Job Description:

Atrius Health, an innovative healthcare leader, delivers an effective system of connected care for more than 690,000 adult and pediatric patients at 30 medical practice locations in eastern Massachusetts. Atrius Health’s 645 physicians and primary care providers, along with 420 additional clinicians, work in close collaboration with hospital partners, community specialists and skilled nursing facilities. Our vision is to transform care to improve lives. Atrius Health provides high-quality, patient-centered, coordinated, cost effective care to every patient we serve. By establishing a solid foundation of shared decision making, understanding and trust with each of its patients, Atrius Health enhances their health and enriches their lives. Atrius Health is part of Optum, a health services company focused on building the leading value-based care system in the country.

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SUMMARY

The Medication Prior Authorization Supervisor supports and manages a group of Medication Renewal Coordinators and oversees the prior authorization and financial coordination aspects of the program and staff as needed (e.g., Prior Authorization Specialists and Infusion Financial Coordinators). This team is oriented to provide support for patients receiving medications in the clinic setting, including infusion and oncology areas. Serves as functional supervisor for centralized In-Clinic Medication Prior Authorization support staff. The Supervisor is the subject matter expert for the Medication Prior Authorization team, so while resolving complex prior authorization issues, the Supervisor is also the person to whom team members come to for guidance while also providing continuous coaching and feedback. Other duties may be assisting new hires with additional training; monitoring calls to ensure that department quality standards are met; identifying areas for improvement; following the progressive discipline model as necessary and scheduling staff according to department needs.

EDUCATION/LICENSES/CERTIFICATIONS

Bachelor’s Degree in an appropriate discipline (or equivalent education, training or experience) required.

EXPERIENCE

Requires knowledge of medical support functions in an ambulatory care setting, typically acquired through 5 - 7 years of medical practice experience including at least 2 directly supervising at least two staff. Experience with EPIC or a similar electronic medical records system required. Experience with prior authorizations, particularly as a pharmacy technician in specialty or infusion areas highly preferred. Medical terminology and attention to details.

SKILLS

· Medical Terminology: Requires in depth knowledge of area of specialty medical terminology, CPT and ICD codes and insurance billing for medical and pharmacy benefit. Knowledge of oncology and infusion insurance prior authorization process. Excellent communication, organizational and interpersonal skills. Understanding of revenue cycle functions such as patient access, billing, payments, and denials.

· Ability to review patient data and clinical guidelines and provide the appropriate information to insurance companies to secure insurance authorization.

· Strong interpersonal skills needed with the ability to interact effectively with patients and medical professionals. Sound judgment with the ability to work and make decisions in a fast-paced environment. Leadership potential.

· Organization: Ability to organize multiple activities and effectively handle a fast-paced, changing workload with daily deadlines. Demonstrated accuracy in record keeping and documentation with strong attention to detail. Excellent follow-up skills with the ability to handle multiple assignments simultaneously.

· Customer Service: Ability to provide a high level of customer service to patients, visitors, staff and external customers in a professional, service-oriented, respectful manner using skills in active listening and problem solving. Ability to remain calm in stressful situations.

· Decision Making: Ability to make decisions that are guided by general instructions and practices requiring some interpretation. May make recommendations for solving problems of moderate complexity and importance. Demonstrated good judgement as well as attention to detail while working well with a team.

· Problem Solving: Ability to address problems that are varied, requiring analysis or interpretation of the situation using direct observation, knowledge and skills based on general precedents. Must be able to effectively arrive at a solution that is patient friendly and able to satisfy business requirements.

· Independence of Action: Ability to follow precedents and procedures. May set priorities and organize work within general guidelines. Seeks assistance when confronted with difficult and/or unpredictable situations. Work progress is monitored by supervisor/manager.

· Written Communications: Ability to summarize and communicate in English moderately complex information in varied written formats to internal and external customers.

· Oral Communications: Ability to comprehend and communicate complex verbal information in English to medical center staff, patients, families and external customers.

· Knowledge: Ability to demonstrate full working knowledge of standard concepts, practices, procedures and policies with the ability to use them in varied situations.

· Team Work: Ability to work collaboratively in small teams to improve the operations of immediate work group by offering ideas, identifying issues, and respecting team members.

· Time management and organizational skills will be crucial for as they manage the day-to-day responsibilities in a fast-paced, deadline driven environment.

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Atrius Health is committed to a policy of non-discrimination and equal employment opportunity. All patients, employees, applicants, and other constituents of Atrius Health will be treated with respect and dignity regardless of race, national origin, gender, age, religion, disability, veteran status, marital/domestic partner status, parental status, sexual orientation and gender identity and/or expression, or other dimensions of diversity.

Benefits Include:

· Up to 8% company retirement contribution

· Generous Paid Time Off

· 10 paid holidays

· Paid professional development

· Generous health and welfare benefit package

Atrius Health is an equal opportunity/affirmative action employer and does not discriminate in recruiting, hiring, training, promoting or any other employment practices on the basis of race, color, religion, sex, marital status, age, sexual orientation, gender identity, national origin, military service or application for military service, veteran or disability status.

Applicants have rights under Federal Employment Laws: Family and Medical Leave Act (FMLA);Equal Employment Opportunity (EEO); and Employee Polygraph Protection Act (EPPA).

VEVRAA Federal Contractor

Request Priority Protected Veteran & Disabled Referrals for all of our locations within the state

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