As a not-for-profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community by leading innovation across our system. Founded by Brigham and Women's Hospital and Massachusetts General Hospital, Mass General Brigham supports a complete continuum of care including community and specialty hospitals, a managed care organization, a physician network, community health centers, home care, and other health-related entities. Several of our hospitals are teaching affiliates of Harvard Medical School, and our system is a national leader in biomedical research.
We're focused on a people-first culture for our system's patients and our professional family. That's why we provide our employees with more ways to achieve their potential. Mass General Brigham is committed to aligning our employees' personal aspirations with projects that match their capabilities and creating a culture that empowers our managers to become trusted mentors. We support each member of our team to own their personal development-and we recognize success at every step.
Our employees use the Mass General Brigham 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.

The position is eligible for a one-time bonus of up to $2,000.

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.

Required Qualifications:

• 2 years' Pharmacy Technician experience required, open to various industries: retail, hospital, clinic, etc.
• Microsoft Office experience required
• HS Diploma/ GED required
• Licensed as a pharmacy technician in the state of MA
• Nationally Certified (CPht)
• A combination of education and experience may be substituted for requirements

Preferred Qualifications:

• Experience with prior authorizations, patient scheduling, and medication renewals
• Experience working with patients receiving Specialty Medications
• Experience with EPIC, or similar medical record software preferred
• Associates or bachelor's degree, preferred in business or healthcare-related field

EEO Statement

Mass General Brigham is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. 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.