TriHealth
Pharmacy Compliance Auditor – 340B Program
Join to apply for the
Pharmacy Compliance Auditor – 340B Program
role at
TriHealth .
Job Description Play a vital role in ensuring access to affordable medications for underserved communities. Protect the integrity of the 340B Drug Pricing Program—a federal initiative that enables healthcare organizations to stretch resources and provide comprehensive care.
As a Pharmacy Compliance Auditor, you’ll work closely with pharmacy leadership to conduct audits, monitor compliance, and identify opportunities for improvement. This role offers the chance to develop specialized expertise in 340B operations, gain advanced certifications, and make a meaningful impact on patient care and organizational success.
Minimum Job Requirements
Minimum of High School Degree or GED is required
Must successfully complete Apexus 340B University within the first 6 months in the position.
Advanced 340B Operations Certificate within the first 12 months.
Minimum of 2-3 years of experience in one or more of the following: Hospital Pharmacy Technician, Pharmacy purchasing, 340B Program operations.
Job Overview The Pharmacy Compliance Auditor works under the supervision of the Sr. Director of Pharmacy and guidance of the 340B Pharmacy Compliance Coordinator to audit and monitor the 340B Program. Functions include execution and documentation of daily, weekly, monthly, and quarterly audits to verify adherence with the 340B Program regulations and/or guidelines as outlined in 340B policies and procedures.
Job Responsibilities Accurately and efficiently perform 340B audits on a scheduled basis, including contract pharmacy, mixed use pharmacy, and outpatient pharmacy, and ensure compliance with the 340B Program. Address reconciliations that arise. Monitor and audit state Medicaid claims using Excel to filter out non-eligible transactions. Evaluate patient eligibility for qualified and non-qualified patients in mixed-use areas and clinics. Maintain and audit the Prescriber file provided by Medical Staffing Office. Assist with external audits as assigned.
Maintain easily retrievable copies of audits and reports for compliance and audit purposes. Review findings, identify issues, and steps taken to reconcile the issue with the Pharmacy Compliance Coordinator. Ensure that reporting meets organizational, regional, national, state, and federal requirements/guidelines. Routinely monitor industry publications, websites, and that organization has latest updates and information. Sign up for 340B webinars.
Audit Contract Pharmacy matches, analyze causes of incorrect accumulations, and reverse incorrect matches. Identify and accumulate eligible matches from suspects. Maintain records of purchases sent to Contract Pharmacies and payments made to the Covered Entity. Audit Outpatient Pharmacy matches, analyze causes of incorrect accumulations, and reverse incorrect matches. Audit whether correct pricing plan was applied to Medicaid/Managed Medicaid. Audit the sub-clarification code 20 application to all FFS and MCO Medicaid claims, as well as verifying that the 08 code was applied. Identify and accumulate eligible matches from suspects.
Responsible for loan‑borrow tracking. Maintain records and facilitate inventory reconciliations. Compile purchasing information such as list of TriHealth purchasing accounts. Provide Pharmacy Buyers with information needed to place orders using appropriate accounts to replenish inventory in the mixed‑use inventory setting. Verify data integrity within 340B software and wholesaler/vendor purchase reports after corrections and rebills are made and approve the order review in the queue. Provide root cause analysis and corrections of NDCs. Identify and submit Individual wastes.
Other Job‑Related Information
Healthcare system knowledge base/skills
Proficiency in Microsoft Office software, specifically Excel, Word, and Outlook
Ability to quickly learn technical systems such as EMR systems, retail pharmacy systems, and/or 340B software systems
Ability to work in a complex team environment and to collaborate with peers to complete required work
Strong interest in pharmacy practice advancement
Excellent verbal and written communication skills; communication style that is open and fosters trust, credibility and understanding.
