Manager Business Operations

We are looking for a Business Operations Manager to manage and lead the daily business and personnel activities and to provide administrative support to the Director. Carefully scrutinize all assigned financial reports and determine appropriate operational adjustments to assist with meeting departmental and hospital fiscal goals. To actively collaborate with the Director and Medical Service Chief and/or other key stakeholders to ensure the delivery of optimal quality care in a cost effective manner, within a family centered environment and ensure compliance with CMS billing regulations. Collaborate with department leadership to develop and maintain a performance improvement infrastructure, assist with program development and maintain interdepartmental relationships.

The manager will be responsible for planning, implementing, supporting, and optimizing projects related to the 340B program. Participates in the policy and procedure development, education to internal and external stakeholders, rules/ guidance surveillance, registration/ recertification, self and external audits, contract management, and reporting and program enhancement/ optimization projects. Serves as the subject matter expert for all matters regarding the 340B Program.

Essential duties and responsibilities:
– Compliance:
· Continually monitors 340B regulations to ensure federal compliance, staying up to date on all rule changes, including HRSA/OPA and Medicaid. Shares all learnings and hot topics with management and staff. Keeps abreast of trends and issues by attending 340B trainings, monitoring industry publications and websites, professional media, literature, and peers to ensure that the institution has the latest information regarding interpretations, rulings, suggestions and advanced ideas for improving participation.
– Registration/ Recertification:
· Ensures that the annual HRSA recertification is completed within the allowable time frame. Ensures that the HRSA 340B Database is accurate for all organization entities.
– Auditing:
· Responsible for the oversight of required 340B audits, both internally and externally. Maintains a current state of “audit readiness.” Serves as the point person and coordinator for all audits. Coordinates all requests and responses. Coordinates external compliance assessments with outside firms, where appropriate, to validate internal processes. Leads 340B purchasing and utilization audits or compliance assessments internally, as needed to ensure compliance with all applicable regulations. This includes, self-audits of 340B processes, annual audit of contract pharmacies, and monthly audits of 340B eligible locations. Coordinates the remediation of findings. Routinely reviews data and related reports from all points of service at which 340B participation occurs to ensure that policies and procedures are followed, entity eligibility requirements are met, and all patients meet patient definition requirements. Works with medical auditors on third-party payer audits to ensure coordination of efforts and maximum collection.
– 340B Contract Management:
· 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.
– Program Enhancement/ Optimization:
· Develops strategies to appropriate use of the program working directly with manufacturers and wholesalers. Assesses opportunities for cost savings, business and system improvements. Participates in projects, councils and special initiatives related to 340B, compliance, auditing, and vendor selection and medication management. Monitors all outpatient points of service to continually check for new areas that may qualify for the 340B program. Provides oversight for the implementation of process improvement initiatives and creates an environment that places an emphasis on continuous monitoring and improvement. Provides input and implements business plans in coordination with the organization’s pharmacy leadership for organizational facilities to help use 340B savings to expand and improve care provided to underserved and vulnerable populations; assists facilities to prioritize and implement outpatient program development and contract pharmacy agreements related to 340B; and assists the organization’s leadership with program development and optimization.
– Reporting and Financial Analysis:
· Prepares, monitors and reports measurements to ensure satisfaction with the 340B program. Develops, monitors, and presents reports on 340B participation that clearly document utilization, savings, problem areas, exceptions, and/or discrepancies to pharmacy and administrative leadership. Routinely communicates any questions, issues, or discrepancies with the appropriate authority. Reports monthly on saving opportunities. Communicates key metrics and improvement actions to management. Ensures appropriate documentation and audit trail across areas of responsibility. Develops, monitors, maintains, and presents reports to managers and directors on budget variances. Develops and prepares drug spend analysis for forecasting and budgeting.
Completes analytics on any department changes that may affect budget to make appropriate budgetary adjustments. Serves as the point person for finance as it relates to reporting needs for drug expense.
– Operations:
· Responsible for the day-to-day management, compliance review, and operations of clinic-administered medications in eligible locations, mixed-use areas managed by split-billing software, outpatient prescriptions fulfilled by an owned pharmacy, and outpatient prescriptions fulfilled by a contract 340B pharmacy. Responsible for managing and troubleshooting pharmacy billing issues and ensuring that adequate systems checks are reviewed to prevent billing issues. Participate in interviews, selection, orientation, and training of new employees. Provide input on staff performance including providing feedback for performance evaluations. Participate in staff meetings to communicate changes and address issues that need to be discussed. Address customer concerns/complaints as they arise. Assist in the implementation of policies and procedures and ensures uniform compliance. Utilize time tracking tools, as required by department to assure accurate project planning and budgeting needs.
– Policies and Procedures:
· Develops, implements, and modifies consistent policies and procedures according to all applicable guidelines as approved by the legal department. Ensures that policies and procedures support maximum productivity and efficiency to avoid any unnecessary costs or operational barriers

• Communicate effectively with an assortment of personalities
· Effective interpersonal skills, including the ability to effect collaborative alliances, promote teamwork and ensure a high degree of internal and external customer satisfaction
· Excellent verbal and written English communication skills.
· Excellent organizational and time management abilities
· Ability to work as a team player or autonomously with strong organizational skills, project management skills and attention to detail
· Ability to work with vendors and other departments to keep multiple tasks on track and bring projects successfully to completion.
· Ability to initiate and follow through on complex programs of both short and long term duration
· Highly developed problem-solving skills including the ability to identify and resolve complex problems
· Extensive knowledge of the 340B program regulatory and compliance procedures, as well as program issues, trends, and challenges
· Comprehensive knowledge of pharmacy practices and knowledge of 340B program
· Experience with analyzing and reporting data to identify issues, trends, or exceptions to drive improvement of results and find solutions
· Previous experience with 340B statutes, compliance, guidelines, and policies

QUALIFICATIONS
Education
- Bachelor's Degree required
- Master's Degree preferred
Experience
- 3 years required - Business operations or experience in a healthcare environment (i.e. hospital, outpatient clinic or physician practice)
Preferred: Previous leadership experience AND Work experience in pediatrics, rehabilitation therapies, and/or financial business or insurance experience

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