Clinical Support Liaison
INSIGHT HEALTH SYSTEMS, INC.
Clinical Support Liaison
Insight Institute of Neuroscience & Neurosurgery (IINN) aims to advance, challenge, and revolutionize neurosciences and medicine through scientific research and advanced technology, driven by a passion to help others regardless of any obstacles and challenges that may lie ahead. Our integrated team of medical professionals does so through creative, innovative techniques and care principles developed because of our continuous pursuit to improve the field of medicine. Our integrated team works together to find solutions to both common and complex medical concerns to ensure more powerful, reliable results. Having multiple specialties "under one roof" Insight achieves its purpose in providing a comprehensive, collaborative approach to neuromusculoskeletal care and rehabilitation to ensure optimal results. Our singular focus is Patient Care Second to None!
Position Summary: The Clinical Support Liaison will oversee the management of specialties across multiple providers' practices and locations. This position ensures seamless coordination among providers, patients, clinical staff, insurance companies, and specialty pharmacies. The role involves comprehensive case management, real-time data tracking, and operational efficiency to support treatments for cases.
Benefits for our Full Time Team Members:
- Comprehensive health, dental, and vision insurance coverage
- Paid time off, including vacation, holidays, and sick leave
- 401K with Matching; offerings vested fully @ 3 months of employment paired with eligibility to contribute
- Short & Long Disability, and Life Term insurance, complementary of Full Time Employment
- Additional Supplementary coverages offered @ employee's elections: Accident, Critical Illness, Hospital Indemnity, AD&D, etc.
Key Responsibilities:
1. CDTM Management
- Reach out to providers or their offices via phone, secure email, or fax to request signed documentation.
- Schedule reminders to follow up if documentation has not been received in a timely manner. Use tracking systems (CRM or spreadsheets) to monitor requests.
- Obtain access to EMR, if access is not possible obtain pertinent information associated with patient needed for pharmacist visit such as recent progress notes, lab work, prescriptions, and any other necessary documentation.
- Organize digitally in specified folders and tracker systems categorized by specialty and provider.
2. Telehealth Management
- Schedule and coordinate telehealth appointments for new and existing patients.
- Provide technical assistance and communicate with patients regarding telehealth requirements and processes.
3. Prior Authorizations (PA)
- Handle PA submissions through respective platforms CoverMyMeds, PromptPA, Availity, Champs, and/or paper fax.
- Verify insurance details, review formulary guidelines, and prepare chart audits with supporting documentation.
- Manage renewal processes, appeals, and formulary adjustments as required.
4. Patient Access to Medications
- Notify patients and clinical staff upon PA approval.
- Coordinate medication delivery through IM2 or external specialty pharmacies. Routing to the appropriate medical staff member as needed.
- Assist patients with copay payments and support enrollment in manufacturer assistance programs or free drug initiatives.
5. Specialty Pharmacy Coordination
- Prepare and manage meeting materials for specialty pharmacy discussions with Pharmacy tech in Chicago hospital.
- Ensure efficient case resolution and inclusion of additional patient cases as needed.
6. Patient Communication
- Provide status updates, PA progress, and formulary changes through phone calls, texts, and messaging platforms like Klara.
- Escalate unresolved communication issues to clinical staff for follow-up.
7. Communication Management
- Maintain critical communication threads with daily interactions, including providers and teams at various providers' practices.
- Facilitate seamless communication across locations and teams to address patient needs.
8. Tracker Management
- Maintain real-time updates on all trackers for specialties across providers' practices.
- Manage patients through the trackers.
- Ensure trackers are accurate and actively used for daily operations.
9. Clinical and Tracker Audits
- Conduct regular audits of clinical schedules and trackers to ensure compliance with PA renewals, refills, and patient follow-ups.
- Address discrepancies and ensure accurate tracking of patient cases and shipments.
10. Miscellaneous Duties
- Manage FedEx shipment tracking for patient medications.
- Oversee a to-do list for providers, prioritizing activities across providers' practices.
Qualifications:
- Ability to demonstrate authorization to work in the U.S. for any employer.
- Bachelor's degree in Business Administration, Healthcare Administration, Management, or related field is required
- Proven experience in case management or a related healthcare role.
- Expertise in insurance verification, prior authorizations, and patient assistance programs.
- Proficiency in tracking tools, data management, and real-time updates.
- Strong organizational and communication skills to manage multiple stakeholders.
- Ability to work independently in a fast-paced, dynamic environment.
Preferred Skills:
- Familiarity with specialty pharmacy operations and manufacturer assistance programs.
- Knowledge of telehealth platforms and virtual care processes.
- Experience working with clinical staff and providers across multiple locations.
This comprehensive role requires a proactive, detail-oriented individual passionate about enhancing patient access to biologics while ensuring seamless coordination among healthcare stakeholders. Insight is an equal opportunity employer and values workplace diversity!
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