Site: Mass General Brigham Incorporated
Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.
Job Summary
Work directly with patients, Specialty Pharmacy staff, and clinic staff to manage the specialty medication needs of Mass General Brigham 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 benefit coordination and financial assistance, manage prior authorizations, and ensure patients receive their medications at the appropriate time.
Principal Duties and Responsibilities:
Work with physicians, nurses and pharmacists to ensure that each patient receives the medications he/she needs at the appropriate time:
- Review medication regime with 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
Support MGBSP Patient Needs:
- Answer patient questions about the service, insurance issues, financial assistance needs, etc.
- Ensure all questions are answered timely and accurately
- Ensure clinical questions are appropriately escalated to a pharmacist
- Ensure employee back-up coverage is trained and knowledgeable
- Report any Patient Safety Events according to MGB SP guidelines
Commit to Building Relationships:
- Quickly forge and sustain (or develop and maintain) strong relationships with pharmacists, coworkers, prescribers, nurses and patients to build/support the services we provide
- Provide caring service, adjusting approaches to reflect developmental level and cultural differences of population served
- Improve processes to facilitate communication and service between patient, and clinic, infusion center and discharge pharmacy teams to ensure accurate and timely delivery of medications
- Participates in MGB SP Clinical Subcommittees
Act as the insurance specialist:
- Understand Medicare/Medicaid regulations and billing guidelines as they pertain 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
- Cross train within PCC roles as directed to support emergent and ongoing business needs.
Pharmacy technician experience, or equivalent combination of education and related experience working directly with patients in a healthcare setting. Experience with prior authorizations and their renewal, and medication and financial assistance renewals are a plus.
Computer skills (Microsoft Office, Excel, Word, Access). Experience with Pharmacy, EPIC or similar medical record software a plus.
License/Certification/Registration:
Minimum Experience:
Preferred Experience:
Four-year degree in healthcare-related field or four-year degree and experience in a healthcare setting.
Experience working with patients receiving Specialty Medications.
Proficiency on other languages a plus
Additional Requirements:
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
Provide On-call support on a scheduled rotation
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.
Due to differences in scope of care, practice, or service across settings, the specific experience required for this position may vary
Additional Job Details (if applicable)
• This position is 100% onsite in Burlington, MA.
• The schedule is Monday - Friday, 8:30 AM - 5:00 PM EST
Onsite
31 North Avenue
40
Regular
Day (United States of America)
Pay Range
$ - $31.71/Hourly
Grade
4
At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.
0100 Mass General Brigham Incorporated is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.
Mass General Brigham Competency Framework
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.