It takes a lot of very smart, hard-working and talented people to provide the level of care that we give to our patients. Tufts Medical Center is an internationally respected academic medical center and we pride ourselves not only on the sophistication of the care we deliver, but the compassionate way in which we provide it. And that starts with our employees.

The Research Assistant (RA) will be a member of the Center for the Evaluation of Value and Risk in Health (CEVR), which is part of the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center in Boston. 

The RA position supports research activities involving health plan coverage of medical technology, health economics, and cost-effectiveness analyses. Activities include but are not limited to data extraction, management and analysis, review and summary of literature, and assisting with the preparation of manuscripts and presentations. The position requires strong writing and organizational skills. 

The RA must be able to work independently and handle competing demands in order to meet project deadlines. The RA will be supervised by CEVR faculty and senior research staff.

PRINCIPAL DUTIES AND ESSENTIAL FUNCTIONS:

• Data extraction, management, and analysis.
• Conducting literature searches and developing written literature summaries.
• Assisting with manuscript and grant application preparation, including the drafting of text, preparation of tables and figures, and preparation of bibliographies.
• Assisting with other research activities.

JOB REQUIREMENTS

• Excellent written and oral communication skills.
• Strong computer skills, including proficiency with MS Office (Word, Excel and Power Point). Familiarity with databases (e.g., experience using MS Access) and/or computer programming skills are a plus.
• Ability to work both independently with limited supervision as well as in a collaborative team environment.
• Ability to multi-task and prioritize responsibilities appropriately.
• Strong organizational skills and attention to details.

EDUCATION:

• Bachelor's degree in a quantitative or scientific field with an interest in health policy. Economics degree a plus.

EXPERIENCE:

• Some research experience, preferably in an academic, research or medical setting is a plus.

WORKING CONDITIONS/PHYSICAL DEMANDS:

Normal office work environment

All your information will be kept confidential according to EEO guidelines.

AMERICANS WITH DISABILITIES STATEMENT:

Must be able to perform all essential functions of this position with reasonable accommodation if disabled.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed, as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Tufts Medical Center reserves the right to modify position duties at any time, to reflect process improvements and business necessity.

COVID-19 POLICY:

Please note that effective October 1, 2021, as a condition of employment at Tufts Medical Center, all employees and new hires must have received their complete dose of the COVID-19 vaccine, unless they have been granted an exemption.  

It takes a lot of very smart, hard-working and talented people to provide the level of care that we give to our patients. Tufts Medical Center is an internationally respected academic medical center and we pride ourselves not only on the sophistication of the care we deliver, but the compassionate way in which we provide it. And that starts with our employees.

This position supports the central operations of the Department of Medicine and Research Administration.  The Research Project Coordinator provides a wide range of project management and administrative assistance to the Executive Director that are essential to the effective conduct of business, including reporting, compliance, and communications across the research community.

Principal Duties and Responsibilities:

• Compiles, curates content, and sends the monthly research newsletter to the research community, keeping the institution informed on new grant awards, policies, and ongoing research projects of interest.
• Organizes, maintains, and distributes the weekly data on compliance towards institutional requirements for the completion of performance appraisal, mandatory education modules, and flu shot compliance, across research.  
• Processes monthly billing for CORI payments relative to Special & Scientific Staff reappointments for the Medical Staffing Office.
• Oversees the institutional SAS license, ensuring requests are completed by IT and billing the end user(s). 
• Compiles/prepares/processes employee and faculty expense reimbursements.
• Maintains master email distribution list for all research faculty and staff, adding and removing individuals as necessary from the corresponding email lists.
• Serves as the holder of the Departmental P-card, responsible for allocating transactions to make sure that every purchase is charged to the correct account and that receipts related to each purchase is collected and stored.
• Assists Exec Director with monthly financial account reconciliation.
• Ensures monthly effort reports and distributed, completed, certified, and submitted across the Departments of Medicine.
• Ensures monthly postdoc calendars documenting time off are distributed across research, and maintains the documentation centrally for Departments of Medicine & Ophthalmology.
• Manage and ensure that individual’s time is correct and entered into Kronos for payroll across the Departments of Medicine and Research Administration.
• Provides administrative support to the Executive Director, Research Administration.
• Performs other similar and related duties as required or directed.

JOB KNOWLEDGE AND SKILLS:

• Experience in project management
• Ability to successfully plan and organize an event
• Excellent interpersonal skills to deal effectively with researchers, staff, administrators and customers. Outstanding customer service skills required.
• Excellent organizational skills to manage work flow independently. Ability to prioritize quickly and appropriately.
• Must be able to multitask, working on multiple studies and protocols.
• Requires meticulous attention to detail with excellent data management and organizational skills.

