340B/Pharmacy Auditor

Description

About Jordan Valley Community Health Center:

Jordan Valley Community Health Center (JVCHC) is a mission-driven organization dedicated to improving the health of individuals and families in underserved communities. We provide comprehensive healthcare services including primary medical, dental, vision, and behavioral health. Our mission is simple: Improve our community’s health through access and relationships. By working collaboratively with partners and continually innovating, JVCHC strives to be a leader in providing essential healthcare for the underserved, ensuring everyone in our community has access to quality healthcare.

Job Summary

The 340B/Pharmacy Auditor is responsible for conducting E&M audits, Pharmacy audits, and ongoing review of 340B pharmacy utilizing established criteria and auditing tools. Auditor will be responsible for additional operational and compliance auditing processes to include reconciliation of any variances. Auditor will keep current with coding standards and 340B regulations and program changes, policy and procedures, and understanding, accessing and utilizing various vendor software as applicable. Auditor will prepare management reports of completed audits, benchmarking, trends, and patterns as well as other data metrics. Auditor will work with billing, coding, finance, and operations teams as appropriate. Auditor will participate in compliance meetings and vendor calls, as appropriate. Auditor will prepare management reports of completed audits, benchmarking, trends, and patterns as well as other data metrics. Auditor will assist the Director of Compliance in the completion of additional reports, reviews and gathering of data and metrics for investigations, audits, or certification/reviews as identified.

Key Responsibilities

• Performs monthly audits of contract pharmacy and in-house pharmacy claims per 340B Internal Audit program.
• Performs monthly audits of Clinic Administered Drugs per 340B Internal Audit program, including verification of correct billing.
• Performs monthly audits of clinic samples per 340B Internal Audit program.
• Keeps current with coding standards, 340B regulations/program changes, applicable service standards and regulations
• Responsible for ongoing coding and billing audit of all Pharmacy services provided in clinic
• Work alongside Pharmacist to develop and implement internal Pharmacy auditing and oversight of compliance.
• Compiles audit results and creates requested reports tailoring to appropriate audiences.
• Facilitates other on-going or periodic compliance audits as assigned by the annual work plan following the same plan to include process improvement and education opportunities and implementation.
• Assist the Director of Compliance in the completion of additional reports, reviews and gathering data and metrics for investigations, audits or certification/reviews as identified.
• Attends and participates in compliance meetings, departmental meetings, committee meetings, team meetings and vendor calls, as assigned. When requested, attendance will be in person.
• Attains all agreed goals and objectives within specified time frames, as part of the Clinic’s overall mission.
• Demonstrates respect and regard for the dignity of all patients, families, visitors and fellow employees to ensure a professional, responsible and courteous environment.
• Other projects and duties as assigned.
  
  

Benefits Overview

• Medical and Prescription Drug Coverage: Three comprehensive plan options (Buy-up, Base, and High Deductible) through UnitedHealthcare's Choice Plus network, covering various deductibles and out-of-pocket limits. Includes access to telemedicine services via Teladoc.
• Health Savings Account (HSA): Available for employees in the High Deductible Plan with employer contributions and tax advantages.
• Flexible Spending Account (FSA): Options for both healthcare and dependent care FSAs, allowing pre-tax contributions for qualified expenses.
• Dental and Vision Coverage: Dental insurance through Cigna’s DPPO network and vision coverage through EyeMed’s Insight network.
• Retirement Plan: Pre-tax and Roth 403(b) retirement plans with a 5% employer match starting after 30 days of employment.
• Life and Disability Insurance: Basic Life and AD&D insurance provided at no cost, with the option to purchase additional coverage. Long-term and short-term disability insurance are also available.
• Employee Assistance Program (EAP): Free confidential support for personal and professional challenges, including counseling and crisis intervention.
• Additional Voluntary Benefits: Options for critical illness, accident, hospital care, and pet insurance through MetLife.
• Pay On Demand Available
  
  

Holidays

• Nine paid holidays per year.
  
  

Health Requirements

All employees are required to provide proof of vaccination for Flu, Hepatitis B and Tuberculosis (TB) as part of our commitment to maintaining a safe and healthy workplace.

Application Process

Interested applicants should submit a resume and cover letter through the JVCHC career portal at Careers & Education - Jordan Valley. Applications will be accepted on a rolling basis until the position is filled.

Jordan Valley Community Health Center is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, or disability status.

Requirements

• Coding credential or coding auditing credential desired.
• Relevant degree, such as pharmacy, healthcare administration, or compliance desired
• Apexus 340B University training or Apexus ACE Certification desired
• Bachelor’s degree in related field preferred.
• Minimum of two years pharmacy auditing or experience is preferred.
• Clinical background preferred.