Mount Sinai Careers
340B Program Coordinator II - Pharmacy
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340B Program Coordination:
- Serves as primary internal and external program coordinator and liaison for all 340B-related matters.
- Serves as the institutional “compliance expert or authority” on 340B regarding program details, policies, and procedures of the virtual inventory processes required for mixed-use areas.
- Serves as primary internal liaison to key stakeholders to help ensure appropriate utilization of the 340B program and compliance with all program requirements.
- Acts as the liaison with necessary affiliated departments to ensure 340B program integrity.
- Provides oversight and leadership from the department of pharmacy for the 340B program.
- Provides expertise with the 340B program to staff and participants regarding ongoing compliance.
- Develops and maintains internal relationships (accounting, legal, national) and external relationships (wholesalers, manufacturers, contract pharmacies, split-billing software vendors, employee benefit pharmacy benefits managers (PBMs), and third-party administrator (TPA) vendors) as needed.
- Serves as the institutional compliance liaison on 340B.
- Acts as a liaison to the department of pharmacy and regional facilities as well as with the organization’s purchasing office.
- Actively engages with senior leadership and participates in decision-making processes related to the implementation of new 340B processes.
Policy and Procedure Development:
- Ensures that policies and procedures are developed and implemented according to organizational, regional, national, state, and federal requirements and guidelines and are approved by the institution’s legal department.
- Assists organizational leadership to develop a regular compliance audit program.
- Contributes processes and materials to promote programs or support the goals of the department and institution.
- Establishes consistent policies and procedures for 340B that ensure productivity and efficiency so that long-term management of the program does not hamper operations or create unnecessary costs.
- Develops and modifies 340B policies in accordance with state, federal, and system program requirements.
- Monitors and assesses 340B guidance and or rule changes. Attends regular 340B trainings and shares learnings and hot topics with staff.
- Routinely monitors industry publications and websites as well as the professional media, literature, and peers to ensure that the institution has the latest information regarding interpretations, rulings, suggestions, and advanced ideas for improving participation.
- Ensures that the 340B pharmacy program is continuously compliant with 340B federal regulations.
- Maintains knowledge of the policy changes that affect the 340B program, including, but not limited to, HRSA/OPA rules and Medicaid changes.
- Provides expertise on all 340B program legislation and policy changes from HRSA and OPA, informing and collaborating with legal and compliance teams.
- Collaborates with the Prime Vendor Program, pharmacy leadership, and other 340B institutions to determine the most appropriate use of the 340B program staff.
- Develops knowledge and maintains awareness of current regulations, trends, and issues pertaining to the 340B program.
- Keeps abreast of trends and issues pertaining to the program and relays applications and interpretations to assist departments.
- Serves as the point person and coordinator for all audits. Coordinates all requests and responses. Maintains a current state of “audit readiness.”
- Works with medical auditors on third-party payer audits to ensure coordination of efforts and maximum collection.
- Provides oversight for all audits performed by independent external auditors.
- Coordinates external compliance assessments with outside firms, where appropriate, to validate internal processes.
340B Contract Management:
- Reviews and negotiates any new 340B contracts. Maintains all 340B contracts.
- Manages 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.
- Works directly with manufacturers, as well as through GPO and peer professional relationships, to determine companies that are contracting with inpatient facilities to offer 340B or equivalent pricing and develops strategies to maximize such participation.
- Assesses opportunities for cost savings and business improvements in 340B contract pharmacy utilization.
- Assesses opportunities for cost savings and system improvements to yield higher compliance.
- Oversees the 340B contract pharmacy marketing program to attract and retain qualified retail pharmacy contracts and serve eligible patients.
- Analyzes utilization of the program and existing software to identify ways to compliantly use the 340B program to its fullest extent to meet the needs of underserved patients.
- Works directly with the manufacturers as well as the wholesalers to develop strategies for appropriate use of the program.
- Participates in projects, councils, and special initiatives related to 340B, compliance, auditing functions, vendor selection, and medication management.
- Develops business plans to prioritize and implement programs related to program services and contract pharmacy agreements.
- Develops action plans to close identified gaps in collaboration with organizational leadership.
- Participates in projects, councils, and special initiatives related to 340B.
- Implements business plans in coordination with organizational pharmacy leadership at these facilities to help use 340B savings to expand and improve care provided to underserved and vulnerable populations.
- Collaborates with department leadership to improve and enhance service offerings.
- Implements programs that address the programmatic needs of the department and institution.
- 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 organization 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.
- Tracks and reports program savings on a regular basis; communicates to the leadership team on an ongoing basis.
- Routinely monitors monthly and annual reports on 340B participation that clearly document utilization, savings, problem areas, and exceptions or discrepancies, to be passed on to pharmacy leadership and administration.
- Develops routine reports that are a by-product of the inventory process and software, allowing for concise information to be communicated to the leadership responsible for 340B inventory management.
