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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.
Qualifications
License/Certification/Registration:
Minimum Experience:
Preferred Experience:
Additional Requirements:
Due to differences in scope of care, practice, or service across settings, the specific experience required for this position may vary
Please apply directly on our careers page:
Pay: $22.22 - $35.00 per hour
Work Location: Hybrid remote in Burlington, MA 01803
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