Infusion Operations Specialist

Infusion Operations Associate The Infusion Operations Associate will support the implementation and growth of Infusion services across a site or sites; serve as a generalist and/or flex resource based on need Participate in various activities to promote the development, quality, and coordination of Infusion services across many stakeholders and functions; develop a plan to improve, streamline, and increase the efficiency and effectiveness of the Infusion program Support oversight of Medical Intake Coordinators and other resources aligned to Infusion program; develop processes for tracking referrals, prior authorizations and appeals, and patient engagement Participate in discussions to help identify and solve for root causes of presented opportunities and/or causes of denied claims; develop workflow solutions to optimize patient care and engagement Participate in the development, implementation and evaluation of policies and procedures; assist Operations teams with the development of new policies and procedures and assure timely review and revision of procedures as the program expands. Key Responsibilities Support onboarding and training of new hires supporting Infusion services, including Medical Intake Coordinator, Medical Billing Specialist, and Nursing Coordinator; host Medical Billing Training (Week 4) Serve as Stabilizer and/or support stabilization (Weeks 5 and 6) of new hires into clinics and/or workflows Conduct frequent audits on people, processes, and workflows to uphold quality and compliance standards as well as ensure consistency across the team Work with Operations and Implementation teams to develop workflows and recommend enhancements to improve as necessary; support day-to-day operations, new clinic implementations and other growth initiatives Develop and refresh written training materials and/or job aids when needed specific to site, initiative, and/or role; perform both gap and quality analyses regularly to ensure materials are current and relevant based on changing factors Support ongoing development of team through one-on-one sessions, refresher workshops, and creation of educational material/job aids/presentations; monitor team productivity Support creating weekly outline and gameplan to ensure all activities, tasks, and to-dos are completed on time; monitor communications in real time to catch or prevent any issues Launch new clinics as the in-seat resource until permanent resource is identified, hired and trained Provide transitional coverage support for FMLA, voluntary / involuntary transitions, and other coverage gaps (including short- and long-term PTO) Provide education and serve as subject matter expert about the Shields/Health System Infusion Care Model to clinic leadership, staff, patients and other stakeholders Compile, monitor, analyze, audit and present data to internal teams and make recommendations as needed; monitor outlined key metrics and KPIs on regular basis to improve operational and financial performance Engage and partner with Regional leaders and participate in team meetings, discussions, and initiatives to establish “one team” identity Facilitate communication between multiple teams and proactively share information pertaining to new initiatives, best practices, changes in the way we do things proactively Assist in identifying gaps in the onboarding and training process, as well as other opportunities to support development and growth of our team Problem solve and collaborate with other members of the team when schedules, priorities, and needs of the business are not in sync Support development of meeting agendas with team, clinics, and other key stakeholders (internal and external); support outline/recap of next steps Participate in interview process Perform other tasks and responsibilities at the discretion of their direct manager and/or leadership of the site they are actively supporting Experience/Requirements High school education or equivalent required Current certification and/or licensure as a Pharmacy Technician required? A national OR state? And what state (is it where they live or any state?) 3-5+ years health care experience required; 3+ as a pharmacy technician required  1+ years in a supervisory or leadership role required; 3+ years preferred 3+ years’ experience with infusions, coordinating and subcontracting referrals, infusion and medical reimbursement required; experience must include medical pre-certification, benefits investigation, prior authorization, and financial assistance; 2+ years of experience specific to home infusion preferred Strong interpersonal skills, strong verbal and written communication skills Strong mathematical skills, including calculating doses, out of pocket costs based on benefits Strong time management skills Understands the pre-certification process for specialty/non-specialty infusions; knowledge and understanding of nuances of infusion therapy v. “standard” outpatient specialty pharmacy Knowledge of infused specialty medications preferred; knowledge of common home infusion J-codes and HCPC codes (including per diem and nursing) preferred Experience with major and local medical plans preferred; strong knowledge of Medicare and Medicaid regulations and commercial insurer criteria for payment of infusion and home care services Highly proficient in navigating various systems including: EMR’s (e.g., EPIC, Cerner), and dispensing systems (e.g. CPR+, EPIC WAM) etc. California residents employed by or applying for work at Shields have certain privacy rights. Please review our: https://www.shieldshealthsolutions.com/wp-content/uploads/2023/01/CPRA-Notice-Shields-Website-January-1-2023.pdf and https://www.shieldshealthsolutions.com/privacy-policy/   By providing your mobile number, you agree to receive text messages from Shields Health Solutions related to job opportunities, interview scheduling, and recruiting updates. Message and data rates may apply. You may opt out at any time by replying 'STOP.' Consent is not a condition of employment. Shields Health Solutions provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. Offices: (Corporate);