Pharmacy Business Manager

Responsibilities

• 340B Program Compliance, Governance, and Audit Readiness
• Oversees day-to-day compliance of the 340B Drug Pricing Program across all applicable covered entities, child sites, points of service, and contract pharmacy arrangements.
• Collaborates with HRSA recertification activities, eligible site registrations, and ongoing program eligibility monitoring in collaboration with internal stakeholders.
• Maintains expertise in 340B regulations, guidance, audit trends, and regulatory updates; evaluates operational and financial impacts and provides recommendations to leadership.
• Develops, reviews, and maintains 340B policies, procedures, and standard work to support regulatory compliance and operational consistency.
• Oversees compliance activities related to medication procurement, diversion prevention, duplicate discount prevention, Medicaid billing controls, inventory management, and GPO prohibition requirements.
• Coordinates internal audits, external audits, self-audits, and compliance reviews; documents findings and supports corrective action planning and implementation.
• Serves as a subject matter expert for pharmacy business systems and automated dispensing technology.
• Pharmacy Procurement, Inventory, and Medication Supply Management
• Oversees pharmacy purchasing operations to ensure timely, cost-effective procurement of medications, vaccines, emergency supplies, equipment, and related products.
• Manages purchasing workflows including receiving, inventory management, purchase requisitions, purchase orders, invoice reconciliation, and coordination with Accounts Payable.
• Maintains pharmacy procurement systems, inventory technologies, automated dispensing system interfaces, and related software or hardware supporting pharmacy operations.
• 340B Operations, Analytics, Systems, and Financial Optimization
• Oversees 340B operational workflows, accumulations, replenishment processes, split-billing systems, purchasing records, and program documentation.
• Collaborates with pharmacy, finance, revenue cycle, information technology, and supply chain teams to support system functionality, claim accuracy, and compliant program participation.
• Develops and analyzes dashboards, reports, and metrics related to utilization, savings, audit findings, discrepancies, compliance trends, and operational risks.
• Partners with pharmacy leadership to evaluate pricing strategies, purchasing account structures, and savings optimization opportunities.
• Vendor Management, Contracting, and Financial Stewardship
• Serves as a resource regarding vendor relationships, wholesaler operations, purchasing accounts, product sourcing, and group purchasing organization contracts.
• Evaluates vendor performance, pricing trends, utilization data, and contract compliance to support fiscally responsible procurement practices.
• Supports growth, oversight, and compliance activities related to specialty pharmacy and other pharmacy business entities.
• Pharmacy Billing
• Oversees pharmacy billing operations and related workflows to support compliant charging, reimbursement, revenue integrity, and claim resolution activities.
• Collaborates with pharmacy, finance, revenue cycle, and information systems teams to address billing discrepancies, optimize reimbursement processes, and support accurate medication charging practices.
• Maintains billing-related reporting, trends, denials, and reconciliation activities and supports corrective action and process improvement initiatives as needed.
• Leadership, Staff Supervision, Education, and Operational Improvement
• Directly supervises procurement, billing, and 340B personnel, including purchasers, analysts, coordinators, and related staff as assigned.
• Develops training materials, competency tools, workflows, and educational resources related to purchasing systems, inventory systems, billing, and 340B operations.
• Provides operational oversight and accountability related to pharmacy workflows impacted by procurement, billing, inventory, and compliance requirements.

