340B Auditor Jobs (NOW HIRING)

Site: Mass General Brigham Incorporated

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Job Summary

Program Director 340B MGB Enterprise
The Opportunity
MGB Enterprise 340B Program Director position is Full Time, M-F with comprehensive benefits that start Day 1.
This role is Hybrid with planned meetings.
The 340B Program Director oversees 9 entities for this large scale, complex enterprise program. This is a highly visible role with growth opportunity. MGB is looking for a strong director, who can lead and has a strong skill set in business pharmacy operations and development. The director owns the compliance and operational aspects of the program, managing the day to day and engaged in stakeholder meetings. The team is comprised of 15 employees now (direct and indirect reports) and is evolving.
The Opportunity
The Director is responsible for leading the operational and compliance aspects of the pharmacy business services, including financial management and compliance with the 340B Drug Pricing Program. This role ensures the efficient delivery of pharmacy services across all care settings, maximizes cost savings, and maintains adherence to regulatory requirements.
Reporting to the Enterprise Director of Pharmacy Strategy and Business Development, The Enterprise 340B Program Director is responsible for planning, implementing, supporting, and optimizing projects related to the 340B program at Mass General Brigham health system. 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 director will oversee all uses of the split billing and financial software. The Enterprise 340B Program Director serves as the institutional compliance expert and authority on 340B program details and oversees all 340B Program Services. This position functions as the primary 340B program contact, HRSA Primary Contact and liaison for all 340B subject matters.
Assists and leads the various System 340B oversight committees. Develops relationships and works with leadership, staff and external vendors as related to the 340B program. Prepares/Manages Budget and Human Resource matters.
Responsibilities include:
A. Training and Education
a. Develops training and competency materials for all staff who work with the 340B program.
b. Conducts ongoing 340B program training for staff.
c. 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.
B. Policies and Procedures
a. Develops, implements, and modifies consistent policies and procedures according to all applicable guidelines as approved by the legal department
b. Ensures that policies and procedures support maximum productivity and efficiency to avoid any unnecessary costs or operational barriers
C. Compliance
a. Continually 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.
b. 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.
c. Determines the best use of 340B program staff by collaborating with Prime Vendor Program, Pharmacy Leadership, and other 340B institutions.
D. Registration/Recertification
a. Ensures that the annual HRSA recertification is completed within the allowable time frame.
b. Ensures that the HRSA 340B Database is accurate for all organization entities.
c. Ensures registration of any new child site within the allowable time frame.
E. Auditing
a. Is responsible for the oversight of required 340B audits, both internally and externally.
b. Maintains a current state of "audit readiness."
c. Serves as the point person and coordinator for all audits.
i. Coordinates all requests and responses.
ii. Coordinates external compliance assessments with outside firms, where appropriate, to validate internal processes.
d. 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.
e. 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.
f. Works with medical auditors on third-party payer audits to ensure coordination of efforts and maximum collection.
g. Lead and implement automation software such a Robotic Process Automation, RPAs, and 340B ESP submissions.
F. 340B Contract Management
a. Manages relationships, billing services, and compliance with contracted 340B pharmacies.
Mass General Brigham
b. Evaluates all current and future contract pharmacy opportunities, including contract language, fee structure, data setup, and internal and independent external auditing.
G. Program Enhancement/Optimization
a. Develops strategies to appropriate use of the program working directly with manufacturers and wholesalers
b. Assesses opportunities for cost savings, business and system improvements
c. Participates in projects, councils and special initiatives related to 340B, compliance, auditing, vendor selection and medication management.
d. Monitors all outpatient points of service to continually check for new areas that may qualify for the 340B program.
e. Provides oversight for the implementation of process improvement initiatives and creates an environment that places an emphasis on continuous monitoring and improvement.
f. 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.
H. Reporting and Financial Analysis
a. Prepares, monitors and reports measurements to ensure satisfaction with the 340B program.
b. Develops, monitors, and presents reports on 340B participation that clearly document utilization, savings, problem areas, exceptions, and/or discrepancies to pharmacy and administrative leadership.
c. Routinely communicates any questions, issues, or discrepancies with the appropriate authority.
d. Reports monthly on saving opportunities.
e. Communicates key metrics and improvement actions to management.
f. Ensures appropriate documentation and audit trail across areas of responsibility.
g. Develops, monitors, maintains, and presents reports to managers and directors on budget variances
h. Develops and prepares drug spend analysis for forecasting and budgeting
i. Completes analytics on any department changes that may affect budget to make appropriate budgetary adjustments
j. Serves as the point person for finance as it relates to reporting needs for drug expense
I. Operations
a. Responsible 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.
b. Responsible for managing and troubleshooting pharmacy billing issues and ensuring that adequate systems checks are reviewed to prevent billing issues.
c. Participate in interviews, selection, orientation, and training of new employees
d. Provide input on staff performance including providing feedback for performance evaluations.
e. Participate in staff meetings to communicate changes and address issues that need to be discussed.
f. Address customer concerns/complaints as they arise.
g. Assist in the implementation of policies and procedures and ensures uniform compliance.
h. Utilize time tracking tools, as required by department to assure accurate project planning and budgeting needs.

What You'll Bring

• Healthcare knowledge and experience 8-10+ years preferred
• Bachelor's Degree Pharmacy required
• Master's Degree Pharmacy preferred
• Master's Degree Related Field of Study preferred
• Pharm D or clinical license, MA state license highly preferred

• Develop and maintain policies and procedures related to 340B program operations.
• Coordinate with internal and external stakeholders to maximize program benefits and address compliance issues.
• Communicate latest information, rulings, and trends around 340B Program to ensure all institutional
• stakeholders have the latest information
• Develop, monitor and track 340B Program performance and KPIs, including those for individual enhancement initiatives
• Performs other duties as assigned
• Complies with all policies and standards

Working Model Requirements

• M-F Eastern Business Hours
• Quarterly business reviews and planned team and/or stakeholder meetings will be onsite
• Must be Flexible for quarterly workdays in office, as planned for the business needs, generally the team meets 2-4x quarterly
• Remote workdays require stable, secure, quiet, compliant work space

Hybrid

399 Revolution Drive

40

Regular

Day (United States of America)

Pay Range

$124,342.40 - $180,897.60/Annual

Grade

9

At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.

0100 Mass General Brigham Incorporated is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.

Mass General Brigham Competency Framework