Posted in Other about 11 hours ago.
Site: Mass General Brigham Incorporated
At Mass General Brigham, we know it takes a surprising range of talented professionals to advance our mission-from doctors, nurses, business people and tech experts, to dedicated researchers and systems analysts. As a not-for-profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community. We place great value on being a diverse, equitable and inclusive organization as we aim to reflect the diversity of the patients we serve.
At Mass General Brigham, we believe a diverse set of backgrounds and lived experiences makes us stronger by challenging our assumptions with new perspectives that can drive revolutionary discoveries in medical innovations in research and patient care. Therefore, we invite and welcome applicants from traditionally underrepresented groups in healthcare - people of color, people with disabilities, LGBTQ community, and/or gender expansive, first and second-generation immigrants, veterans, and people from different socioeconomic backgrounds - to apply.
Job Summary
General Summary
Working directly with patients, Specialty Pharmacy Clinical Coordinators, and clinic staff to manage the specialty medication needs of Mass General Brigham HealthCare patients. Understand the complex medication needs of patients and coordinate with pharmacy and medical/nursing staff to meet those needs while providing extraordinary service. Assist patients with benefits coordination and financial assistance, manage prior authorizations, and ensure patients receive their medications when needed.
Principal Duties and Responsibilities:
Work with physicians, nurses, and pharmacists to ensure that each patient receives the medications they need at the appropriate time:
• Review medication regime with the patient to determine which medications need to be dispensed
• Process medication orders confirming that they are billed to all third parties correctly
• Monitor patient concerns, charts, and profiles to meet their medication therapy needs
Assist in education efforts for MGB Specialty Pharmacy:
• Answer patient questions about the service, insurance issues, etc.
• Ensure all questions are answered timely and accurately
• Provide patient education materials and information about other resources
• Ensure employee back-up coverage is trained and knowledgeable
Commit to Building Relationships:
• Quickly forge and sustain (or develop and maintain) strong relationships with pharmacists, co-workers, prescribers, nurses, and patients to build the service
• Provide caring service, adjusting approaches to reflect developmental level and cultural differences of population served
• Improve processes to facilitate communication and service between the patient, and clinic, infusion center, and discharge pharmacy teams to ensure accurate and timely delivery of medications
Act as the insurance specialist:
• Understand Medicare/Medicaid regulations and billing guidelines as they pertain to patient pharmacy benefits
• Understand billing primary, secondary and tertiary insurance claims
• Resolve any billing issues and obtain Prior Authorizations for medications.
• Obtain benefit information and verify patient insurance eligibility and level of coverage
Assist Clinical Coordinators with tasks as assigned:
• Collect data and run statistics
• Monitor productivity
Demonstrates Commitment to Customers and fellow employees:
• Seeks to understand and value differences between employees
• Treats other employees with dignity and respect
• Demonstrates open, honest communication and behavior
• Resolves conflict in a positive manner
• Contributes to the productivity of the workgroup
• Use/s the Mass General Brigham HealthCare values to govern decisions, actions, and behaviors. These values guide how we get our work done: Patients, Affordability, Accountability & Service Commitment, Decisiveness, Innovation & Thoughtful Risk; and how we treat each other: Diversity & Inclusion, Integrity & Respect, Learning, Continuous Improvement & Personal Growth, Teamwork & Collaboration
• Other duties as assigned
Demonstrates Commitment to Health System:
• Lives the values of dignity, integrity, service, and compassion
• Supports the mission/vision
• Speaks positively about Health System
• Chooses to make Health System a better place
• Responsible for confidential data: Respect the confidentiality of all information, including information regarding patients, staff members, or Health System business issues, and share information only with those who need to know
• Excellent customer service skills, excellent written and verbal communication skills, proficient in the English language, good attention to detail, ability to problem solve effectively, ability to follow policies and procedures, basic math skills, advanced computer skills, and proficient with medical terminology
Work Conditions:
• Training for this position is onsite in Burlington, MA. After the training period, the position will be a hybrid role with a combination of work from home and some onsite requirement in Burlington. This is subject to change based on business need.
• The schedule is Monday - Friday, 8:30 am - 5:00 pm.
The position is eligible for a one-time bonus of up to $2,000.
Qualifications
Required Qualifications:
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