JOB DESCRIPTION FOR JOB TITLE: - Home | UW Health
Program Manager – Pharmacy 340BJob Code: 703001FLSA Status: ExemptMgt. Approval: J. TempleDate: June 2020Department : PharmacyHR Approval: J. TheisenDate: June 2020JOB SUMMARYThe 340B Program Manager is responsible for planning, implementing, supporting, and optimizing projects related to the 340B program at UW Health. The incumbent participates in the policy and procedure development, education to internal and external stakeholders, rules/ guidance surveillance, registration/ recertification, self and external audits, contract management, and reporting and program enhancement/ optimization projects. The incumbent serves as the subject matter expert for all matters regarding the 340B Program. Additionally, the incumbent will oversee all uses of the split billing software.MAJOR RESPONSIBILITIESTraining and EducationDevelops training and competency materials for all staff who work with the 340B program.Conducts ongoing 340B program training for staff.Regularly communicates with all staff involved with the 340B program to ensure that processes remain efficient and to address any problems or suggestions for improvement. Policies and ProceduresDevelops, implements, and modifies consistent policies and procedures according to all applicable guidelines as approved by the legal departmentEnsures that policies and procedures support maximum productivity and efficiency to avoid any unnecessary costs or operational barriersComplianceContinually monitors 340B regulations to ensure federal compliance, staying up-to-date on all rule changes, including HRSA/OPA and Medicaid. Shares all learnings and hot topics with management and staff.Keeps abreast of trends and issues by attending 340B trainings, monitoring industry publications and websites, professional media, literature, and peers to ensure that the institution has the latest information regarding interpretations, rulings, suggestions and advanced ideas for improving participation.Determines the best use of 340B program staff by collaborating with Prime Vendor Program, Pharmacy Leadership, and other 340B institutions.Registration/RecertificationEnsures that the annual HRSA recertification is completed within the allowable time frame.Ensures that the HRSA 340B Database is accurate for all organization entities.Ensures registration of any new child site within the allowable time frame.AuditingIs responsible for the oversight of required 340B audits, both internally and externally.Maintains a current state of “audit readiness.”Serves as the point person and coordinator for all audits. Coordinates all requests and responses. Coordinates external compliance assessments with outside firms, where appropriate, to validate internal processes.Leads 340B purchasing and utilization audits or compliance assessments internally, as needed to ensure compliance with all applicable regulations. This includes, self-audits of 340B processes, annual audit of contract pharmacies, and monthly audits of 340B eligible locations. Coordinates the remediation of findings.Routinely reviews data and related reports from all points of service at which 340B participation occurs to ensure that policies and procedures are followed, entity eligibility requirements are met, and all patients meet patient definition requirements.Works with medical auditors on third-party payer audits to ensure coordination of efforts and maximum collection.340B Contract ManagementManages relationships, billing services, and compliance with contracted 340B pharmacies. Evaluates all current and future contract pharmacy opportunities, including contract language, fee structure, data setup, and internal and independent external auditing. Program Enhancement/OptimizationDevelops strategies to appropriate use of the program working directly with manufacturers and wholesalersAssesses opportunities for cost savings, business and system improvementsParticipates in projects, councils and special initiatives related to 340B, compliance, auditing, vendor selection and medication management. Monitors all outpatient points of service to continually check for new areas that may qualify for the 340B program.Provides oversight for the implementation of process improvement initiatives and creates an environment that places an emphasis on continuous monitoring and improvement.Provides input and implements business plans in coordination with the organization’s pharmacy leadership for organizational facilities to help use 340B savings to expand and improve care provided to underserved and vulnerable populations; assists facilities to prioritize and implement outpatient program development and contract pharmacy agreements related to 340B; and assists the organization’s leadership with program development and optimization.Reporting and Financial AnalysisPrepares, monitors and reports measurements to ensure satisfaction with the 340B program.Develops, monitors, and presents reports on 340B participation that clearly document utilization, savings, problem areas, exceptions, and/or discrepancies to pharmacy and administrative leadership.Routinely communicates any questions, issues, or discrepancies with the appropriate authority.Reports monthly on saving municates key metrics and improvement actions to management.Ensures appropriate documentation and audit trail across areas of responsibility.Develops, monitors, maintains, and presents reports to managers and directors on budget variancesDevelops