EDUCATION:

• Bachelor of Science or Bachelor of Arts degree required.

EXPERIENCE:

• Two or more years experience in an academic or medical research setting highly desirable.
• An equivalent combination of education and experience, which provides proficiency in the areas of responsibility listed above, may be substituted for the above education and experience requirements.

WORKING CONDITIONS/PHYSICAL DEMANDS:

• Consistent with a normal office work environment. Work requires frequent continuous typing/computer keying, telephone use and sitting for extended periods.

AMERICANS WITH DISABILITIES STATEMENT:

Must be able to perform all essential functions of this position with reasonable accommodation if disabled.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed, as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Tufts Medical Center reserves the right to modify position duties at any time, to reflect process improvements and business necessity.

COVID-19 POLICY:

Please note that effective October 1, 2021, as a condition of employment at Tufts Medical Center, all employees and new hires must have received their complete dose of the COVID-19 vaccine, unless they have been granted an exemption.  

Tufts Clinical and Translational Science Institute (CTSI) (www.tuftsctsi.org), one of more than 60 organizations supported by the National Institutes of Health (NIH) Clinical and Translational Science Awards (CTSAs), was established in 2008 to transform the biomedical research process through education, promoting collaboration, and the provision of research infrastructure and support services. Tufts CTSI accelerates the translation of laboratory research into clinical use, medical practice, and health policy. In addition to its work with Tufts University, Tufts Medical Center, and other partner organizations, Tufts CTSI contributes to the national CTSA Consortium.

This is an exciting opportunity for the right applicant to make an impact on the future of health care by joining the Health Informatics Program at Tufts CTSI. You will join the team that facilitates open science, develops data assets, innovates new methods, and implements solutions and workflows for knowledge generation, sharing, and delivery to the point of care or dissemination to inform policies. We integrate health care and research support, and work with observational data generated from health care settings including EHR, location-based (GIS), claims, device and other data types.

You will join the team of likeminded individuals and will work on cutting edge initiatives such as developing the research infrastructure in the cloud environment, extending the content and functionality of a clinical research data warehouse and cloud architecture development, you will have the opportunity to explore and contribute to development of novel approaches to data integration, support the research community locally and nationally through the research networks such as N3C, in their data needs in collaboration with other technical team members.

If you are a developer who enjoys community engaged open source development and collaboration, takes initiative, and works well independently and as part of a team, apply today!

Responsible for executing software development initiatives for end users at Tufts Medical Center.

PRINCIPAL DUTIES AND ESSENTIAL FUNCTIONS:

Responsible for executing software development initiatives. 

Implementation

• Collaborate with various stakeholders to understand requirements and design solutions
• Evaluate options and develop technical design
• Develop solution using appropriate programming language and/or technical tools
• Complete thorough testing of solution
• Provide input to the development of integrated test plan
• Execute integrated test plan
• Provide input to the development of LIVE plan
• Support LIVE activities

Ongoing Enhancements and Support

• Build enhancements to current functionality using appropriate programming language and/or technical tools
• Perform detailed testing of software updates and upgrades
• Communicate in a friendly and professional manner, share the ideas, solutions, the approach, risks, and impacts, set appropriate expectations for the development timeline
• Participate in after-hours on call support rotation for one or more applications which generate Incidents outside of business hours.
• Participate in cross-training, as a trainer and a learner, for personal development and to ensure adequate secondary coverage on all applications

JOB REQUIREMENTS:

• Strong interpersonal skills demonstrated through prior work experience.
• The ideal candidate has strong software development skills; able to deploy and debug software of varying scope and stack; must be able to work in a team environment as a member and a facilitator; has the ability to manage own time effectively; and able to perform some work independently. Additionally, the candidate must be highly motivated and willing to learn and adopt to new, leading-edge technologies. The candidate must possess excellent analytical, problem-solving skills, along with strong oral and written communication and interpersonal skills. Lastly, the candidate must be comfortable interacting with colleagues within the Tufts CTSI network and within the broader research community.

JOB KNOWLEDGE AND SKILLS:

• Knowledge and experience developing, deploying, and maintaining systems inside of both AWS and Azure;
• Knowledge of development and maintenance of small to medium-scale ETL processes, ETL tools, ideally within a biomedical environment.
• Strong working knowledge of either one of or all: R, Python, MS SQL. Knowledge of other languages is a plus.
• Some familiarity with large scale observational research methods and practices OMOP CDM and OHDSI Tool Stack experience preferred.
• Familiarity with common data models in used in distributed health sciences research networks.
• Familiarity with HL7, FHIR interface.
• The successful candidate must be comfortable using Windows- and Linux-based operating systems.
• Thorough understanding of software development life cycle
• Excellent customer service orientation
• Flexibility and can-do attitude

EDUCATION:

• Degree in Computer science, bioinformatics, or similar discipline.

