Compliance Specialist

About Us

Primary Health Care (PHC) was founded in 1981 by Dr. Bery Engebretsen in Des Moines, IA. Our mission is to provide healthcare and supportive services to all, regardless of insurance, immigration status, or ability to pay. Based on the needs of the communities we serve, PHC offers a spectrum of medical and dental services including family practice, behavioral health, HIV care and services, and pharmacy. PHC’s Homeless Support Services is the entry point for serving people experiencing homelessness in Polk County. Enabling services are available to help patients with benefits enrollment, case management, transportation, translation, and patient education. We currently have locations in Ames, Des Moines, & Marshalltown.

About the Role

As a Compliance Specialist, you will assist with the day-to-day activities of the Corporate Compliance Program. You will assist with overseeing 340B-related activities for in-house pharmacy and contract pharmacies, monitor and maintain adherence to 340B Program regulations, and provide expertise to PHC staff for ongoing compliance. You will develop and maintain relationships across multiple areas of PHC and with external contacts, acting as a liaison to ensure 340B program integrity. You will demonstrate PHC’s iCare Values in your daily work.

Responsibilities

• Provides expertise to PHC staff related to the 340B Program; develops and maintains a thorough understanding of the 340B Program within the organization and works to improve its overall efficiency, value, and internal support.
• Ensures a 340B quality assurance training program for employees as appropriate.
• Serves as the compliance expert on 340B, reviewing, monitoring, and ensuring that policies and procedures comply with federal requirements.
• Maintains up-to-date policies and procedures on 340B purchasing processes; recommends and implements changes as needed to ensure compliance.
• Conducts monthly audits of all 340B-eligible locations, in-house pharmacy, and contract pharmacies to verify adherence with program guidelines and policies.
• Presents and resolves reconciliation issues to ensure program compliance for qualified patients, drugs, and locations.
• Assists Compliance & Risk Director and Pharmacy Director in assessing opportunities for cost savings and business improvements in the 340B program.
• Monitors drug inventory, utilization records, and 340B accounts for proper replenishment.
• Reviews and refines monthly 340B cost savings reports detailing purchasing and replacement practices, as well as dispensing patterns; provides recommendations as appropriate.
• Works with the pharmacy team to ensure best practices are followed regarding 340B through monitoring, reporting, and analyzing contract pharmacy and in-house pharmacy 340B activities.
• Provides reports to PHC’s Compliance Committee; recommends efficiency improvements.
• Develops and maintains reports to educate staff and assist management in tracking the overall financial impact to the organization.
• Builds other reports, as appropriate, to monitor and improve 340B Program compliance and performance.
• Collaborates with the Pharmacy, Compliance, and Compliance Committee to develop monthly, quarterly, and yearly audit metrics.
• Maintains all 340B contracts.
• Assists Compliance & Risk Director in reviewing and negotiating new 340B contracts; manages relationships, billing services, and compliance with contracted 340B pharmacies.
• Evaluates all current and future contract pharmacy opportunities, including contract language, fee structure, data setup, and internal and independent external auditing.
• Ensures all required annual recertifications and quarterly registrations are completed within the allowable time frame.
• Assists Compliance & Risk Director with event reporting, patient survey tracking, and other data elements as needed.
• Collaborates with Training Manager and others to develop effective compliance training, including for new employees and ongoing training for all employees.
• Assists with risk assessment audits targeting potential vulnerabilities in conjunction with the Corporate Compliance Committee.
• Develops/implements corrective action plans as needed in conjunction with the Compliance & Risk Director.
• Provides reports regularly to executive leadership, the Board of Directors, and the Corporate Compliance Committee.
• Performs other duties as assigned.

Requirements

• Bachelor’s degree in Health Care Administration, Business Administration, Accounting, or a related field or equivalent combination of education and experience.
• A minimum of 2 years’ experience in health care compliance and auditing, 340B, or other relevant experience, plus contract review.
• Community Health Center experience.
• 340B Certification to be completed within the first year of employment.
• Excellent interpersonal and communication skills in verbal and written form.
• Team orientation with ability to work effectively and positively with diverse employees.
• Proficiency with Microsoft Office applications.
• Good problem-solving and decision-making skills with ability to exercise good judgment under pressure.
• Ability to deal with a variety of abstract and concrete variables.
• Detail orientation with a high degree of accuracy.
• Organization and time management skills with ability to multi-task and manage priorities.

Preferred Qualifications

• Master’s degree in Health Care Administration, Business Administration, Accounting, or a related field.
• 5 years’ relevant experience to include reviewing and managing contracts.
• 2 years’ experience working with 340B program rules and regulations and HRSA regulations.
• 340B Certification.

Benefits

• Generous PTO accrual (equal to 4 weeks at the end of the 1st year) plus paid holidays.
• License/certification fee reimbursement.
• Paid time off for continuing education & continuing education reimbursement.
• Tuition reimbursement program.
• 401k with company match.
• Medical, dental, and vision insurance.
• Life & disability insurance.
• Flexible spending & health savings accounts.
• Supplemental accident & critical illness insurance.
• Discounts on pet insurance.

Pay

Your experience and skills determine your base pay. The hiring range for this position is typically $47,120 - $58,900 annually. Candidates with extensive work experience related to this position may be considered for additional compensation up to the pay grade maximum of $70,680.