Senior Manager, 340B Program Integrity
Bristol Myers Squibb
4 months ago
Remote friendly (Washington, DC)
United States
Market Access
Summary
- The Senior Manager, 340B Program Integrity leads enterprise 340B program integrity efforts, including validating claims flagged for potential duplicate discounts, identifying diversion activities, and managing Good Faith Inquiries (GFIs) and audits in coordination with vendor partners. Ensures activities are executed compliantly, timely, and in alignment with the enterprise 340B strategy.
Responsibilities
- Review and validate Medicaid claims flagged for potential duplicate discounts.
- Analyze chargeback data to identify potential diversion activities.
- Lead GFI and audit processes: identify and prioritize CEs, compile supporting data, secure internal reviews/approvals, and engage CEs in collaboration with Legal and external vendors.
- Select and manage vendors for GFI support and audits (with the Senior Director, Business Optimization & Analytics Lead).
- Ensure program integrity activities align with HRSA rules/regulations and internal compliance policies/procedures.
- Provide feedback on analytics and tools used to identify duplicate discount and diversion activity.
- Document and report GFI and audit metrics, outcomes, and trends to 340B COE leadership and executives.
- Identify and recommend process improvements to strengthen program integrity efforts.
Qualifications
- Bachelor’s degree required; advanced degree or certification in compliance, health administration, or business preferred.
- 4–6 years of experience in compliance, audit management, or government pricing (ideally in pharmaceutical/healthcare).
- Skilled in managing complex, cross-functional projects in a matrixed organization.
- Proven ability to analyze complex data sets and identify trends/insights.
- Excellent organizational and communication skills; strong attention to detail and documentation accuracy.
- Experience selecting and managing vendors.
- Strong knowledge of 340B program requirements, including manufacturer GFI and audit rules/procedures.
- Prior experience managing 340B program integrity activities (GFIs and audits) within a pharmaceutical manufacturer.
Compensation / Benefits (explicitly stated)
- Compensation range: Princeton, NJ: $139,200–$168,683; Washington, DC: $139,200–$168,683 (plus potential incentive cash/stock based on eligibility).
- Benefits include: health coverage (medical/pharmacy/dental/vision), wellbeing support programs, and financial wellbeing/protection (401(k), disability, life/accident/supplemental health, business travel protection, personal liability, identity theft benefit, legal support, survivor support).
- Work-life benefits include Paid Time Off, including flexible time off (unlimited with manager approval) and paid national holidays (details vary by location/role).
Application instructions (explicitly stated)
- If your resume doesn’t perfectly line up, the company encourages applying anyway.
- The Senior Manager, 340B Program Integrity leads enterprise 340B program integrity efforts, including validating claims flagged for potential duplicate discounts, identifying diversion activities, and managing Good Faith Inquiries (GFIs) and audits in coordination with vendor partners. Ensures activities are executed compliantly, timely, and in alignment with the enterprise 340B strategy.
Responsibilities
- Review and validate Medicaid claims flagged for potential duplicate discounts.
- Analyze chargeback data to identify potential diversion activities.
- Lead GFI and audit processes: identify and prioritize CEs, compile supporting data, secure internal reviews/approvals, and engage CEs in collaboration with Legal and external vendors.
- Select and manage vendors for GFI support and audits (with the Senior Director, Business Optimization & Analytics Lead).
- Ensure program integrity activities align with HRSA rules/regulations and internal compliance policies/procedures.
- Provide feedback on analytics and tools used to identify duplicate discount and diversion activity.
- Document and report GFI and audit metrics, outcomes, and trends to 340B COE leadership and executives.
- Identify and recommend process improvements to strengthen program integrity efforts.
Qualifications
- Bachelor’s degree required; advanced degree or certification in compliance, health administration, or business preferred.
- 4–6 years of experience in compliance, audit management, or government pricing (ideally in pharmaceutical/healthcare).
- Skilled in managing complex, cross-functional projects in a matrixed organization.
- Proven ability to analyze complex data sets and identify trends/insights.
- Excellent organizational and communication skills; strong attention to detail and documentation accuracy.
- Experience selecting and managing vendors.
- Strong knowledge of 340B program requirements, including manufacturer GFI and audit rules/procedures.
- Prior experience managing 340B program integrity activities (GFIs and audits) within a pharmaceutical manufacturer.
Compensation / Benefits (explicitly stated)
- Compensation range: Princeton, NJ: $139,200–$168,683; Washington, DC: $139,200–$168,683 (plus potential incentive cash/stock based on eligibility).
- Benefits include: health coverage (medical/pharmacy/dental/vision), wellbeing support programs, and financial wellbeing/protection (401(k), disability, life/accident/supplemental health, business travel protection, personal liability, identity theft benefit, legal support, survivor support).
- Work-life benefits include Paid Time Off, including flexible time off (unlimited with manager approval) and paid national holidays (details vary by location/role).
Application instructions (explicitly stated)
- If your resume doesn’t perfectly line up, the company encourages applying anyway.