EXPERIENCE:

• Graduate degree and 4-6 years of experience in the DevOps, healthcare or data science related field
• An equivalent combination of education and experience that exhibits proficiency in the areas of responsibility listed above may be substituted for the above requirement

All your information will be kept confidential according to EEO guidelines.

This position is grant funded until April 2023 with strong probability of renewal. 

AMERICANS WITH DISABILITIES STATEMENT:

Must be able to perform all essential functions of this position with reasonable accommodation if disabled.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed, as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Tufts Medical Center reserves the right to modify position duties at any time, to reflect process improvements and business necessity.

COVID-19 POLICY:

Please note that effective October 1, 2021, as a condition of employment at Tufts Medical Center, all employees and new hires must have received their complete dose of the COVID-19 vaccine, unless they have been granted an exemption.  

It takes a lot of very smart, hard-working and talented people to provide the level of care that we give to our patients. Tufts Medical Center is an internationally respected academic medical center and we pride ourselves not only on the sophistication of the care we deliver, but the compassionate way in which we provide it. And that starts with our employees.

GENERAL SUMMARY:

The Research Assistant (RA) will be a member of the Center for the Evaluation of Value and Risk in Health (CEVR), which is part of the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center in Boston. 

The RA position supports research activities involving health plan coverage of medical technology, health economics, and cost-effectiveness analyses. Activities include but are not limited to data extraction, management and analysis, review and summary of literature, and assisting with the preparation of manuscripts and presentations. The position requires strong writing and organizational skills. 

The research assistant’s primary responsibility will be to support the Specialty Drug Evidence and Coverage (SPEC) Database, which CEVR researchers use to examine patient access to specialty medications through private health plan coverage decisions.

The RA must be able to work independently and handle competing demands in order to meet project deadlines.  The RA will be supervised by CEVR faculty and senior research staff.

PRINCIPAL DUTIES AND ESSENTIAL FUNCTIONS:

• Data extraction, management, and analysis.
• Conducting literature searches and developing written literature summaries.
• Assisting with manuscript and grant application preparation, including the drafting of text, preparation of tables and figures, and preparation of bibliographies.
• Assisting with other research activities.

JOB REQUIREMENTS

• Excellent written and oral communication skills.
• Strong computer skills, including proficiency with MS Office (Word, Excel and Power Point). Familiarity with databases (e.g., experience using MS Access) and/or computer programming skills are a plus.
• Ability to work both independently with limited supervision as well as in a collaborative team environment.
• Ability to multi-task and prioritize responsibilities appropriately.
• Strong organizational skills and attention to details.

EDUCATION:

• Bachelor's degree in a quantitative or scientific field with an interest in health policy.  Economics degree a plus.

EXPERIENCE:

• Some research experience, preferably in an academic, research or medical setting is a plus.

WORKING CONDITIONS/PHYSICAL DEMANDS:

Normal office work environment.

All your information will be kept confidential according to EEO guidelines.

AMERICANS WITH DISABILITIES STATEMENT:

Must be able to perform all essential functions of this position with reasonable accommodation if disabled.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed, as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Tufts Medical Center reserves the right to modify position duties at any time, to reflect process improvements and business necessity.

COVID-19 POLICY:

Please note that effective October 1, 2021, as a condition of employment at Tufts Medical Center, all employees and new hires must have received their complete dose of the COVID-19 vaccine, unless they have been granted an exemption.  

It takes a lot of very smart, hard-working and talented people to provide the level of care that we give to our patients. Tufts Medical Center is an internationally respected academic medical center and we pride ourselves not only on the sophistication of the care we deliver, but the compassionate way in which we provide it. And that starts with our employees.

This position is responsible and accountable for the management of care for an assigned patient population by unit, across the continuum of care.  The Case Manager works to achieve daily clinical, quality and cost outcomes by providing well-coordinated experiences for patients/families through the synchronization of care activities of multiple disciplines and negotiating with third party payors.

This is accomplished by negotiating, procuring and coordinating services and resources needed by patient/family; ensuring and facilitating the achievement of quality and clinical customer service; cost and clinical outcomes; intervening at key points for individual patients; addressing and resolving patterns or issues that have a negative quality-cost impact; and creating opportunities and systems to enhance outcomes.

