Posted in Other 8 days ago.
Location:
Hollywood, Florida
At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience.
Summary:
The Corporate Finance 340B Internal Auditor is responsible for surveillance and auditing of pharmacy processes, medication-related activities and applicable software-related transactions across 340B eligible areas within Memorial Healthcare System. Responsible for preparing responses to transaction audits, including audits by finance or payors, drug utilization audits, and review of ineligible 340B claims.
Responsibilities:
Develops audit tools for proper identification, reconciliation, and resolution. Escalates any identified issues as they arise during the monitoring, auditing and reconciliation process.
Develops and fosters working relationships with external and internal applicable working counterparts (i.e. nursing, IT, compliance, revenue & reimbursement, Finance, 340B, and others) to provide data and analytics, report issues, mitigate findings, and facilitate productive exchange of information to achieve and sustain compliance.
Performs pharmacy claim documentation audits to ensure compliance and adherence to established programs, regulations, policies and procedures, and at-risk transactions on a routine basis as established by department lead.
Responsible for identifying risk areas and analyzing of 340B Policy in day-today 340B pharmacy operations.
Integrates applicable information from the pharmacy operating systems and any applicable platform and incorporates such information into auditable and compliant processes.
Maintains applicable 340B software integrity, including updates. Reviews applicable reports to identify ineligible claims and areas to improve capture rate.
Works with internal and external parties to develop and validate action plans. Follows up on progress and completion of action plans as necessary.
Competencies:
ACCOUNTABILITY, ACCURACY, ANALYSIS AND DECISION MAKING, CUSTOMER SERVICE, DEVELOPING RELATIONSHIPS, PROBLEM SOLVING, RESPONDING TO CHANGE, STANDARDS OF BEHAVIOR, THIRD PARTY AUDITS
Education and Certification Requirements:
High School Diploma or Equivalent (Required)
Additional Job Information:
Complexity of Work: Requires initiative, critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work demonstrate a resilient and can do attitude. Be able to respond to change positively. Required Work Experience: Five (5) years of experience in a pharmacy setting, hospital administration, finance, and or related field.
Working Conditions and Physical Requirements:
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