Working Conditions
Climbing – Rarely
Concentrating – Consistently
Continuous Learning – Consistently
Hearing: Conversation – Frequently
Interpersonal Communication – Consistently
Kneeling – Rarely
Lifting
Lifting 50+ lbs. – Rarely
Lifting 11‑50 lbs. – Rarely
Pulling – Rarely
Pushing – Rarely
Reaching – Rarely
Reading – Consistently
Sitting – Consistently
Standing – Occasionally
Stooping – Rarely
Thinking/Reasoning – Consistently
Use of Hands – Occasionally
Color Vision – Consistently
Walking – Occasionally
TriHealth SERVE Standards and ALWAYS Behaviors
Serve: ALWAYS… Welcome everyone by making eye contact, greeting with a smile, and saying “hello”
Serve: ALWAYS… Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist
Serve: ALWAYS… Refrain from using cell phones for personal reasons in public spaces or patient care areas
Excel: ALWAYS… Recognize and take personal responsibility to address and recover from service breakdowns when a customer’s expectations have not been met
Excel: ALWAYS… Offer patients and guests priority when waiting (lines, elevators)
Excel: ALWAYS… Work on improving quality, safety, and service
Respect: ALWAYS… Respect cultural and spiritual differences and honor individual preferences.
Respect: ALWAYS… Respect everyone’s opinion and contribution, regardless of title/role.
Respect: ALWAYS… Speak positively about my team members and other departments in front of patients and guests.
Value: ALWAYS… Value the time of others by striving to be on time, prepared and actively participating.
Value: ALWAYS… Pick up trash, ensuring the physical environment is clean and safe.
Value: ALWAYS… Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste.
Engage: ALWAYS… Acknowledge wins and frequently thank team members and others for contributions.
Job Keywords Accredited Pharmacy Technician, Certified Pharmacy Technician (CPhT), Chemotherapy Pharmacy Technician (Chemo Pharmacy Technician), Compounding Technician, OR Pharmacy Tech (Operating Room Pharmacy Tech), RPhT (Registered Pharmacy Technician).
About Us Careers at TriHealth are diverse. From clinical to administrative, sales to service, our team members contribute skills that are as varied as the services we offer and the people we serve. As an employer, TriHealth demonstrates the organization’s values by offering comprehensive benefits packages, competitive wages, and milestone recognition. Explore our career options to help you determine the type of job best for you as well as help narrow your search within our website. We look forward to you joining the TriHealth family!
Get notified about new Compliance Auditor jobs in
Norwood, OH .
Seniority level
Mid‑Senior level
Employment type
Full‑time
Job function
Finance and Sales
Industries
Hospitals and Health Care
Referrals increase your chances of interviewing at TriHealth by 2x.
#J-18808-Ljbffr
Pharmacy Compliance Auditor – 340B Program
role at
TriHealth .
Job Description Play a vital role in ensuring access to affordable medications for underserved communities. Protect the integrity of the 340B Drug Pricing Program—a federal initiative that enables healthcare organizations to stretch resources and provide comprehensive care.
As a Pharmacy Compliance Auditor, you’ll work closely with pharmacy leadership to conduct audits, monitor compliance, and identify opportunities for improvement. This role offers the chance to develop specialized expertise in 340B operations, gain advanced certifications, and make a meaningful impact on patient care and organizational success.
Minimum Job Requirements
Minimum of High School Degree or GED is required
Must successfully complete Apexus 340B University within the first 6 months in the position.
Advanced 340B Operations Certificate within the first 12 months.
Minimum of 2-3 years of experience in one or more of the following: Hospital Pharmacy Technician, Pharmacy purchasing, 340B Program operations.
Job Overview The Pharmacy Compliance Auditor works under the supervision of the Sr. Director of Pharmacy and guidance of the 340B Pharmacy Compliance Coordinator to audit and monitor the 340B Program. Functions include execution and documentation of daily, weekly, monthly, and quarterly audits to verify adherence with the 340B Program regulations and/or guidelines as outlined in 340B policies and procedures.
Job Responsibilities Accurately and efficiently perform 340B audits on a scheduled basis, including contract pharmacy, mixed use pharmacy, and outpatient pharmacy, and ensure compliance with the 340B Program. Address reconciliations that arise. Monitor and audit state Medicaid claims using Excel to filter out non-eligible transactions. Evaluate patient eligibility for qualified and non-qualified patients in mixed-use areas and clinics. Maintain and audit the Prescriber file provided by Medical Staffing Office. Assist with external audits as assigned.
Maintain easily retrievable copies of audits and reports for compliance and audit purposes. Review findings, identify issues, and steps taken to reconcile the issue with the Pharmacy Compliance Coordinator. Ensure that reporting meets organizational, regional, national, state, and federal requirements/guidelines. Routinely monitor industry publications, websites, and that organization has latest updates and information. Sign up for 340B webinars.
