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Department:

Pharmacy

The 340B Program Auditor is responsible for conducting comprehensive audits of 340B prescription claims, verifying patient eligibility, prescriber-location relationships, and ensuring site compliance to maintain the hospital's eligibility and prevent diversion in the 340B Drug Pricing Program. This role supports both in-house and contract pharmacy auditing, provides documentation for HRSA audit readiness, and ensures adherence to federal program requirements.

Daily and Weekly Auditing Operations:

• Review accumulations and dispensing events from third party administrator (TPA) and contract pharmacy management systems
• Validate prescriber-patient-location relationships for each claim to ensure compliance
• Identify and document exceptions or potential diversion risks
• Perform monthly compliance audits of contract pharmacies, hospital-owned retail pharmacies, specialty pharmacies, and hospital mixed-use pharmacy operations
• Monitor and audit state Medicaid claims to ensure compliance and prevent duplicate discounts

Patient and Provider Eligibility Verification:

• Perform monthly compliance audits of patient eligibility criteria

• Verify provider eligibility and location eligibility requirements

• Review utilization records and 340B purchasing accounts to ensure software tools are working properly and accurately

• Conduct targeted audits and negative audits to identify additional eligibility opportunities

System Maintenance and Data Management:

• Maintain 340B Program software to ensure appropriate products are mapped to correct charge codes and ratios

• Perform daily maintenance of 340B Split Billing Software

• Upload purchase data to 340B Split Billing Software monthly for all purchases made outside of wholesaler

• Conduct monthly audits to verify mapping accuracy in 340B Split Billing Software

• Update charge code billing units from EHR into split-billing software for accuracy and consistency

​ Compliance Documentation and Reporting:

• Prepare and maintain comprehensive audit logs and exception reports

• Support HRSA audit responses and internal compliance reviews

• Ensure data traceability and documentation readiness for regulatory requirements

• Monitor monthly and annual reports on 340B Program participation documenting utilization, savings, problem areas, and exceptions

Contract and Purchase Monitoring:

• Monitor purchases for contract compliance, 340B compliance, and accurate pricing

• Review product accumulation in split-billing software to ensure proper accumulations and identify negative trends

• Analyze purchasing records where 340B participation occurs, documenting utilization, savings, and discrepancies

• Provide purchasers with information and assistance for placing orders using appropriate accounts to maximize 340B benefit

• Performs other duties as assigned.

Education: High school diploma or equivalent required. Bachelor’s degree in Information Technology, Business Management, or Hospital Administration preferred.

Licensure/Certifications: Apexus 340B University Certificate required within 90 days of hire. Apexus Advanced Operations Certificate preferred. California Pharmacy Technician license required. Nationally Certified by the Pharmacy Technician Certification Board preferred.

Experience: One (1) year of healthcare auditing, pharmacy technician, or compliance experience required. 340B Drug Pricing Program experience preferred. Experience in data analysis, audit process, reporting and hospital or retail pharmacy experience preferred.

Salary Range: The hourly rate for this position is $38.42 - $48.03 The range displayed on this job posting reflects the target for new hire salaries for this position.

Job Specifications:

● Union: Non-Affiliated

● Work Shift: Day Shift

● FTE: 1.0

● Scheduled Hours: 40

If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!