PRINCIPAL DUTIES AND ESSENTIAL FUNCTIONS:

CARE COORDINATION COMPLETES:

• Case Managers complete assessments on all new admissions to determine the need for all appropriate Case Management services.
• Conducts daily multidisciplinary rounds on assigned units, reviews patient’s plan of care and coordinates:
  • Assessment of patient/family needs
  • Completion and report of diagnostic tools in a timely manner
  • Completion of treatment appropriate for the acute episode of illness
  • Modification of plan to meet continuing care needs of the patient
  • Monitors ongoing process of gathering adequate information from all relevant sources to insure operation of plan
• Discusses estimated length of stay, treatment and discharge plan with the attending physician and healthcare team
  • Establish strong, collaborative relationships with your physicians and team members
  • Discusses with MD the appropriateness of resource utilization, consults and treatment plan
• Ensures that the interdisciplinary care plan and discharge plan are consistent with the patient’s clinical course, covered services and continuing care needs.
• Identifies patients and families with complex psychosocial, financial and legal discharge planning needs and refers them to social work.
• Incorporates knowledge of clinical expertise, quality initiatives, insurance and finance into decision-making and problem solving of individual patient cases and across case type during care management activities.
• Fosters and maintains a positive working relationship with referral agencies and liaisons to enhance patient flow.
• Collects and reports on quality projects, i.e.:
  • CHF
  • Re-admissions within 30 days
  • Delay Day Variances
  • Risk management
  • Quality improvement
• Documents patient/family progress towards discharge and all critical events and information associated with the hospital stay in SoftMed.
• Supports the EMR and all computer programs, including SoftMed and Soarian.

UTILIZATION

• Using Interqual criteria, reviews appropriateness of admission, the need for continued stay and information needed for discharge.
• Responds to third party payor requests for concurrent clinical information in timely manner.
• Ensures that documentation in the medical record supports the admission and continued stay, in order to reduce denial rate.
• Documents care management activities in the initial assessment and as the patient progresses towards discharge and at discharge.
• Inteacts with Admitting, Financial Counselors, Insurance Case Managers, Finance and Screeners as appropriate.
• Maintains clinical competency and current knowledge of regulatory and payor requirements to perform job responsibilities.
• Works with documentation specialist to have accurate length of stay information.

DISCHARGE PLANNING

• Provides superior customer services to all internal and external clients, customers and patients
• Completes roles and functions related to discharge planning/coordination including case identification, high risk screening, assessment of patient and resources, goal setting, implementing, maintaining and evaluating process. Goal is to complete within 24 hours.
• Coordinate all discharge activities.
• Initiate all appropriate referrals to continuum of care agencies in a timely manner.
• Facilitates patient transfer from one level of care to the next.
• Incorporate the highest standard of professional, clinical, legal and ethical practice into their own daily practice (i.e. patient’s rights, maintains confidentiality, role model to nursing).

AGE SPECIFIC COMPETENCIES:

Possesses and applies the skills and knowledge necessary to provide care to patients throughout the life span, with consideration of aging processes, human development stages and cultural patterns in each step of the care process. This includes:

• Knowledge of growth and development
• Ability to interpret age specific data and response to care
• Ability to provide age specific communication
• Knowledge of appropriate resources available (homecare, SNF, infusion, rehab)

JOB KNOWLEDGE AND SKILLS:

• Maintains clinical competency and current knowledge of regulatory and payer requirements to perform job responsibilities
• Working knowledge of InterQual or designated screening tool to Tufts Medical Center
• Competencies of this role include but are not limited to:
  • Continuous Learning – Assesses own strengths and weaknesses; seeks feedback to improve performance; pursues training and development opportunities; strives to continuously build knowledge and skills; shares expertise with others.
  • Corporate Responsibility – Adheres to rules, regulations and policies; understands and respects patient rights; performs duties in an ethical manner; operates within scope of position.
  • Performance Improvement – Demonstrates an understanding of the performance improvement process; participates in performance improvement efforts, seeks ways to improve systems and services; focuses on achieving patient/client satisfaction.
  • Analytical – Synthesizes complex or diverse information; collect and researches data; uses intuition and experience to complement data; designs work flows and procedures.
  • Diversity Awareness – Demonstrates an understanding of diversity; demonstrates an understanding of the value of diversity; displays respect for others by utilizing inclusive behaviors; contributes to a harassment-free work place; assists all patient, clients, residents and employees.
  • Professional Responsibility – Meets attendance and punctuality guidelines; adheres to appropriate dress code; attends required meetings and in-service programs; maintains current certifications and licensing; completes mandatory annual education.

