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Job Summary This job is temporary with an expected duration of 3-4 months with hospital option to extend or shorten based on operational or clinical needs. The role is an integral part of our clinical coordination team, providing support to providers, facilities, and members to ensure streamlined end-to-end transplant coordination. This position will be the single point of contact for facilities and providers for members who require transplant support, planning, utilization review, and follow-up.
This role will track all members across lines of business identified for the transplant program. The position collaborates with members of the Utilization Management, Care Management, and medical director teams to support transplant-specific needs. Does this position require Patient Care?
No
-In conjunction with other team members, ensures that transplant coordination is holistic and managed from end to end. -Directly interact with providers and their staff to obtain additional clinical information, as well as with members or their advocates to understand the full extent of the need to plan transplant activities. -Review information and provide recommendations to the collaborative team based on analysis of the clinical material. -Tracks and monitors the status transplant eligible members to ensure comprehensive support and management. -Coordinates communication between patients, healthcare providers, and insurance companies regarding discharge needs. -Obtains appropriate authorizations and tracks each member individually to ensure accuracy in the file and to provide the full support required to coordinate transplant activities. -Participates in interdisciplinary meetings to discuss complex cases and recommend solutions.
Qualifications
-Associate's Degree Nursing required and/or Bachelor's Degree Healthcare Administration or related field of study required Can this role accept experience in lieu of a degree? No Licenses and Credentials: Registered Nurse [RN - MA State License]
- 2
- 3 years' experience in health plan clinical services/utilization management required. 2
- 3 years Clinical experience required. 2
- 3 years transplant management expertise/knowledge required. Knowledge, Skills and Abilities: - Strong analytical and critical thinking skills. - Excellent verbal and written communication abilities. - Proficient in using electronic health records (EHR) and billing systems. - Detail-oriented with strong organizational skills. - Ability to handle sensitive information with confidentiality and professionalism. - Strong interpersonal skills to work effectively with various stakeholders. Additional Job Details (if applicable) Remote Type Onsite Work Location 45 Francis Street
- $79,560.00 - $115,720.80/Annual Grade 7 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. EEO Statement: 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.