Shields Health Solutions
Business Overview:
Shields Health Solutions (SHS) is the first and largest specialty pharmacy integrator and accelerator, providing innovative care for the nation’s chronically ill patient population. Shields creates and manages hospital-owned specialty pharmacy programs for hospitals and health systems that want to offer coordinated care services. Using an integrated approach to patient care through TelemetryRx, the Patient Liaison model, and a centralized clinical support team, SHS aims to deliver fully integrated care from clinic to pharmacy to the patient’s homes. Position Overview:
Shields Health Solutions is looking to hire a 340B Pharmacy Business Analyst, reporting to the regional Directors of 340B, to work directly with pharmacy compliance, finance, and operations individuals at its health system partners. The Pharmacy Business Analyst’s primary responsibility is to ensure pharmacy program compliance and generate additional 340B savings in order to service a greater volume of the most vulnerable patient populations. The 340B team is responsible for building and supporting a compliant 340B program for each of its clients while identifying opportunities for enhanced 340B savings. They will develop new 340B strategies, design policies and procedures aligned with 340B best practices, and work with regional operations teams to track the value of the 340B Program for SHS health system partners. Each SHS client relies on the 340B Program to operate effectively and to provide high-quality care to patients. They will interact with leaders across the business as we unlock value for the Company and our customers. Responsibilities
Develop a thorough understanding of the 340B program, monitor recent legislative changes or proposed 340B pharmacy regulations, and communicate current 340B trends and interpretations directly affecting SHS health system partners Work directly with health system 340B Compliance/Operations teams to monitor 340B Program compliance, audit non-340B prescriptions, identify new margin enhancement opportunities, and implement new 340B expansion strategies Develop an innate knowledge of all SHS partner pharmacy dispensing systems, EMRs, as well as various 340B platforms to monitor 340B activity Review Hospital Medicare Cost Reports and identify 340B eligible departments for new partner opportunities Track 340B Program savings generated by SHS health system partners Assist in implementing new 340B Third-Party Administrator (TPA) platforms for new hospital clients Develop and/or update 340B policies and procedures utilized by SHS partners to reflect 340B Program best practices and ensure partner 340B Program qualifications are met and maintained Assess and analyze each customers’ wholesaler accounts to ensure appropriate pricing is reflected for all medications Review each customer’s wholesaler catalog to confirm access to Limited Distribution Drugs (LDD) at all price points (340B & Non-340B) Ability to track LDD products dispensed as well as on-hand inventory levels in order to develop required reports by select PhRMA manufacturers Monitor 340B pricing restrictions issued by manufacturers and communicate SHS partner impact/SHS contribution profit Develop strategies in collaboration with SHS partners to consistently update eligible provider listings and data extracts utilized to identify 340B prescriptions Manage and track partner pharmacy activity dispensed through contract pharmacy arrangements. Create monthly reports to identify 340B revenue, dispensing fees, and corresponding COGS dispensed via contract pharmacy Maintain knowledge of pharmacy billing requirements for each State Medicaid agency Create daily reports to identify 340B eligible Managed Medicaid prescriptions and ensure appropriate 340B modifiers are included at the claim level to mitigate the risk of duplicate discounts Develop monthly reports and reprocess Medicaid Fee-for-Service prescriptions to reflect required acquisition cost reimbursement Perform weekly audits of non-340b prescriptions dispensed by partner pharmacy locations and gather 340B supporting documentation from the EMR to identify 340B optimization opportunities Collaborate with 340B Compliance teams and pharmacy liaisons to assess 340B eligibility for patients in cases in which the 340B price is the only procurement method Review and assess pharmacy purchasing trends by client in order to identify ordering inconsistencies or areas to improve purchasing efficiencies Evaluate available pricing offered to each client and identify cost savings opportunities via cheaper medication alternatives Collaborate with Shields Trade Relations group to obtain 340B pricing for drugs designated as an orphan drug for clients subject to the Orphan Drug Exclusion Develop and update 340B Program reporting detailing 340B volume, financial value, and other 340B KPIs as needed Expand professional development through 340B related classes and seminars, current publications, and 340B Coalition conference attendance Qualifications
3+ years experience National Pharmacy Technician license preferred Apexus 340B Certification preferred Entrepreneurial attitude - willingness to roll up sleeves to make things happen quickly and create value Must be highly motivated, results-driven professional who can thrive in a team-oriented environment Highly collaborative with team members to ensure overall success of the function Outstanding leadership potential Growth-mindset Highly analytical with strong attention to detail Exceptional technical skills and ability to navigate computer software, including medication management software, healthcare billing systems, electronic medical records, 340B third party administrators, pharmacy management and dispensing systems, and Microsoft applications Values-oriented, data-driven decision-making style Ability to distill complex issues into structured frameworks and concrete action plans Ambitious, reliable, self-starter who is able to work independently, with limited oversight from managers Effective at multi-tasking; someone who enjoys and thrives wearing multiple hats Outstanding written and verbal communication skills Enthusiastic and service-oriented Education
Bachelor’s Degree California residents employed by or applying for work at Shields have certain privacy rights. Please review our: California Workforce Privacy Notice and Privacy Policy. By providing your mobile number, you agree to receive text messages from Shields Health Solutions related to job opportunities, interview scheduling, and recruiting updates. Message and data rates may apply. You may opt out at any time by replying 'STOP.' Consent is not a condition of employment. Shields Health Solutions provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
