Review and validate Medicaid claims flagged for potential duplicate discounts
Analyze chargeback data to identify potential diversion activities
Lead GFI and audit processes including identification and prioritization of CEs, compiling supporting data, securing necessary internal reviews and approvals, and engaging CEs in collaboration with Legal and external vendors
Select and manage vendors for GFI support and audits in partnership with the Senior Director, Business Optimization & Analytics Lead
Ensure all program integrity activities align with HRSA rules and regulations and internal compliance policies and procedures
Collaborate with the Senior Director, 340B Business Optimization & Analytics Lead to provide feedback on analytics and tools used to support duplicate discount and diversion activity identification
Document and report GFI and audit metrics, outcomes, and trends to the 340B COE leadership team and executives
Identify and recommend process improvements to strengthen program integrity efforts

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 within a pharmaceutical or healthcare environment
Skilled in managing complex, cross-functional projects within a matrixed organization
Proven ability to analyze complex data sets and identify trends and insights
Excellent organizational and communication skills with strong attention to detail and documentation accuracy
Experience selecting and managing vendors
Strong knowledge of 340B program requirements, including manufacturer GFI and audit rules and procedures
Prior experience managing 340B program integrity activities including GFIs and audits within a pharmaceutical manufacturer

Health Coverage: Medical, pharmacy, dental, and vision care.
Wellbeing Support: Programs such as BMS Well-Being Account, BMS Living Life Better, and Employee Assistance Programs (EAP).
Financial Well-being and Protection: 401(k) plan, short
and long-term disability, life insurance, accident insurance, supplemental health insurance, business travel protection, personal liability protection, identity theft benefit, legal support, and survivor support.
Work-life benefits include: Paid Time Off US Exempt Employees: flexible time off (unlimited, with manager approval, 11 paid national holidays (not applicable to employees in Phoenix, AZ, Puerto Rico or Rayzebio employees) Phoenix, AZ, Puerto Rico and Rayzebio Exempt, Non-Exempt, Hourly Employees: 160 hours annual paid vacation for new hires with manager approval, 11 national holidays, and 3 optional holidays Based on eligibility*, additional time off for employees may include unlimited paid sick time, up to 2 paid volunteer days per year, summer hours flexibility, leaves of absence for medical, personal, parental, caregiver, bereavement, and military needs and an annual Global Shutdown between Christmas and New Years Day.

Senior Manager, 340B Program Integrity

Key skills