EDUCATION:

• Bachelors Degree required, Bachelors Degree in Nursing preferred.
• BLS Certification required

EXPERIENCE:

• Minimum of three years Case Management experience required

LICENSES, ETC:

• Current MA License Registered Nurse 

WORKING CONDITIONS/PHYSICAL DEMANDS:

• Prolonged, extensive or considerable standing/walking
• Contact with patients under a wide variety of circumstances
• Subject to varying and unpredictable situations
• Subject to irregular hours
• Work requires some typing/computer keying
• May be exposed to the risk of bloodborne diseases and other transmissible infections
• May have contact with hazardous materials and/or chemicals

All your information will be kept confidential according to EEO guidelines.

AMERICANS WITH DISABILITIES STATEMENT:

Must be able to perform all essential functions of this position with reasonable accommodation if disabled.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed, as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Tufts Medical Center reserves the right to modify position duties at any time, to reflect process improvements and business necessity.

COVID-19 POLICY:

Please note that effective October 1, 2021, as a condition of employment at Tufts Medical Center, all employees and new hires must have received their complete dose of the COVID-19 vaccine, unless they have been granted an exemption.  

It takes a lot of very smart, hard-working and talented people to provide the level of care that we give to our patients. Tufts Medical Center is an internationally respected academic medical center and we pride ourselves not only on the sophistication of the care we deliver, but the compassionate way in which we provide it. And that starts with our employees.

Tufts Medical Center Post-Doctoral Fellow in Health Economics and Value Measurement

We are pleased to announce a post-doctoral fellow position at the Center for the Evaluation of Value and Risk in Health (CEVR) at Tufts Medical Center. This two-year fellowship program, sponsored by Sunovion Pharmaceuticals in Marlborough, MA, provides an excellent opportunity for the fellow to gain unique and in-depth applied work experience in health economic evaluation, value measurement, and global health research.  The expected start date of the fellowship is September 2022.

In the first year, the fellow will train at CEVR under the direction of Peter J. Neumann, ScD (CEVR’s Director), Joshua T. Cohen, PhD (Deputy Director), Paige Lin, PhD (Associate Professor), Tara Lavelle, PhD (Assistant Professor) and their colleagues. The fellow will spend four days a week with CEVR and one day a week with Sunovion in the first year and four days with Sunovion/one day with CEVR in the second year. The fellowship program will prepare the fellow for careers in academic, consulting, or industry settings.

Candidates should have recently completed or expect to soon complete their doctorate studies with a strong research record in health policy, health economics, decision science, or a related field. Experience in biostatistics, simulation modeling or large databases analysis is desirable. 

All your information will be kept confidential according to EEO guidelines.

AMERICANS WITH DISABILITIES STATEMENT:

Must be able to perform all essential functions of this position with reasonable accommodation if disabled.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed, as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Tufts Medical Center reserves the right to modify position duties at any time, to reflect process improvements and business necessity.

COVID-19 POLICY:

Please note that effective October 1, 2021, as a condition of employment at Tufts Medical Center, all employees and new hires must have received their complete dose of the COVID-19 vaccine, unless they have been granted an exemption.  

It takes a lot of very smart, hard-working and talented people to provide the level of care that we give to our patients. Tufts Medical Center is an internationally respected academic medical center and we pride ourselves not only on the sophistication of the care we deliver, but the compassionate way in which we provide it. And that starts with our employees.

The Project Director will be a member of the Center for the Evaluation of Value and Risk in Health (CEVR), within the Institute for Clinical Research and Health Policy Studies (ICRHPS) at Tufts Medical Center in Boston. 

The Project Director’s principal responsibility will be to develop and lead research studies.

The position requires someone with strong writing and organizational skills who thrives both as part of a team and when working independently.

PRINCIPAL DUTIES AND ESSENTIAL FUNCTIONS:

• Conception, design, and management of research studies.
• Development of manuscript drafts for submission to peer-review journals (candidate would be expected to lead manuscript writing).
• Project management, including tracking project timelines, planning external meetings, and engaging with project partners and stakeholders.
• Oversight and mentorship of supporting staff members for management and technical support.
• Support faculty in the development of research proposal.

JOB KNOWLEDGE AND SKILLS

• Strong written communication skills, e.g., as demonstrated by a history of major contributions to published reports or manuscripts, and lead authorship of published or unpublished papers or reports that present original analytic work.
• Experience in project management.
• Experience manipulating and analyzing large datasets, such as claims data or other healthcare data.
• Experience performing systematic literature reviews is a plus.
• Experience mentoring junior researchers.
• Experience using statistical and general programming language (e.g., SQL, R, SAS, or STATA). 
• Knowledge of the US health care system. In particular, familiarity of the US health insurance landscape is highly desirable.

EDUCATION

• Master’s degree (or higher) in health policy, health economics, public health, decision science, or a related field.

