulfilling our Mission, which includes improving the health of the communities we serve.