and prepares drug spend analysis for forecasting and budgeting Completes analytics on any department changes that may affect budget to make appropriate budgetary adjustmentsServes as the point person for finance as it relates to reporting needs for drug expenseOperationsResponsible for the day-to-day management, compliance review, and operations of clinic-administered medications in eligible locations, mixed-use areas managed by split-billing software, outpatient prescriptions fulfilled by an owned pharmacy, and outpatient prescriptions fulfilled by a contract 340B pharmacy.Responsible for managing and troubleshooting pharmacy billing issues and ensuring that adequate systems checks are reviewed to prevent billing issues.Participate in interviews, selection, orientation, and training of new employeesProvide input on staff performance including providing feedback for performance evaluations.Participate in staff meetings to communicate changes and address issues that need to be discussed.Address customer concerns/complaints as they arise.Assist in the implementation of policies and procedures and ensures uniform compliance.Utilize time tracking tools, as required by department to assure accurate project planning and budgeting needs. ALL DUTIES AND REQUIREMENTS MUST BE PERFORMED CONSISTENT WITH THE UW HEALTH PERFORMANCE STANDARDS.JOB REQUIREMENTSEducationMinimumBachelor’s degree in Pharmacy or a PharmD degreePreferredMaster’s Degree in health system pharmacy administration, business administration, or other relevant fieldsWork ExperienceMinimum Three (3) years of institutional experience (hospital—acute care, nursing home, home health care, integrated health system) PreferredThree (3) years of experience in pharmacy business operations with an emphasis on 340BLicenses & CertificationsMinimum Licensed or eligible for licensure to practice pharmacy in the State of WisconsinPreferredAdvanced 340B Operations Certificate (340B ACE)Required Skills, Knowledge, and AbilitiesExcellent verbal and written English communication skills.Excellent organizational and time management abilities.Effective interpersonal skills, including the ability to effect collaborative alliances, promote teamwork and ensure a high degree of internal and external customer satisfaction.Ability to work as a team player or autonomously with strong organizational skills, project management skills and attention to detail.Ability to work with vendors and other departments to keep multiple tasks on track and bring projects successfully to completion.Strong skills in standard Microsoft Office applications (Excel, Word, Outlook, Access)Ability to initiate and follow through on complex programs of both short and long term duration.Highly developed problem-solving skills including the ability to identify and resolve complex problemsAGE SPECIFIC COMPETENCY (Clinical jobs only)Identify age-specific competencies for direct and indirect patient care providers who regularly assess, manage and treat patients.Instructions: Indicate the age groups of patients served either by direct or indirect patient care by checking the appropriate boxes below. Next, Infants (Birth – 11 months)Adolescent (13 – 19 years)Toddlers (1 – 3 years)Young Adult (20 – 40 years)Preschool (4 – 5 years)Middle Adult (41 – 65 years)School Age (6 – 12 years)Older Adult (Over 65 years)JOB FUNCTIONSReview the employee’s job description and identify each essential function that is performed differently based on the age group of the patient.PHYSICAL REQUIREMENTSIndicate the appropriate physical requirements of this job in the course of a shift. Note: reasonable accommodations may be made available for individuals with disabilities to perform the essential functions of this position.Physical Demand LevelOccasionalUp to 33% of the timeFrequent34%-66% of the timeConstant67%-100% of the timexSedentary: Ability to lift up to 10 pounds maximum and occasionally lifting and/or carrying such articles as dockets, ledgers and small tools. Although a sedentary job is defined as one, which involves sitting, a certain amount of walking and standing is often necessary in carrying out job duties. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.Up to 10#NegligibleNegligibleLight: Ability to lift up to 20 pounds maximum with frequent lifting and/or carrying of objects weighing up to 10 pounds. Even though the weight lifted may only be a negligible amount, a job is in this category when it requires walking or standing to a significant degree.Up to 20#Up to 10# or requires significant walking or standing, or requires pushing/pulling of arm/leg controlsNegligible or constant push/pull of items of negligible weightMedium: Ability to lift up to 50 pounds maximum with frequent lifting/and or carrying objects weighing up to 25 pounds.20-50#10-25#Negligible-10#Heavy: Ability to lift up to 100 pounds maximum with frequent lifting and/or carrying objects weighing up to 50 pounds.50-100#25-50#10-20#Very Heavy: Ability to lift over 100 pounds with frequent lifting and/or carrying objects weighing over 50 pounds.Over 100#Over 50#Over 20#List any other physical requirements or bona fide occupational qualifications:Note:The purpose of this document is to describe the general nature and level of work performed by personnel so classified; it is not intended to serve as an inclusive list of all responsibilities associated with this position. ................
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