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Job ID: 37465
Location: Morrisville, NC
Facility/Division: Shared Services
Status: Full Time
Shift: Day Job
Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve.
This position provides general support to the senior analyst by conducting routine audits and performing system maintenance of the third party administrator or split billing software to ensure compliance.
Perform audits on a scheduled basis evaluating patient eligibility for qualified and non-qualified patients in hospital-based mixed-use areas and clinics by reviewing patient medical records, insurance plans, and hospital status.; may involve presenting and resolving reconciliation issues.
Ensure compliance with 340B program requirements for qualified patients, drugs, and locations
Monitor and audit state Medicaid claims to ensure compliance to prevent duplicate discounts
Monitor drug purchasing activity and perform general maintenance of third party splitting software
Perform checks on file transfer jobs to splitting software and support Business Analytics Specialist to triage transfer job failures.
Support senior analyst in developing data extracts from multiple data systems for annual program audits and HRSA audits
Monitor and triage incoming communications from external vendors, other entities, and regulatory bodies
Using Excel or a comparable data management program, filter out non-eligible transactions, including, but not limited to, drugs used to treat patients during inpatient care, Medicaid patients, drugs provided free by manufacturers, those provided at non-eligible locations, or prescriptions written by non-eligible providers
● BS degree or equivalent
Professional Experience Requirements:
● Preferred experience in an analyst role with auditing and/or pharmacy supply chain.
● AA with 3 years of pharmacy experience
Knowledge/Skills/and Abilities Requirements:
Legal Employer: NCHEALTH
Entity: Shared Services
Organization Unit: Pharmacy 340B Programs
Work Type: Full Time
Standard Hours Per Week: 40.00
Work Schedule: Day Job
Location of Job: US:NC:Morrisville
Exempt From Overtime: Exempt: Yes
This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Health Care System, in a department that provides shared services to operations across UNC Health Care; except that, if you are currently a UNCHCS State employee already working in a designated shared services department, you may remain a UNCHCS State employee if selected for this job.
The UNC Health System and the UNC School of Medicine are committed to valuing all people throughout our organization, regardless of background, lifestyle, and culture. A diverse and inclusive work environment for staff and culturally appropriate care for our patients, are essential to fulfilling our UNC Health vision of improving the health of all North Carolinians.
UNC Health is an equal opportunity and affirmative action employer.
Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.
All interested applicants are invited to apply for career opportunities. Please refer to our Employment Application Accessibility page if you need a reasonable accommodation to search and/or to apply for a career opportunity.
To verify employment eligibility, UNC Health is committed to Form I-9 and the E-Verify process.