Director 340B Optimization
Employment Type : Full-Time
Shields Health Solutions is the first and largest hospital owned specialty pharmacy integrator. We help health systems create and accelerate specialty pharmacies blending science, care, and compassion with bottom line. Together with our 40+ national health system partners, we have the expertise and capabilities to make specialty pharmacy easy for both partners and patients. Shields provides the fastest, lowest-risk model for health systems to eliminate financial, execution and organizational risks.
Shields Health Solutions is looking to hire a Regional Director of 340B Optimization who will partner with health systems to optimize their 340B programs. The Director's responsibility is to maximize value for our health system partners in order to generate additional 340B savings and service a greater volume of the most vulnerable patient populations. This role will be at the forefront of a fast paced and growing opportunity, utilizing new technologies and innovative problem solving to advance 340B programs across the country. The Director will lead a team of 340B analysts and be responsible for all aspects of Shields' 340B services for their regions. This includes 340B implementation, operations, optimization, and advisory services. The Director will be the go-to 340B person for our clients' pharmacy, finance, operations teams, and will be an experienced thought partner on all 340B matters. The Director will be responsible for the relationship with the client on a day-to-day basis. The ideal candidate will be a great communicator with outstanding interpersonal skills, will be a subject matter expert in 340B while thinking strategically to drive value for our partners, will have exceptional analytical skills and a growth-oriented mindset, will be results-oriented in a highly entrepreneurial environment and will motivate the team to provide exceptional customer service and value to our partners.
Job Responsibilities and Duties:
- Serve as the thought leader on all 340B matters with credible experience working with and influencing pharmacy, finance and operations teams across health systems.
- Develop and drive 340B strategy across the regions, continuing to evolve 340B strategies based on the 340B Federal statute, HRSA guidelines, HRSA audit trends and industry knowledge.
- Maintain a thorough understanding of the 340B program, including monitoring legislative changes or proposed 340B regulations, and communicate current 340B trends and interpretations directly affecting SHS health system partners.
- Work directly with covered entity 340B administrators and compliance teams to monitor 340B program compliance, assist in quarterly audits and help covered entities prepare for HRSA audits
- Analyze 340B opportunities across the regions, including contract pharmacy expansion opportunities.
- Develop customized roadmaps and granular project plans for executing 340B enhancement strategies across the regions and project manage to completion. Drive the implementation and track execution of 340B strategies across our partners.
- Develop annual 340B strategy targets and guide health systems through the implementation of 340B strategies to increase the number of 340B eligible patients and drive 340B savings, this includes but is not limited to provider-based clinic conversions and implementation of Collaborative Drug Therapy Management programs.
- Project manage provider-based clinic conversions and implementation of collaborative drug therapy management programs
- Perform weekly audits of non-340B prescriptions dispensed by the partner pharmacy locations and analyze for missed opportunities. This includes gathering supporting documentation from the EMR to identify 340B optimization opportunities.
- Implement weekly / monthly tracking of 340B program savings generated by SHS 340B team through weekly non-340B audits and implementation of 340B enhancement strategies. Communicate those savings regularly to our partners in a consistent way.
- Develop an innate knowledge of SHS partner pharmacy dispensing systems, EMRs, as well as various 340B platforms to monitor 340B activity
- Implement 340B programs for new pharmacies including split-billing software set-up, workflow optimization and policies and procedures.
- Review Hospital Medicare Cost Reports and identify 340B eligible departments for opportunities.
- Develop and/or update 340B policies and procedures utilized by SHS partners to reflect 340B program best practices.
- Manage day-to-day operations of the team and ensure consistent practices are being utilized to monitor 340B program effectiveness, including reviewing wholesalers accounts for appropriate pricing, monitoring TPA logic, and TPA data extracts.
- Monitor compliance with Managed Medicaid and Medicaid Fee-for-Service requirements and ensure claims are billed appropriated
- Develop and update 340B program reporting detailing 340B volume, financial value, and other 340B KPIs as needed.
Skills and Position Requirements:
- Three plus years of previous experience with 340B program management is preferred
- Apexus 340B Certification preferred
- Entrepreneurial attitude - willingness to roll up his/her sleeves and work alongside team members to make things happen quickly and create value
- Must be highly motivated, results-driven professional who can thrive in a team-oriented environment
- Outstanding leadership skills – ability to lead the regional 340B team, motivate team members and serve as the subject matter expert for health system counterparts on all 340B related matters
- Must possess exceptional analytical, organizational, and problem-solving skills. Must have excellent written and verbal communication skills for interfacing with all levels of staff, physicians, patients, executives, and colleagues
- 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
- Ability to take a data-driven approach and distill complex subjects into structured frameworks and concrete action plans
- Ambitious, reliable, self-starter who is able to work independently, with limited oversight and is enthusiastic and customer-service oriented