EXPERIENCE

• Five to seven years’ experience in health policy, health economics, decision science or a related field.

WORKING CONDITIONS/PHYSICAL DEMANDS:

• Normal office work environment.
• Work requires continuous typing/computer keying.

All your information will be kept confidential according to EEO guidelines.

AMERICANS WITH DISABILITIES STATEMENT:

Must be able to perform all essential functions of this position with reasonable accommodation if disabled.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed, as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Tufts Medical Center reserves the right to modify position duties at any time, to reflect process improvements and business necessity.

COVID-19 POLICY:

Please note that effective October 1, 2021, as a condition of employment at Tufts Medical Center, all employees and new hires must have received their complete dose of the COVID-19 vaccine, unless they have been granted an exemption.  

It takes a lot of very smart, hard-working and talented people to provide the level of care that we give to our patients. Tufts Medical Center is an internationally respected academic medical center and we pride ourselves not only on the sophistication of the care we deliver, but the compassionate way in which we provide it. And that starts with our employees.

GENERAL SUMMARY:

The Senior Project Manager is a senior member of a research team within the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center. Working closely with the Principal Investigator, this position has responsibility for the planning, management and execution of projects within the Center for Community -Engaged Medicine.  The Senior Project Manager will assist the Center Director in the effective submission, management and execution of multiple grants and contracts.  

This person will provide leadership and guidance while overseeing the day-to-day operations of the Center.   The largest program of the Center is the development and dissemination of HOPE – Healthy Outcomes from Positive Experiences. HOPE, grounded in science, builds from the formative role of positive experiences in human development to inspire fundamental changes in how we advance health and well-being for our children, families, and communities. HOPE believes all families should be treated with dignity; marginalized families and communities are not judged as broken, but are valued, respected, and heard.  For more information about the HOPE framework please visit positiveexperience.org.

This project involves multiple grants and contracts from philanthropic foundations, federal and state sources, and income generated through training and technical assistance.  HOPE has an active National Advisory Board, a newly formed Family and Community Expert (FACE) council, and an active website and social media presence.  In addition to the Center director and consultants, HOPE has six full-time staff members, half of whom work remotely.

The Senior Project Manager will provide organizational support for new projects in the expanding Center.  The Center is in the process of bringing in new faculty members with their own academic interests, and the project manager may be asked to provide support for these projects.

PRINCIPAL DUTIES AND ESSENTIAL FUNCTIONS:

• Organizing daily activities including the daily morning team meeting and other internal communications
• Coordinating the existing and planned networks, including both professional and community groups
• Maintaining work flows and tracking deliverables for all grants and contracts
• Supporting the development of contracts and grant applications.
• Manage relationships with outside vendors and consultants
• Devising new programs that support the Center for Community-Engaged Medicine
• Working with other departments within the Institute for Clinical Research and Health Policy Studies
• Meeting with internal and external stakeholders to discuss program status, operations, and goal attainment
• Working with business strategy consultants to expand the influence and sustainability of the Center
• Collects and analyzes data to inform strategic decisions and resource allocation and to track program/project progress.
• Prepares reports, proposals, and presentations.
• Provides excellent internal and external communication.
• Supervises one or more project coordinators or other support staff.
• Maintains collaborative team relationships with peers and colleagues in order to effectively contribute to the working group’s achievement of goals, and to help foster a positive work environment.
• Performs other similar and related duties as required or directed.

JOB KNOWLEDGE AND SKILLS:

• Experience managing complex programs.
• Excellent group facilitation skills
• Outstanding attention to detail and organizational skills required.
• Excellent judgment, highly professional manner with an ability to maintain sensitivity, confidentiality, and tactfulness.
• Demonstrated strong interpersonal skills, must work well independently and as a member of a team, and possess the ability to interact with a wide variety of personnel, departments, and organizations.
• Superior communication skills (both written and oral), organizational skills, project planning and management skills. Innovative, proactive, and motivated, with a focus on continuous improvement and a strong desire to succeed.
• Ability to take initiative and in turn function at a high level of independence as demonstrated by independent decision-making, ability to solve problems, know when to ask for guidance, and the ability to represent the Center
• Supervisory experience required.
• MS Office software, database management/creation, data collection analysis experience, and overall computer proficiency required.
• Experience managing projects involving external funders (both public and private)

EDUCATION:

• Bachelor's degree required, Master's degree preferred.

EXPERIENCE:

• Minimum of five years’ experience directly related to the duties specified is required.

An equivalent combination of education and experience, which provides proficiency in the areas of responsibility listed above, may be substituted for the above education and experience requirements.

