Diabetes & Technology Patient Navigator

Site: The Brigham and Women's Hospital, Inc.

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

Working under the supervision of the Director of the BWH Diabetes Program, the Diabetes Technology Patient Navigator enables the coordination of multidisciplinary follow up care for patients and the coordination of diabetes technology devices for insulin pumps and Continuous Glucose Monitors (CGM). This individual will also serve as the liaison for specialty services and will work closely with our other Diabetes Program locations and clinicians to create an efficient and patient-centered system for scheduling multidisciplinary new diabetes clinic appointments as well as providing the necessary loop closure for referring physicians.

Reports directly to Director of Brigham Diabetes Program. Interacts extensively with Brigham and Women's Hospital providers and staff.

Does this position require Patient Care? No

Essential Functions
1. Receiving requests from Providers via Epic inbasket for specific diabetes technology prescriptions for their patients
2. Interfacing with several applications as required by insurance companies, pharmacies, and supply companies to initiate prior authorization requests. These applications may include but are not limited to Parachute Health, CoverMyMeds and Masshealth’s specialized prior authorization for Diabetes supplies.
3. Oversight of the Diabetes Faxcom, an electronic facsimile (e-fax) web application that receives faxes from Pharmacies and Durable Medical Equipment (DME) Companies who service BWH diabetes patients seen in BWH Endocrinology.
4. Communicating with Access Center staff when faxes are identified to be medication prescription requests rather than device requests, and appropriately forwarding directly to the Pharmacy Technician teams through Faxcom
5. Gathering and securely submitting (by electronic file, e.g. PDF) necessary patient data to fulfill prior authorization requirements, which are specific to the insurance company. This may include but is not limited to laboratory data and clinical notes in Epic, as well as patient-collected data found on web-based secure portals.
6. Maintaining relationships and open lines of communication with representatives at DME companies as needed for rapid processing of prescriptions.
7. Contacting patients when devices are authorized and instructing them on how to obtain their devices.
8. Maintaining patient communication as needed via Gateway or by phone to support ongoing access to prescribed devices or device supplies.
9. Cross trained with the Diabetes Patient Navigator for Special Programs to provide coverage during planned vacations.
10. Assists patients with scheduling multidisciplinary new diabetes clinic appointments, procedures, and/or appointments. Coordinates with multidisciplinary services to help patients navigate the system and schedule these appointments.
11. Work closely with the Practice Manager and clinical staff to identify patients that appear to have barriers to care (i.e.: multiple missed appointments) and offer scheduling assistance to meet their individual needs, identifying patients who are appropriate for Social Work involvement to achieve compliance.
12. Works closely with clinicians and follows the triage protocols to ensure patients are seen by the right clinician at the right place and at the right time. Ensures that patients are knowledgeable about next steps in care and future appointments.
13. Responsible for patient navigation (e.g. ensuring appropriate visit scheduling, facilitating patient access to program information, following-up with patients as they progress through their program) and works closely with our colleagues to facilitate scheduling of imaging studies and/or procedures on behalf of the patient with coordination of appointments to, whenever possible, avoid multiple visits for the patient
14. Can speak knowledgeably about each of the services available for each program available within the Diabetes Program (i.e. Diabetes in Pregnancy, Endocrine Transition of Care Clinic, and Setting Targets Achieving Results in Diabetes program) including their locations of care and specific provider requests.
15. Coordinates, participates, and presents at weekly meetings with the directors of all three programs.
16. Attends and presents at meetings as needed.
17. Act as a super user with the electronic medical record system, EPIC
18. Develop and maintain referral pathways and protocols with clinician leaders.
19. Serve as a liaison to collaborating call centers, including Endocrinology, Diabetes & Hypertension, OBGYN, our multiple diabetes locations as well as Boston Children’s Hospital
20. Enters Patient Data in computerized registries and calendars as well as export data into various computer systems.
21. Offers guidance and support for each program including the development and documentation of project plans, timelines and progress reports by documenting the progress toward goal milestones.
22. Alerts program leadership to patient service issues and any areas in need of improvement.

Education
Bachelor's Degree Clinical Social Work required or Bachelor's Degree Healthcare Management required or Bachelor's Degree Related Field of Study required

Can this role accept experience in lieu of a degree?
Yes

Experience
Social work, case management or related field preferably in a clinical setting 1-2 years preferred
Prior Authorization experience preferred

Knowledge, Skills and Abilities
- Strong knowledge of healthcare resources, community services, and patient advocacy.
- Excellent communication and interpersonal skills.
- Ability to collaborate effectively with healthcare professionals across multiple disciplines and experiences.
- Strong organizational and time management skills.
- Familiarity with electronic health records and case management software.

Hybrid221 Longwood Avenue40RegularDay (United States of America)

Pay Range

$23.34 - $33.37/Hourly

Grade

5At 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.2200 The Brigham and Women's Hospital, Inc. 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.

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