This position is responsible for auditing prescription claims to ensure compliance with requirements of the 340B pharmacy drug program, assists in preparing the pharmacy for audits under HRSA guidelines. This position acts as backup to the PBM Pharmacy Technicians.

Essential Duties (at least 5 that are non-negotiable duties and are absolutely pertinent to successfully completing the job without accommodations):

• Audits prescription claims to ensure compliance with 340B program
• Regular review of prescription program for 340B compliance
• Documentation and preparation for HRSA, Manufacturer or other audits
• Makes recommendations to pharmacy leadership regarding 340B audit findings
• Create and maintain provider file for all third-party administrators
• Create and provide quarterly Provider ID file
• Create, review and upload claims files for submission to manufacturer platform
• Create quarterly 340B compliance reports and monthly leadership reports
• Ensures pharmacy billing process and related duties comply with 340B regulations, CommUnityCare Standard Operating Procedures and CommUnityCare Policies and Procedures
• Participate in quality and compliance improvement activities such as the development of policies and procedures as it relates to 340B and Pharmacy Compliance
• Acts as backup to PBM Pharmacy Technicians including use of PBM platform for claims overrides
• Ensure all actions, job performance, personal conduct and communications represent CommUnityCare in a highly professional manner at all times
• Ensure all tasks provided and associated with patient care, patient administrative processes and related duties comply with all regulatory and accreditation standards including The Joint Commission and        CommUnityCare Standard Operating Procedures and CommUnityCare Policies and Procedures
• Uphold and ensure compliance and attention to all company policies and procedures as well as the overall mission and values of the organization
• Develop and maintain favorable internal relationships, partnerships with team members, including clinical managers, clinical support staff, providers and business office staff
• Special projects and other duties as assigned

Knowledge/Skills/Abilities:

• Knowledge of 340B drug program
• Knowledge of CUC reporting and third-party platforms
• Knowledge of retail pharmacy
• Drug purchasing experience
• Demonstrate extensive knowledge of medical/pharmaceutical terms and nomenclature
• Comprehensive knowledge of prescription dispensing processes
• Critical thinking/problem solving
• Excellent verbal and written communication skills
• Ability to engage community partners and openly communicate effectively
• Communicate with tact and diplomacy
• Work with multi-functional teams to complete projects
• Strong attention to detail and accuracy
• Demonstrate a high level of skill at building relationships and providing excellent customer service
• Develop and maintain favorable internal relationships, partnerships with co-workers.
• Demonstrated familiarity with tools, technology, and systems typically found within most health care environments (i.e. personal computer skills, spreadsheets, word processing, patient records systems, EMR systems, etc.)
• Collaborate with CUC staff
• Complete all mandatory training and maintain appropriate credentials/licensure.

EDUCATION:

• High school diploma or equivalent-Required. 
• Associates degree preferred. 

EXPERIENCE:

• Three (3) years of experience as a Pharmacy Technician - Required
• 1 year of 340B drug program experience, 1 year of Microsoft Excel and Access experience -Preferred 

REQUIRED CERTIFICATIONS/LICENSURE:

• Current Pharmacy Technician registration with Texas State Board of Pharmacy- Required.
• Current Health Care Provider Cardiopulmonary Resuscitation (CPR) certification through American Heart Association or American Red Cross required. (Will be required to maintain a current CPR certification during employment) -Required
• National Certification with the Pharmacy Technician Certification Board (CPhT) 340B ACE -Preferred 
• 340B University **within 6 months of hire **