WORKING CONDITIONS/PHYSICAL DEMANDS:

• 1. Normal office work environment.
• 2. Work requires frequent typing/computer keying, telephone use, and sitting for extended periods.

AMERICANS WITH DISABILITIES STATEMENT:

Must be able to perform all essential functions of this position with reasonable accommodation if disabled.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed, as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Tufts Medical Center reserves the right to modify position duties at any time, to reflect process improvements and business necessity.

COVID-19 POLICY:

Please note that effective October 1, 2021, as a condition of employment at Tufts Medical Center, all employees and new hires must have received their complete dose of the COVID-19 vaccine, unless they have been granted an exemption.  

It takes a lot of very smart, hard-working and talented people to provide the level of care that we give to our patients. Tufts Medical Center is an internationally respected academic medical center and we pride ourselves not only on the sophistication of the care we deliver, but the compassionate way in which we provide it. And that starts with our employees.

GENERAL SUMMARY:

Responsible for initiating, processing, and obtaining referrals and/or out-of-network authorization requests prior to a patient’s scheduled appointment. The Referral Management Coordinator will work with PCP offices and individual payors on verifying patient’s demographics and/or checking on referrals/authorization statuses. Notifying patients and Tufts Medical Center clinics on any discrepancies that the patient might have that would affect the financial status of the appointment.

PRINCIPAL DUTIES AND ESSENTIAL FUNCTIONS:

• Reviewing and verifying scheduled outpatient visits for accuracy. This includes important demographic information and insurance information. Contact Tufts MC patient if any discrepancies are found.
• Submit referral request or out-of-network request based on Tufts Medical Center contracting rules.
• Manage daily ONTRAC work list and prioritize accordingly. Follow-up on pending cases, as needed.
• Verify insurance via eligibility tool or phone call to the payor.
• Submit referral request and follow up on any pending referrals to secure financial clearance prior to date of service. Document all steps taken in host system.
• Verify referrals received through E-Fax and linking them to patient’s accounts in hospital system while noting in Ontrac and Experian.
• Meet daily and weekly productivity standards.
• Provide excellent customer service when receiving in-bound calls from patients and doctors’ offices.

JOB REQUIREMENTS:

JOB KNOWLEDGE AND SKILLS:

• The ability to multitask and follow through with day to day responsibilities.
• Two to three years’ experience in insurance, managed care, private physician’s office practice or hospital registration setting.
• The ability to work efficiently as a team and/or independently.
• Strong customer service skills and excellent telephone etiquette with the capability to communicate effectively with all hospital employees.
• High degree of delicacy is necessary due to frequent interaction with patients, physicians, and insurance companies.
• Knowledgeable of Microsoft office, Davincian, Ontac, RCO, and payor websites preferred.
• Thorough knowledge and understanding of health care delivery systems with special emphasis on the referral management process for managed care providers.
• Preferred understanding of Medicaid replacement products including ACO plans
• Excellent organizational skills required with attention to detail.

EDUCATION

• Level of knowledge generally obtained via completion of an associate degree.

EXPERIENCE:

• One to two years of experience in insurance, managed care, private physician’s office practice or hospital registration setting.
• An equivalent combination of education and experience, which provides proficiency in the areas of responsibility listed above, may be substituted for the above education and experience requirements.

WORKING CONDITIONS/PHYSICAL DEMANDS:

• Works in a fast-paced, high-pressure office environment. There will be significant pressure to meet or exceed goals and expectations. There is little discomfort due to dust, dirt or other environmental factors.
• Constant contact with patients, internal and external physicians, payers and Tufts MC managerial staff.

All your information will be kept confidential according to EEO guidelines.

AMERICANS WITH DISABILITIES STATEMENT:

Must be able to perform all essential functions of this position with reasonable accommodation if disabled.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed, as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Tufts Medical Center reserves the right to modify position duties at any time, to reflect process improvements and business necessity.

COVID-19 POLICY:

Please note that effective October 1, 2021, as a condition of employment at Tufts Medical Center, all employees and new hires must have received their complete dose of the COVID-19 vaccine, unless they have been granted an exemption.  

It takes a lot of very smart, hard-working and talented people to provide the level of care that we give to our patients. Tufts Medical Center is an internationally respected academic medical center and we pride ourselves not only on the sophistication of the care we deliver, but the compassionate way in which we provide it. And that starts with our employees.

The student intern will be a member of the Center for Clinical Evidence Synthesis (CCES), directed by Dr. Nanguneri Nirmala, within the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center. The student intern will work under the supervision of a faculty member on a defined project in line with his/her educational goals. Specific tasks and learning objectives will be defined by the student and faculty member. 

