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Job Summary
GENERAL SUMMARY/ OVERVIEW STATEMENT:Qualifications
Supports the Transplant Service Line by assisting with patient medication management
Receives reviews and facilitates requests for medication renewal. Reviews the requests according to guidelines. Pends the requests in the electronic medical record (Epic) and routes to prescriber for review and signature.
When electronic prescribing is not available acts as an agent of the provider to transmit prescription information to pharmacies by phone fax or paper.
Acts as resource for patients on procedures of obtaining prescriptions generic medications prior approval requirements insurance procedures and other medication related issues.
Completes medication prior authorization paperwork for signoff by the clinical care team. Monitors progress of prior authorization status throughout review process updating appropriate parties as necessary.
Answers the phone provides information and directs calls to the appropriate areas.
Assists in department-wide initiatives for improved medication prescribing such as preferred medications medication recalls or alerts medication formulation changes.
Performs all job functions in compliance with applicable federal state hospital policies and procedures.
Handles confidential information in compliance with HIPAA guidelines.
Attends team meetings as required and contributes in a positive manner focusing on constructive processes and quality improvement.
Maintains clean and organized work areas.
Follows intuitional and departmental policies and procedures.
Demonstrates accountability and ownership of job responsibilities.
Exhibits professional behaviors and attitudes related to communication punctuality workplace attire personal internet or phone use and teamwork.
Perform other duties as needed including leading projects initiatives.
Insurance/Billing Support:
Manages Referral and Waitlist workqueue and complete insurance verification for all new patients
Review of medication benefits at referral and point of transplant
Obtain evaluation authorizations when needed
Obtain clinic referrals as needed for cross coverage
Manage prior authorizations prior to
Assist with copayment deductions and patient financial counseling
Other duties:
Participates in weekly transplant team conferences.
Participates in Process Improvement initiatives or data projects.
All other duties as assigned.
QUALIFICATIONS:
High school diploma or equivalent. Must be at least 18 years of age. Successful completion of an accredited or Board-certified Pharmacy Technician or Medical Assistant training program or equivalent institutional/retail pharmacy or medical office experience is highly desirable.
One-year experience in a medical setting is required. Prior pharmacy experience desirable.
Requires knowledge of laws and regulations related to clinical practice and patient confidentiality.
Requires knowledge of medication abbreviation and symbols medication indication and dosage and common medication questions.
Requires knowledge of medical terminology abbreviations and computer technology.
Experience with electronic medical record system(s) and Outlook is preferred. Experience with Epic is desirable.
Strong written and verbal communication skills in English required. Bilingual (Spanish) written and verbal communication skills a plus.
Ability to communicate clearly and effectively with patients families providers and staff while protecting patient confidentiality and demonstrating courtesy and respect.
Demonstrated skills in service excellence including active listening problem solving and ability to remain calm in emotional situations.
Demonstrated ability to apply good judgment in resolving problems independently while following department guidelines.
Attention to detail strong organizational skills with the ability to prioritize multiple tasks and work independently especially when there are time constraints.
Excellent interpersonal skills and ability to work well as part of a team with all levels of personnel including management physicians practitioners and staff
Experience:
Medical Office/Hospital/Managed Care experience 1-2 years required and Medication Administration/Pharmacy experience 1-2 years required and Experience with electronic medical record system(s) and Outlook preferred
WORKING CONDITIONS:
Works in an office setting healthcare environment. Hybrid model.
Attends meetings in and out of the hospital.
Is available for early and late meetings and flexible to meet frequent deadlines.
OTHER DUTIES AND RESPONSIBILITIES:
Works within legal regulatory accreditation and ethical practice standards relevant to the position and as established by BWH/Partners.
Follows safe practices required for the position.
Complies with appropriate BWH and Partners policies and procedures.
Fulfills any training required by BWH and/or Partners as appropriate.
Brings potential matters of non-compliance to the attention of the supervisor or other appropriate hospital staff.
Can this role accept experience in lieu of a degree: No
Licenses and Credentials: No
Additional Job Details (if applicable)
Physical Requirements
Remote Type
Work Location
Scheduled Weekly Hours
Employee Type
Work Shift
Pay Range
$18.99 - $27.17/HourlyGrade
4EEO Statement:
At Mass General Brigham our competency framework defines what effective leadership looks like by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance make hiring decisions identify development needs mobilize employees across our system and establish a strong talent pipeline.
Required Experience:
IC
Patients at Mass General have access to a vast network of physicians, nearly all of whom are Harvard Medical School faculty and many of whom are leaders within their fields.