Kansas Works Veterans Jobs

This job was posted by https://www.kansasworks.com : For more information, please see: https://www.kansasworks.com/jobs/13052499

THE RUNDOWN:

This position has responsibility assisting with pharmacy contracting and auditing tasks, and works directly with CHC/SEKs Compliance Team. This position is responsible for overseeing the contracting with CHC/SEKs in-house pharmacies (Apothecare Pharmacies) are appropriately and timely completed, while assisting with 340b auditing requirements related to CHC/SEKs in-house pharmacies and contract pharmacies.

Requirements

::: {bind="html: Job.Requirements"} WHAT YOU\'LL BE DOING:

Pharmacy Contracting:

• Completes in-house pharmacy credentialing tasks associated with the Kansas Board of Pharmacy, the Drug Enforcement Agency, and other state and federal agencies (e.g. Medicare and Medicaid) to ensure all in-house pharmacies are functioning lawfully in the State of Kansas and, as needed/appropriate, the State of Oklahoma.
• Completes contracting tasks associated with private insurance enrollments for all in-house pharmacies.
• Addresses problems with payers regarding timeliness of approvals and works with the payer to find a resolution.

Pharmacy Auditing:

• Maintains a thorough understanding of CHC/SEKs 340B program structure and requirements in order to ensure compliance in regard to qualified patients, providers, vendors, payers, and locations.
• Actively engages in the implementation of new and ongoing 340B-related projects at all clinic sites, in-house pharmacies, and contract pharmacies.
• Assists with 340B self-audits, including, but not limited to: monthly clinic-administered drug audits at all CHC/SEK facilities, monthly audits at all CHC/SEK in-house pharmacies, and monthly audits of all CHC/SEK contract pharmacies.
• Generates documentation and oversees recordkeeping of internal audit activities of the 340B program, including, but not limited to: internal audit worksheets, audit reports, electronic medical record documentation and prescription hardcopies supporting audit sample compliance, and reports requested from other staff in supporting program compliance as-needed.
• Monitors prescription data, patient data, payer data, site of care, and ICD-10 codes.
• Monitors and audits state Medicaid claims to ensure compliance to prevent potential duplicate discount rebates.
• Monitors and filters non-eligible 340b transactions.
• Evaluates patient eligibility for qualified and non-qualified patients in clinics by reviewing patient medical records, insurance plans, and facility status.
• Assists in evaluating if CHC/SEK facilities are maintaining adherence to 340B Program regulations and guidelines, including, but not limited to: appropriate storage of 340B inventory and reconciliation of 340B inventory.
• Performs audits on a scheduled basis; may involve presenting and resolving reconciliation issues as they arise during the monitoring and reconciliation process.
• Perform all duties, services and documentation in full compliance with CHC/SEK policies and procedures.
• Performs other duties as assigned. :::