Qualifications

• Education and/or Experience Required: Minimum 3–5 years of experience in pharmacy operations, pharmacy purchasing, healthcare supply chain, 340B program administration, healthcare finance, compliance, or related healthcare operational setting; if no Associate Degree, 5-10 years’ experience required.
• Experience working within regulated healthcare environments requiring compliance with operational, financial, and regulatory standards.
• Education and/or Experience Preferred: Education: Bachelor’s or master’s degree in business, healthcare administration, supply chain, pharmacy, finance, or related field or PharmD or equivalent advanced pharmacy degree.
• Experience: Hospital-based pharmacy procurement and/or 340B program experience.
• Experience supporting pharmacy billing, reimbursement, or revenue cycle-related processes.
• Experience managing medication shortages, wholesaler relationships, group purchasing organization (GPO) strategy, or pharmacy inventory operations.
• Previous leadership or supervisory experience overseeing operational, analytical, technical, or pharmacy support staff.
• Experience supporting system implementations, operational reporting, audit preparation, or compliance monitoring activities.
• Licenses and Certifications Required: Current Connecticut Registered Pharmacy Technician or Pharmacist license, as applicable to role/credential.
• Pharmacy Technician Certification Board (PTCB) certification required if functioning in a pharmacy technician capacity.
• Completion of 340B University OnDemand core and role-specific modules within 6 months of hire and ongoing annual refresher training thereafter.
• Completion of ASHP Accreditation & Regulatory Compliance Certificate (or equivalent training) within 12 months of hire.
• Obtain Apexus Advanced 340B Operations Certificate and/or Apexus Certified Expert (ACE) certification within 18 months of hire.
• Licenses and Certifications Preferred: Current ACE, CHC, CMRP, CPSM, or equivalent professional certification.
• Additional continuing education or specialized training related to pharmacy operations, healthcare compliance, supply chain, or 340B program administration.
• Knowledge, Skills and Abilities: Understanding of 340B Drug Pricing Program requirements, including eligibility, registration, recertification, patient definition, diversion prevention, duplicate discount prevention, Medicaid billing, contract pharmacy oversight, GPO prohibition compliance, and audit readiness practices.
• Understanding of pharmacy procurement, healthcare supply chain operations, and inventory management processes, including wholesaler and GPO strategy, purchasing workflows, invoice reconciliation, distribution operations, vendor management, and medication shortage response.
• Familiarity with pharmacy billing, reimbursement workflows, and revenue cycle processes impacting medication charging and claim accuracy.
• Working knowledge of split-billing software, purchasing systems, MMIS/ERP systems, inventory and dispensing technologies, automated dispensing cabinets (ADCs), reporting platforms, and data integrity controls.
• Understanding of regulatory requirements and accreditation standards related to pharmacy operations, controlled substances, medication purchasing, and healthcare compliance.
• Understanding of operational and financial analysis principles, including utilization monitoring, savings analysis, inventory optimization, contract compliance, and expense management strategies.
• Familiarity with policy development, audit preparation, documentation standards, corrective action processes, and continuous quality improvement methodologies.
• Strong analytical and problem-solving capabilities with the capacity to identify operational risks, discrepancies, trends, compliance concerns, and process improvement opportunities.
• Proficiency in analyzing and interpreting data related to procurement, inventory, 340B operations, billing, utilization, audit findings, and financial performance.
• Effective leadership, coaching, staff development, and team coordination techniques.
• Strong organizational and prioritization capabilities with the capacity to manage multiple operational, compliance, and regulatory responsibilities simultaneously.
• Proficiency in developing policies, procedures, workflows, dashboards, training materials, and operational documentation.
• Strong written and verbal communication techniques with the capacity to collaborate effectively across departments and explain complex information clearly.
• Experience managing vendor, wholesaler, and stakeholder relationships and supporting contracting or negotiation activities.
• Proficiency with Microsoft Excel and pharmacy operational systems used for purchasing, inventory management, reporting, billing, and automated dispensing technology.
• Strong documentation, reconciliation, auditing, and follow-through practices to support regulatory readiness and operational accountability.
• Capacity to make sound operational decisions that balance compliance, financial stewardship, medication availability, and patient care priorities.
• Capability to lead operational activities during time-sensitive situations, including medication shortages, recalls, audits, system implementations, and process changes.
• Capacity to maintain a high degree of accuracy and attention to detail in purchasing, inventory, billing, reporting, reconciliation, and audit documentation.
• Ability to establish priorities, manage competing demands, and respond effectively to urgent operational issues.
• Ability to work independently while exercising sound judgment and maintaining accountability.
• Ability to build collaborative relationships with pharmacy, finance, compliance, supply chain, and other relevant departments.