United Health Centers · 13 hours ago
Contracting and 340B Program Manager
US-CA-Fresno-Corporate
Full-time
Onsite
Mid, Senior Level
$77K/yr - $77K/yr
2+ years expUnited Health Centers is seeking a Contracting and 340B Program Manager to oversee the development and implementation of the 340B program and manage payer contracts. This role involves ensuring compliance, optimizing program performance, and leading negotiations with payers to enhance operational efficiency and patient satisfaction.
DentalHealth CareMedicalNon ProfitPharmaceuticalTransportation
Responsibilities
Assist in the development, implementation and ongoing evaluation of the 340B Program
Serve as the primary internal and external liaison for all 340B related matters, programs and information exchange to assure consistent system-wide performance
Supervise staff as needed, such as 340B Program Coordinator
Provide oversight of the 340B program across the health system, assuring compliance and providing reporting to appropriate parties. Work with strategic partners to optimize the return of the program, including, but not limited to vendor oversight, reviewing performance reports, contractual monitoring, and regulation changes
Develop and enhance, in collaboration with other departments, new and innovative methods for facilitating the Operations and oversight of the 340B program. Perform complex statistical, cost, and financial analysis of data regarding the 340B program, and identify and act upon reimbursement and revenue opportunities
Develop, champion, and implement programs and procedures to assure effective and efficient use of pharmacy resources
Develop and maintain compliance programs with HRSA and other regulatory bodies related to 340B, including internal and external audit processes, and perform audits
Ensure that 340B-related policies and procedures are in compliance with state, federal and other regulatory guidelines
Generate innovative ideas which are strategically sound and challenge the status quo. Define alternative/compromise solutions that address others’ fundamental concerns and impacts on long-term relationships and systematically convey pros and cons of alternative solutions and achieve consensus on direction/approach
Develop and update documents, process, and policies and procedures for daily operations and monthly financial reporting and tracking
Regularly navigate UHC’s EHR to verify 340B claims as well as process and document new 340B eligible referral claims while maintaining all files and records regarding referral claim processing
Develop and maintain knowledge of current regulatory trends and issues within the 340B environment as well as track, trend, and report 340B pharmaceutical sales and purchases
Develop and maintain relationships with wholesalers, manufacturers, and contract pharmacies as well as maintaining the accounting for the 340B and pharmacy services
Work with the Contracting and Managed Care Officer to manage UHC’s Office of the Pharmacy Affairs (340B OPAIS) profile
Prevent duplicate discounts, reversal of duplicate discounts and diversions as needed, and submit data to 340B ESP
Guides the coordination of multiple in and out of network organizations to organize cross-function teams to address and remove functional barriers to achieve necessary patient outcomes
Direct the implementation of new programs, staff functions and redesign systems that will improve productivity, enhance patient care outcomes, decrease costs and improve patient satisfaction
Establish and disseminate contracting guidelines with respect to payer contractual terms, reimbursement, provider enrollment and product participation
Negotiating contractual and reimbursement terms with market payers. Conduct biannual reviews of provider contracts
Review and present financial data, utilization trends and patient mix needed to negotiate and re-negotiate payer contracts
Works to establish policies and procedures to assist UHC in maximizing contract provisions with health plans
Works collaboratively with members of the executive/leadership teams to lead, facilitate, coordinate, and/or support projects and process improvement initiatives that enhance UHC third party payer operational efficiency
Effectively communicates changes regarding contracted health plans for claims processing, data management and information systems, financial management, eligibility verification, specialty panel access, patient tracking provider relations, patient satisfaction and health education to staff
Maintains an active awareness of State, Federal, County and agency initiatives that could impact UHC, help strengthen business opportunities and negotiations with health plans
Works to communicate health plans specifics regarding claims processing, data management and information systems, financial management, eligibility verification, and specialty panel access to ensure compliance
Works to establish procedures to assist the health center in maximizing contract provisions with health plans and programs to ensure that they are implemented successfully and that maximum reimbursement is achieved
Develops and coordinates identified training needs of the health center staff as it pertains to contracted insurance policies and procedures and to facilitate access to training
Supports UHC's financial focus by maintaining an active awareness of opportunities that can help strengthen the health center. Maintain knowledge of payer products, enrollment statistics, and trends
Supports compliance with plans by managing and maintaining UHC and provider contract information
Assist the CMCO in contracting and implementing subspecialty programs at UHC
Qualification
Required
Bachelor's degree preferred in business administration, finance, accounting or a similar field
Possess a valid CA driver's license
Minimum of two years of financial experience preferred
Two years of experience with 340B program preferred
Strong verbal and written communication skills
Possess strong business acumen and professionalism
Proficiency with the Microsoft Office, especially Microsoft Excel
Must be able to prioritize multiple responsibilities and manage a large workload within budget and timelines
Must have excellent problem-solving skills and self-motivation
Must have the ability to develop alternative solutions to problems
Must be able to prepare clear, concise, thorough, meaningful, and grammatically correct written reports, letters, memos and other documents
Must be able to independently plan, organize, prioritize, schedule, coordinate, and make decisions related to assigned responsibilities
Must have a very strong customer service orientation, positive attitude, and be highly self-motivated, directed, and change oriented
Preferred
Minimum of two years of financial experience preferred
Two years of experience with 340B program preferred
Benefits
Medical, Dental, and Vision insurance with low premium cost
Paid time off and paid holidays
401k plan with matching contribution
Educational Assistance
Employee discounts and more!
Company
United Health Centers
United Health Centers is a chain of healthcare centers located in the United States.
1001-5000 employees
H1B Sponsorship
United Health Centers has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (20)
2024 (19)
2023 (10)
2022 (10)
2021 (3)
2020 (6)
Funding
Current Stage
Late StageTotal Funding
$2.7MKey Investors
Department of Health Care Access and Information
2024-04-16Grant· $2M
2013-11-11Grant· $0.7M
Leadership Team
Anthony Olivares, MBA
Chief Operations Officer
Faith Driscoll
Chief Legal Officer
Recent News
The Business Journal
2025-10-25
The Business Journal
2025-03-06
The Business Journal
2025-01-18
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