- Constructs appropriate financial metrics to assess areas of improvement.
- Prepares and assists in the monitoring and various tracking and reporting measurements to ensure compliance with the program.
- Reviews and refines 340B cost savings reports detailing purchasing and replacement practices, as well as dispensing patterns.
- Coordinates monthly financial reporting and analysis, including, but not limited to, metric reporting, scorecards, and variance analysis and reporting.
- Participates in the development and implementation of reports generated on the 340B program that outline savings, utilization, exceptions, and discrepancies.
- Ensures that reporting meets organizational, regional, national, state, and federal requirements/guidelines.
- Prepares and assists in the monitoring and reporting measurements to ensure satisfaction with the 340B program.
- Maintains records related to job function and contributes to reports.
- 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 opportunities.
- Communicates key metrics and improvement actions to management.
- Ensures appropriate documentation and audit trail across areas of responsibility.
- Monitors purchasing records for each 340B participant; clearly documents utilization, savings, problem areas, and exceptions or discrepancies. Relays results to pharmacy leadership and administration.
- Monitors for 340B pricing exclusions or shortages and establishes appropriate alternative products that are included where possible, including work with medical staff and formulary to ensure proper position and related use.
- Participates with the prime vendor and routinely reviews 340B formulary pricing, potential alternatives, and possible additional savings as a result of GPO formulary.
- Manages and tracks 340B drug inventory, including proper replenishment.
- Tracks, trends, and reports 340B pharmaceutical sales and purchases data to ensure provider/physician and patient eligibility.
- Manages purchasing, receiving, and inventory control processes.
- Continuously monitors product min/max levels to effectively balance product availability and cost-efficient inventory control.
- Maintains system databases to reflect changes in the drug formulary or product specifications.
- Optimizes purchasing of supplies and medications from the 340 program.
- Ensures compliance with regulations related to 340B purchasing.
- May be required to work on inventory management of the 340B program and offer input as to the application’s overall functionality and opportunities for improving compliance and or efficiency.
- Routinely monitors utilization records and 340B purchasing accounts to ensure that software or tools are working properly.
- Performs thorough quarterly reviews of the new 340B pricing list to search for and quickly address costly changes.
- Oversees 340B regulatory aspects of the inventory purchasing process for outpatient, inpatient, and mixed-use areas.
- Regularly monitors 340B purchasing activity and compliance with established protocols.
- Ensures the effective delivery and distribution of pharmaceuticals and pharmaceutical products as they relate to 340B.
- Establishes a routine approach to updating the CDM/crosswalk for new products and product changes to ensure both the accuracy of the utilization report and the efficiency and accuracy of the charge process.
- Maintains 340B split-billing software integrity and reviews applicable reports to identify areas for improvement.
- Assists in implementing new software packages and other changes in business practice based on changing regulations and policies.
- Is responsible for maintenance and testing of tracking software.
- Integrates information from the pharmacy chargemaster system into the 340B split-billing computer system and incorporates that information into auditable and compliant processes.
- Works with outpatient pharmacy management and pharmacy informatics teams to ensure that the organization’s clinical information system is coordinated and integrated into the work with the 340B program. This shall include the electronic interfaces between the EMR and the virtual accumulator and any interfaces between the organization and contract pharmacy providers and/or administrators. Ensures split-billing software integrity and reviews applicable reports for areas of improvement.
- Periodically performs spot audits or compliance assessments in specific areas and specific products to ensure that the CDM is accurate, charges are coming across accurately, and the utilization numbers are translating accurately into report for 340B reorders.
- Oversees split-billing software maintenance.
- Bachelor's Degree preferred; an equivalent combination of education and/or experience may substitute for the degree when the experiences are closely related to the duties of the job.
- 3 years of experience with a 340B-eligible covered entity preferred
- Pharmacy Technician Certification Board (PTCB) preferred
Who We Are:
Over 35,000 employees strong, the mission of the Mount Sinai Health System is to provide compassionate patient care with seamless coordination and to advance medicine through unrivaled education, research, and outreach in the many diverse communities we serve.
Formed in September 2013, The Mount Sinai Health System combines the excellence of the Icahn School of Medicine at Mount Sinai with seven premier hospital campuses, including Mount Sinai Beth Israel, Mount Sinai Beth Israel Brooklyn, The Mount Sinai Hospital, Mount Sinai Queens, Mount Sinai West (formerly Mount Sinai Roosevelt), Mount Sinai St. Luke’s, and New York Eye and Ear Infirmary of Mount Sinai.
The Mount Sinai Health System is committed to the tenets of diversity and workforce that are strengthened by the inclusion of and respect for our differences. We offer our employees a highly competitive compensation and benefits package, a 403(b) retirement plan, and much more.
The Mount Sinai Health System is an equal opportunity employer. We promote recognition and respect for individual and cultural differences, and we work to make our employees feel valued and appreciated, whatever their race, gender, background, or sexual orientation.