#J-18808-Ljbffr
Shields Health Solutions (SHS) is the first and largest specialty pharmacy integrator and accelerator, providing innovative care for the nation’s chronically ill patient population. Shields creates and manages hospital-owned specialty pharmacy programs for hospitals and health systems that want to offer coordinated care services. Using an integrated approach to patient care through TelemetryRx, the Patient Liaison model, and a centralized clinical support team, SHS aims to deliver fully integrated care from clinic to pharmacy to the patient’s homes. Position Overview:
Shields Health Solutions is looking to hire a 340B Pharmacy Business Analyst, reporting to the regional Directors of 340B, to work directly with pharmacy compliance, finance, and operations individuals at its health system partners. The Pharmacy Business Analyst’s primary responsibility is to ensure pharmacy program compliance and generate additional 340B savings in order to service a greater volume of the most vulnerable patient populations. The 340B team is responsible for building and supporting a compliant 340B program for each of its clients while identifying opportunities for enhanced 340B savings. They will develop new 340B strategies, design policies and procedures aligned with 340B best practices, and work with regional operations teams to track the value of the 340B Program for SHS health system partners. Each SHS client relies on the 340B Program to operate effectively and to provide high-quality care to patients. They will interact with leaders across the business as we unlock value for the Company and our customers. Responsibilities
Develop a thorough understanding of the 340B program, monitor recent legislative changes or proposed 340B pharmacy regulations, and communicate current 340B trends and interpretations directly affecting SHS health system partners Work directly with health system 340B Compliance/Operations teams to monitor 340B Program compliance, audit non-340B prescriptions, identify new margin enhancement opportunities, and implement new 340B expansion strategies Develop an innate knowledge of all SHS partner pharmacy dispensing systems, EMRs, as well as various 340B platforms to monitor 340B activity Review Hospital Medicare Cost Reports and identify 340B eligible departments for new partner opportunities Track 340B Program savings generated by SHS health system partners Assist in implementing new 340B Third-Party Administrator (TPA) platforms for new hospital clients Develop and/or update 340B policies and procedures utilized by SHS partners to reflect 340B Program best practices and ensure partner 340B Program qualifications are met and maintained Assess and analyze each customers’ wholesaler accounts to ensure appropriate pricing is reflected for all medications Review each customer’s wholesaler catalog to confirm access to Limited Distribution Drugs (LDD) at all price points (340B & Non-340B) Ability to track LDD products dispensed as well as on-hand inventory levels in order to develop required reports by select PhRMA manufacturers Monitor 340B pricing restrictions issued by manufacturers and communicate SHS partner impact/SHS contribution profit Develop strategies in collaboration with SHS partners to consistently update eligible provider listings and data extracts utilized to identify 340B prescriptions Manage and track partner pharmacy activity dispensed through contract pharmacy arrangements. Create monthly reports to identify 340B revenue, dispensing fees, and corresponding COGS dispensed via contract pharmacy Maintain knowledge of pharmacy billing requirements for each State Medicaid agency Create daily reports to identify 340B eligible Managed Medicaid prescriptions and ensure appropriate 340B modifiers are included at the claim level to mitigate the risk of duplicate discounts Develop monthly reports and reprocess Medicaid Fee-for-Service prescriptions to reflect required acquisition cost reimbursement Perform weekly audits of non-340b prescriptions dispensed by partner pharmacy locations and gather 340B supporting documentation from the EMR to identify 340B optimization opportunities Collaborate with 340B Compliance teams and pharmacy liaisons to assess 340B eligibility for patients in cases in which the 340B price is the only procurement method Review and assess pharmacy purchasing trends by client in order to identify ordering inconsistencies or areas to improve purchasing efficiencies Evaluate available pricing offered to each client and identify cost savings opportunities via cheaper medication alternatives Collaborate with Shields Trade Relations group to obtain 340B pricing for drugs designated as an orphan drug for clients subject to the Orphan Drug Exclusion Develop and update 340B Program reporting detailing 340B volume, financial value, and other 340B KPIs as needed Expand professional development through 340B related classes and seminars, current publications, and 340B Coalition conference attendance Qualifications
3+ years experience National Pharmacy Technician license preferred Apexus 340B Certification preferred Entrepreneurial attitude - willingness to roll up sleeves to make things happen quickly and create value Must be highly motivated, results-driven professional who can thrive in a team-oriented environment Highly collaborative with team members to ensure overall success of the function Outstanding leadership potential Growth-mindset Highly analytical with strong attention to detail Exceptional technical skills and ability to navigate computer software, including medication management software, healthcare billing systems, electronic medical records, 340B third party administrators, pharmacy management and dispensing systems, and Microsoft applications Values-oriented, data-driven decision-making style Ability to distill complex issues into structured frameworks and concrete action plans Ambitious, reliable, self-starter who is able to work independently, with limited oversight from managers Effective at multi-tasking; someone who enjoys and thrives wearing multiple hats Outstanding written and verbal communication skills Enthusiastic and service-oriented Education
Bachelor’s Degree California residents employed by or applying for work at Shields have certain privacy rights. Please review our: California Workforce Privacy Notice and Privacy Policy. By providing your mobile number, you agree to receive text messages from Shields Health Solutions related to job opportunities, interview scheduling, and recruiting updates. Message and data rates may apply. You may opt out at any time by replying 'STOP.' Consent is not a condition of employment. Shields Health Solutions provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
#J-18808-Ljbffr