Ambulatory Staff Pharmacist, 340B Audit and Compliance Coordinator in Royal Leamington Spa

Primary Function: Provides integrated support to patients and physicians by providing a 'hands-on' approach to total quality patient care through the delivery of a full continuum of medication management services, to include preparing medications, the provision of pharmacological information, monitoring patient drug therapies and providing adherence support.

Responsibilities:

• Prepares and dispenses medications by reviewing and interpreting physician orders; detecting therapeutic incompatibilities.
• Provides thorough patient consultations on disease state management and medication therapies.
• Determines clinical appropriateness for immunizations; counsels and provides immunizations as indicated.
• Performs medication therapy management, including reviewing and monitoring of medication regimens, advising clinicians on evidence-based therapy as indicated, documenting interventions.
• Completes pharmacy operational requirements by organizing and directing technicians' work flow; verifying their preparation and labeling of pharmaceuticals; verifying prescriptions; care coordination, identifying and resolving insurance-related issues, recognizing situations where financial assistance can be applied.
• Understands and works in a manner to support 340B mission and compliance; possesses 340B knowledge sufficient to audit a claim and assist in the event of an external audit; conducts routine 340B contract pharmacy audits to ensure program compliance.
• Reviews third party payor sheets as necessary and makes updates to ensure 340B modifiers are transmitted when required.
• Oversees key 340B compliance functions, including report reviews, claim adjustments, pricing discrepancy resolution, and inappropriate accumulation monitoring.
• Manages ESP uploads for owned and contract pharmacies, maintains audit documentation, and updates NDC/eligibility data to ensure program accuracy.
• Conducts monthly insurance and billing assessments, providing clarification for Medicare Part B, 340B requirements, and Managed Medicare billing.
• Supports internal and external 340B audits and utilises platforms such as Omnisys to ensure accurate billing workflows.
• Performs Beacon and Kalderos/Truzo claims data reporting and determines appropriate billing pathways (340B vs. MFP) based on insurance plan requirements.
• Participates in EPIC enhancements and updates 340B logic within EPIC to maintain compliance with evolving program rules.
• Complies with state and federal drug laws as regulated by the state board of pharmacy, the drug enforcement administration, and local policies and procedures; maintaining records for controlled substances; removing outdated and damaged drugs from the pharmacy inventory; supervising the work results of support personnel; studying existing and new legislation; anticipating legislation; advising management on needed actions.
• Makes referrals to other health professionals as necessary.
• Develops own knowledge by participating in education programs; training pharmacy staff, students, interns, externs, residents, and health care professionals.
• Manages, organizes, and updates relevant data using database applications.
• Applies observations and recommendations to operational issues, increased productivity, quality, and customer-service standards.
• Identifies trends, resolves problems; recommends improvements; implements change.
• Actively participates in process improvement initiatives.
• Protects organization's value by keeping information confidential.
• Updates job knowledge by participating in educational opportunities; reading professional publications; maintaining personal networks; participating in professional organizations.
• Willing to do whatever is necessary for the betterment of the Company.
• Other duties as assigned.

Job Qualifications and Specifications:

• Required Licensure/Certification: Applicant must hold a Doctor of Pharmacy (PharmD) or BS in Pharmacy and be a licensed Pharmacist in the State of Rhode Island. Applicant must have 340B ACE certification or achieve 340B ACE within 6 months of hire.
• Years of Experience: Required 5+ years, Preferred 8+ years' experience in a specialty or retail pharmacy setting.
• Advanced Education: Applicant preferred to hold advanced certification(s) such as: Certified Specialty Pharmacist (CSP), immunization, medication therapy management, diabetic educator, cardiovascular educator.