Transition of Care Specialist

Rush Hospital$61K — $99K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • High School Diploma or equivalent required; Bachelor's degree preferred.
  • Five years of experience in alternate site care environment.
  • Excellent problem-solving skills and the ability to work independently in a fast-paced environment.
  • Strong customer service experience, meeting quality standards.
  • Proficient in interpersonal, verbal, and written communication skills.
  • Knowledge of compliance regulations and pharmacy policies.
  • Advanced knowledge of Medicare, Medicaid, and insurance benefits.

Responsibilities

  • Interact daily with service providers to facilitate patient assessments for Rush Specialty Pharmacy.
  • Ensure proper placement of patients referred for services.
  • Coordinate reviews of patient medical records for treatment planning.
  • Educate patients and caregivers about Rush Specialty Pharmacy offerings.
  • Serve as the main liaison between Rush Specialty Pharmacy and other healthcare providers.
  • Collaborate with patients and caregivers to implement treatment plans while explaining available options.
  • Maintain a strong knowledge of payer contracts and assist patients in qualifying for financial assistance.

Benefits

  • Full-time position with a standard work schedule of 8 hours per day.
  • Opportunity to make a direct impact on patient care and outcomes.
  • Collaborative work environment with healthcare professionals.
  • Engagement in community outreach and educational initiatives.
  • Access to continuing education and professional development opportunities.
Full Job Description
Location: Chicago, Illinois

Business Unit: Rush Medical Center

Hospital: Rush University Medical Center

Department: Specialty Drug Solutions

Work Type: Full Time (Total FTE between 0.9 and 1.0)

Shift: Shift 1

Work Schedule: 8 Hr (9:00:00 AM - 5:00:00 PM)

Pay Range: $29.36 - $47.79 per hour
Rush salaries are determined by many factors including, but not limited to, education, job-related experience and skills, as well as internal equity and industry specific market data. The pay range for each role reflects Rush's anticipated wage or salary reasonably expected to be offered for the position. Offers may vary depending on the circumstances of each case.

Summary:

The Transition of Care Specialist, Specialty Pharmacy, serves as a specialty pharmacy services expert consultant to outpatient clinic staff, and is an advocate for patients, with the goals of raising awareness about the benefits of Rush Specialty Pharmacy. The Specialist will educate patients, physicians, case managers and all customers regarding specialty medication access, including prior authorizations and financial assistance, from Rush Specialty Pharmacy. The Specialist will facilitate patient care coordination for patients referred to Rush Specialty Pharmacy including initial patient set-up and patient/caregiver education. The Specialist interfaces with healthcare professionals and outpatient clinic staff in an effort to strengthen partnerships and grow the HDM pharmacies through referrals. Exemplifies the Rush mission, vision and values and acts in accordance with Rush policieOther information:

Required Job Qualifications:
High School Diploma or Equivalent.

  • Five years' experience in the alternate site care environment.
  • Excellent problem solving skills and the ability to work independently in a fast paced environment.
  • Experience providing customer service to both internal and external customers, including meeting quality standards for service and evaluation of customer satisfaction.
  • Excellent interpersonal, verbal and written communication skills and organizational skills.
  • Knowledge of and guarantees compliance with: state and federal regulations, accrediting body standards, HDM pharmacy policies and procedures and standards of performance.
  • Knowledge of marketing strategies, processes and available resources.
  • Ability to develop, plan and implement short- and long-range goals.
  • Experience in identifying operational issues and recommending and implementing strategies to resolve problems.
  • Computer skills (Word, Excel, patient databases, email); experience using voicemail and cell phones.
  • Telephone, computer systems, copiers, fax machines, calculator and other office equipment as necessary.
  • Advanced knowledge of Medicare, Medicaid and insurance benefits.
  • Normal office and clinical environments.
Preferred Job Qualifications:
  • Bachelor's Degree.
Physical Demands:
  • May be exposed to certain hazardous materials, including but not limited to blood-borne pathogens and chemotherapeutic agents.


Responsibilities:

  • Interacts with area service providers daily to facilitate assessment of patients selected by the hospital/clinic/doctor office to receive care by Rush Specialty Pharmacy.
  • Assures proper placement of patients referred for Rush Specialty Pharmacy services.
  • Coordinates reviews of patient's medical record to gather appropriate assessment documents so that an effective plan of treatment can be formulated. Reviews the record to obtain primary and secondary insurance payer information and relays this information to the intake department.
  • Educates patients, their caregivers and the Rush Medical Staff about the services and products that the Rush Specialty Pharmacy provides.
  • Represents and serves as the point of contact between Rush Specialty Pharmacy and all other levels of care, including physicians, staff nurses, CM staff, agency liaisons and patients/caregivers.
  • Effectively communicates with all levels of care, including CM Staff, nursing agencies, medical team members, pharmacy staff, patients and caregivers to assure access to specialty medications through all avenues.
  • Works in collaboration with the patient and their caregiver to implement an effective treatment plan with mutual goals, explaining available options, including the advantages and disadvantages of each option.
  • Maintains a positive relationship with internal customers, listens to different viewpoints and works collaboratively with others throughout the company to resolve conflicts.
  • Educates and assists patients in qualifying for third party financial assistance.
  • In conjunction with management, establishes and implements a marketing plan for the community served which includes promotional and educational events and materials, physician, patient and medical staff contacts.
  • Maintains a strong knowledge base of all payer contracts to communicate to customers.
  • Participates in targeting and prioritizing business opportunities.
  • Maintains professionalism at all times. Follows through on commitments to others, delivers on promises, maintains personal integrity, is easily accessible at all times, and serves as a role model for others as evidenced by peer feedback and letters of recognition and support.
  • Visits customer referral sources frequently to inquire about satisfaction with the HDM pharmacies; identifies and resolves service issues in a timely manner.
  • Other relevant duties as required.


s and procedures.

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