Audit Contract Pharmacy matches, analyze causes of incorrect accumulations, and reverse incorrect matches. Identify and accumulate eligible matches from suspects. Maintain records of purchases sent to Contract Pharmacies and payments made to the Covered Entity. Audit Outpatient Pharmacy matches, analyze causes of incorrect accumulations, and reverse incorrect matches. Audit whether correct pricing plan was applied to Medicaid/Managed Medicaid. Audit the sub-clarification code 20 application to all FFS and MCO Medicaid claims, as well as verifying that the 08 code was applied. Identify and accumulate eligible matches from suspects.
Responsible for loan‑borrow tracking. Maintain records and facilitate inventory reconciliations. Compile purchasing information such as list of TriHealth purchasing accounts. Provide Pharmacy Buyers with information needed to place orders using appropriate accounts to replenish inventory in the mixed‑use inventory setting. Verify data integrity within 340B software and wholesaler/vendor purchase reports after corrections and rebills are made and approve the order review in the queue. Provide root cause analysis and corrections of NDCs. Identify and submit Individual wastes.
Other Job‑Related Information
Healthcare system knowledge base/skills
Proficiency in Microsoft Office software, specifically Excel, Word, and Outlook
Ability to quickly learn technical systems such as EMR systems, retail pharmacy systems, and/or 340B software systems
Ability to work in a complex team environment and to collaborate with peers to complete required work
Strong interest in pharmacy practice advancement
Excellent verbal and written communication skills; communication style that is open and fosters trust, credibility and understanding.
Working Conditions
Climbing – Rarely
Concentrating – Consistently
Continuous Learning – Consistently
Hearing: Conversation – Frequently
Interpersonal Communication – Consistently
Kneeling – Rarely
Lifting
Lifting 50+ lbs. – Rarely
Lifting 11‑50 lbs. – Rarely
Pulling – Rarely
Pushing – Rarely
Reaching – Rarely
Reading – Consistently
Sitting – Consistently
Standing – Occasionally
Stooping – Rarely
Thinking/Reasoning – Consistently
Use of Hands – Occasionally
Color Vision – Consistently
Walking – Occasionally
TriHealth SERVE Standards and ALWAYS Behaviors
Serve: ALWAYS… Welcome everyone by making eye contact, greeting with a smile, and saying “hello”
Serve: ALWAYS… Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist
Serve: ALWAYS… Refrain from using cell phones for personal reasons in public spaces or patient care areas
Excel: ALWAYS… Recognize and take personal responsibility to address and recover from service breakdowns when a customer’s expectations have not been met
Excel: ALWAYS… Offer patients and guests priority when waiting (lines, elevators)
Excel: ALWAYS… Work on improving quality, safety, and service
Respect: ALWAYS… Respect cultural and spiritual differences and honor individual preferences.
Respect: ALWAYS… Respect everyone’s opinion and contribution, regardless of title/role.
Respect: ALWAYS… Speak positively about my team members and other departments in front of patients and guests.
Value: ALWAYS… Value the time of others by striving to be on time, prepared and actively participating.
Value: ALWAYS… Pick up trash, ensuring the physical environment is clean and safe.
Value: ALWAYS… Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste.
Engage: ALWAYS… Acknowledge wins and frequently thank team members and others for contributions.
Job Keywords Accredited Pharmacy Technician, Certified Pharmacy Technician (CPhT), Chemotherapy Pharmacy Technician (Chemo Pharmacy Technician), Compounding Technician, OR Pharmacy Tech (Operating Room Pharmacy Tech), RPhT (Registered Pharmacy Technician).
About Us Careers at TriHealth are diverse. From clinical to administrative, sales to service, our team members contribute skills that are as varied as the services we offer and the people we serve. As an employer, TriHealth demonstrates the organization’s values by offering comprehensive benefits packages, competitive wages, and milestone recognition. Explore our career options to help you determine the type of job best for you as well as help narrow your search within our website. We look forward to you joining the TriHealth family!
Get notified about new Compliance Auditor jobs in
Norwood, OH .
Seniority level
Mid‑Senior level
Employment type
Full‑time
Job function
Finance and Sales
Industries
Hospitals and Health Care
Referrals increase your chances of interviewing at TriHealth by 2x.
#J-18808-Ljbffr