Clinical Support Liaison

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

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.
• Organize digitally in specified folders and tracker systems categorized by specialty and provider.

Telehealth Management

• Schedule and coordinate telehealth appointments for new and existing patients.
• Provide technical assistance and communicate with patients regarding telehealth requirements and processes.

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.

Patient Access to Medications

• Notify patients and clinical staff upon PA approval.
• Cook specialty pharmacy discussions with Pharmacy tech in Chicago hospital.
• Ensure efficient case resolution and inclusion of additional patient cases as needed.

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.

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.

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.

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.

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.