Job Description
Job Description
Company Overview :
BioMatrix is a nationwide, independently-owned infusion pharmacy with decades of experience supporting patients on specialty medication. Our compassionate care team helps patients navigate the often-challenging healthcare environment. We treat our patients like family and get them started on therapy quickly. We work closely with them as well as their family and their healthcare providers throughout the patient journey, staying focused on optimal clinical outcomes.
At BioMatrix the heart of our Inclusion, Diversity, Equity, & Access (IDEA) philosophy is the commitment to cultivate a welcoming space where everyone’s contributions are acknowledged and celebrated. Our goal is to draw in, develop, engage, and retain talented, high-performing individuals from diverse backgrounds and viewpoints. We believe that both respecting and embracing diversity enriches the experiences and successes of our patients, employees, and partners.
Schedule & Location :
8 : 30 am-5 : 00 pm CST and must be able to work PST. This position is in Overland Park, KS.
The Director of Referral Services will be responsible for the oversight and management of the front end referral process including document management, and data entry Benefit Verification and PA processes for the BioMatrix Neurology, Immunology, Transplant and Specialty Infusion areas. The Manager will understand the specific DM, PAL, BV, and PA roles and support the day-to-day department activities. This position will work closely and collaboratively with other internal department leads, including Intake Coordination CRT, Nursing Services and Pharmacy Services.
QUALIFICATION REQUIREMENTS
- 5-7 years of experience in managing patient referral and prescription activities in infusion or specialty therapies
- 3-5 years of general infusion or specialty therapy reimbursement or payer experience
- 3-5 years of experience in supporting prescriber, healthcare setting, patient, and field facing communications related to referral or prescription services in infusion or specialty therapies
- 1-3 years of successful management / leadership of department employees
- Strong customer service skills internal and external customers, including meeting quality standards for services and evaluation of customer satisfaction.
- High School Diploma or equivalent, Bachelors' Degree preferred
- Advanced computer and internet skills (e.g. Microsoft Office)
- Must know and understand financial information and reporting aspects
- Willing to travel up to 5% of the time for business purposes (when necessary to attend meetings, conferences, seminars, etc.)
- Experience with medical terminology.
QUALIFICATIONS PREFERRED
3 - 5 years of people management experience overseeing team members responsible for pharmacy intake or referral process activitiesStrong knowledge and understanding of infusion therapies, the steps needed to qualify a patient for such therapy, and the ability to lead team members through these stepsGeneral knowledge and understanding of payer contracts for infused therapies and operational requirements to support contracts for pharmacy or prescription servicesESSENTIAL FUNCTIONS AND RESPONSIBILITIES
Sets the tone for the Referral Services departments, develops and supports BioMatrix culture in the work environment, and ensures there is opportunity for team professional development.Oversee the DM team supporting fax queue management and data entry of records applicable to documents received.Set standard metrics and goals for Referral Services team members for pull through of referrals, data entry, and documentation management, PAL, BV, PA processingEstablish training protocols for new employees and evaluate performance against metrics / goals; and determine corrective action or training plans to support performance improvement when neededEstablishes communication processes and procedures for Referral Services team members to engage necessary internal and external stakeholders to gather missing or inaccurate informationWork cohesively with internal department leadership to ensure continuity of patient referral activities are performed optimally.Provide administrative and / or leadership support for accreditation related process or data collection activities that entail information from the Intake or Referral departments.Work collaboratively with referral and pharmacy operations management peers to support successful outcomes overall end to end processes to support getting referrals to their proper destinationDaily & Weekly (or as needed) – Review department alignment with stated SLAs for the department, identify trends among reporting periods, and take action with team or peers as neededSupport staffing and resource adjustments as found necessary to support referral volumes and overall growth goals for the organizationMaintains necessary and thoughtful communications to the intake and Patient Services specialist team members delivering information supplied by leadership with impact to people, process, and technology updates within a given location.Serves as a point of escalation for issue management and resolution support related to services provided by Intake & PAL’sEnsure maintenance of strict confidentiality of patient information and compliance with HIPAA Privacy Rule standards.NON-ESSENTIAL FUNCTIONS & RESPONSIBILITIES
Triages work and assigns duties to staffPerform employee management tasks, including, but not limited to review of productivity, management of job descriptions, timely performance reviews, disciplinary process / corrective action, and all associated personnel paperwork.Ability to prioritize and handle multiple tasks and projects concurrentlyMust have scheduling flexibility and be able to work overtime [Exempt]Overnight travel on occasion by car and planeCareful attention to detailPerforms related duties as requestedParticipates in quality assurance activities and audits as directedKNOWLEDEGE, SKILLS AND ABILITIES REQUIREMENTS
Strong knowledge of specialty prescription and referral documentation workflow, provider communication needs, and necessary steps to vet a referral to outcomeStrong working knowledge of medical / pharmacy terminologyGeneral knowledge of intake requirements for all insurance payors including Medicare, Medicaid, Medicare D, Commercial and pharmacy plansAbility to actively communicate, inspire and motivate all levels of staffAbility to think and act strategically and proactivelyAbility to maintain accurate records and prepare reports and correspondence related to the workAbility to organize and coordinate the work of othersAbility to set priorities and assign work to other professionalsAbility to identify areas for opportunity and process improvement and enact changeExcellent verbal, written, and communication skillsExcellent group presentation skillsCommunication & Technical Skills
Oral Communication - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; Responds well to questions and intake / referral issuesWritten Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectivelyComputer skillsCPR+ knowledge, Microsoft business programs – Excel – Word – Access DatabasePHYSICAL DEMANDS AND WORK ENVIRONMENT
This position requires constant sitting with occasional walking, standing, kneeling or stooping.This position requires the use of hands to finger, handle or feel objects and the ability to reach with hands and arms.This position requires constant talking and hearing.Specific vision abilities required by this job include close vision and the ability to adjust focus.This position must occasionally lift and / or move up to 20 pounds.Required to move / lift physical hardware.AMERICANS WITH DISABILITY SPECIFICATIONS
PHYSICAL DEMANDS
Th The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop; kneel, crouch or crawl; talk or hear; taste or smell. The employee must occasionally lift and / or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.