Consultant | Healthcare Performance Improvement | 340B, Pharmacy and Clinic Services

The Healthcare Consulting Performance Improvement team is looking for a Consultant to join the team in supporting clients in the Pharmacy and Clinic Services space specifically as it relates to compliance, program optimization, and financial performance.

How you will contribute:

• Assist with Financial/Reimbursement assessments to determine reimbursement opportunities for on-campus and off-campus provider-based departments as well as freestanding and provider-based Rural Health clinics.
• Responsible for the financial analysis proactive calculations and modeling of new regulatory changes and impacts
• Assist with PowerPoint presentation reports
• Assist with developing provider-based strategy, gap assessments, and transition advisory processes. Provide guidance to clients regarding provider-based departments.
• Operational Assistance
• Split-billing (technical/professional)
• Chargemaster requirements
• CMS Provider-Based Clinic regulations and Federal and State regulations
• Compliance with provider-based rule requirements
• CMS Checklists
• Assimilate provider-based checklists (attestations)
• Assist with transitions to Rural Health Clinic (RHC) or Provider Based RHC
• Policy and Procedure Development
• Survey readiness assistance
• Become proficient in provider-based (42 CFR 413.65) and RHC regulations and stay abreast of ongoing legislative changes.
• Prepare Medicare RHC cost reporting schedules.
• Calculating RHC visits
• Calculating FTEs for productivity
• Provide guidance to clients regarding their 340B and other pharmacy operations:
• Policy and Procedure Development
• 340B network expansion i.e., development of contract pharmacy arrangements, child sites, direct purchases, orphan drugs, and other opportunities
• Operational Assistance
• Split-billing vendor implementations
• Split-billing vendor maintenance i.e., Drug Crosswalk Maintenance
• Compliance Reviews
• Independent Reviews
• HRSA Audit Experience a plus
• Advise, communicate, and present to all levels including C-suite, management, and clinic staff.
• Provide in-depth provider-based processes and regulatory knowledge to clients.
• Provide an unmatched client experience and identify additional value-added services
• Active participant in specific healthcare industry groups (Becker's, Apexus, 340B Health, HFMA, etc.)

We are looking for people with Forward Vision and:

• Strong analytical and communication skills
• Ability to deliver work products consistently and with high-quality.
• Demonstrated ability to think independently and train other team members as needed.
• Ability to travel up to 50%, depending on client commitments.
• Highly motivated and self-driven to exceed client needs and timelines.

Minimum Qualifications:

• Bachelor's degree in Business, Accounting, Finance, Health Services Administration, or a related field
• 2 years or more of experience working within the healthcare industry, specifically consulting or with a hospital
• Significant experience in advanced Excel, IT platforms, and healthcare
• Strong technical skills, experience with spreadsheets, databases, and an automated audit work paper system
• Experience with project management

Preferred Qualifications:

• Experience in the following areas:
• Healthcare provider-based billing
• Provider-based attestation compliance and submission to Medicare
• Medicare/Medicaid Hospital cost reporting
• Practice operational knowledge in provider-based physician practices, or RHCs.
• EPIC
• Data visualization (Tableau or Power BI)