Procuity is a trusted leader in delivering innovative SaaS solutions designed to support covered entities in optimizing their 340B programs and pharmacy operations. With a deep understanding of healthcare complexities, our technology helps streamline workflows, improve compliance, and enhance financial performance-allowing providers to focus on delivering care to underserved communities.
Backed by Zions Bancorporation (ZION), a $89 billion holding company, Procuity combines the agility of a technology-driven organization with the stability and expertise of an established enterprise. Our commitment to innovation and operational excellence empowers covered entities to maximize program benefits while navigating the evolving healthcare landscape.
The Program Administrator (healthcare referral capture) plays a key role in managing referral prescriptions within the 340B program. This position is responsible for accurate tracking, compliance, and optimization of referral claims, working closely with healthcare providers, pharmacies, and internal teams to maximize program benefits while maintaining regulatory integrity.
Key Responsibilities
- Referral Prescription Management:
- Validate referral prescriptions to confirm patient eligibility under 340B guidelines.
- Collaborate with providers to obtain and store necessary documentation. supporting referral claims.
- Maintain referral verification software and update system configurations as needed.
- Compliance.
- Data Analysis & Reporting:
- Develop and present reports on referral prescription utilization, savings, and program performance.
- Track trends in referral capture efficiency and recommend process improvements.
- Work with IT teams to optimize data feeds and system integrations.
- Stakeholder Collaboration:
- Serve as a liaison between pharmacies, health systems, and internal teams to streamline referral capture.
- Work with interdepartmental teams to create processes, procedures, and enhancements.
- Provide training and guidance on referral documentation and best practices.
- ESP Submission & Trend Monitoring:
- Prepare and submit ESP data to manufacturers in accordance with program requirements.
- Monitor manufacturer restrictions and analyze trends to maximize revenue impact.
- Provide recommendations to optimize ESP submission strategies and improve processes.
- Support initiatives related to NDC exclusions and alternative distribution methods.
Qualifications
- Education: Associate or bachelor's degree in healthcare administration, business, or other directly related experience.
- Experience:
- 2-4 years of experience in 340B program management, pharmacy operations, or healthcare compliance.
- Familiarity with HRSA regulations, referral tracking systems, ESP submissions, and contract pharmacy relationships.
- Proficient in interacting with Electronic Health Records (EHR) across multiple healthcare systems.
- A combination of education and experience may meet job requirements.
- Skills:
- Strong analytical and problem-solving abilities.
- Excellent communication and collaboration skills.
- Proficiency in data management tools and reporting software.
- Strong organizational skills and attention to detail.
- Skilled in optimizing workflows and enhancing operational efficiency through structured processes.
Preferred Certifications
- 340B Apexus Certified Expert (ACE) or equivalent training in 340B program administration.
Benefits
- Medical, Dental and Vision Insurance - START DAY ONE!
- Life and Disability Insurance, Paid Parental Leave and Adoption Assistance
- Health Savings (HSA), Flexible Spending (FSA) and dependent care accounts
- Paid Training, Paid Time Off (PTO) and 11 Paid Federal Holidays
- 401(k) plan with company match, Profit Sharing, competitive compensation in line with work experience
- Mental health benefits including coaching and therapy sessions
- Tuition Reimbursement for qualifying employees
- Employee Ambassador preferred banking products
Pay (depending on experience and location): $60,000-$75,000