• Proficient with Microsoft Word, PowerPoint and Excel computer applications
• Excellent and meticulous organizational and technical skills are of the utmost importance as are documentation skills, and interpersonal and communication skills
• Ability to work independently, under supervision and as a part of a team is required.
• Consistently applies the corporate values of respect, honesty and fairness and the constant pursuit of excellence in improving the health status of the people of the region through the provision of customer-friendly, geographically accessible and high-value services within the environment of a comprehensive integrated academic health care system.
• Maintains collaborative, team relationships with peers and colleagues in order to effectively contribute to the working groups achievement of goals, and to help foster a positive work environment
• Performs other similar and related duties as required or directed.

EDUCATIONAL REQUIREMENTS

• Currently enrolled in a bachlelor’s degree program or higher. 

WORKING CONDITIONS/PHYSICAL DEMANDS:

• Typical clinical and administrative office setting.
• Must be able to perform all essential functions of this position with reasonable accommodation if disabled.
• May access PHI/HIPAA identifiers as part of daily tasks.

All your information will be kept confidential according to EEO guidelines.

AMERICANS WITH DISABILITIES STATEMENT:

Must be able to perform all essential functions of this position with reasonable accommodation if disabled.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed, as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Tufts Medical Center reserves the right to modify position duties at any time, to reflect process improvements and business necessity.

COVID-19 POLICY:

Please note that effective October 1, 2021, as a condition of employment at Tufts Medical Center, all employees and new hires must have received their complete dose of the COVID-19 vaccine, unless they have been granted an exemption.  

It takes a lot of very smart, hard-working and talented people to provide the level of care that we give to our patients. Tufts Medical Center is an internationally respected academic medical center and we pride ourselves not only on the sophistication of the care we deliver, but the compassionate way in which we provide it. And that starts with our employees.

The BMT Quality Program/Data Coordinator will develop, maintain and oversee the Quality Management Plan for the Bone Marrow Transplant and Cellular Therapy Program including all quality assurance, quality improvement and regulatory compliance. The Coordinator will work directly with the BMT Medical Director, BMT Quality Management Director, and BMT nurse coordinators to maintain and improve the Quality Management Program to ensure the highest quality of care and optimal patient outcomes.  The Coordinator will report directly to the executive director of the Cancer Center.

PRINCIPAL DUTIES AND ESSENTIAL FUNCTIONS:

• Ensure compliance with all applicable state and federal regulations and accreditations including the Foundation for the Accreditation of Cellular Therapy (FACT) and Joint Commission
• Maintain, revise,  and implement the Quality Management Plan (QMP) which provides the  principles and tools for quality assurance, control, assessment and improvement activities for the BMT Program
• Manage and maintain the document control system for the creation, review, revision and implementation of standard operation policies and procedures  
• Conduct, review and report audits of BMT program clinical activities to verify compliance with and effectiveness of the Quality Management Plan
• Collaborates with the Medical Director, FACT and BMT Nurse Coordinators to respond to audit findings and implement approved recommendations
• Monitor and review error and accident reports, complaints and adverse events 
• Prepare agenda for QM meetings and coordinate activities related to the QMP in the clinical, apheresis and processing facilities of the BMT Program to assure compliance with accreditation standards. Maintain meeting minutes.
• Develop and maintain a system to document all BMT staff qualifications, training, competencies, annual evaluations and CME activities
• Assist the Medical Director and FACT coordinator in preparing for FACT inspection and to maintain inspection readiness
• Oversee the BMT Program StemSoft database, provide data management including data input, retrieval and analysis
• Prepare quality management and outcome reports for the BMT Program
• In conjunction with the BMT Nurse Coordinators complete and submit outcomes reporting forms for the Center for International BMT Research (CIBMTR)
• Assist with the completion of Request for Information (RFIs) for insurance providers
• In conjunction with the BMT Medical Director and BMT Nurse Coordinators facilitate with the onboarding of new cellular therapy products into the clinic. 
• Position is remote with some onsite.  

JOB KNOWLEDGE AND SKILLS:                                               

• Bachelors of Art or Science degree (nursing or health care preferred)
• Experience in quality/performance improvement and/or bone marrow transplantation preferred
• Excellent written and oral communication skills
• Strong analytical and problem solving skills
• Ability to conduct quality review, develop and execute action plans
• Proficiency with Microsoft Office (WORD, EXCEL, POWERPOINT)
• Experience in data analysis
• Eager to work in a high performance environment and willingness to continue professional development through participation in relevant conferences, training and educational activities

ORGANIZATIONAL RELATIONSHIPS:

• Reports to the Executive Director, Population Health & Contract Performance

MINIMUM EDUCATION:

• Undergraduate degree

EXPERIENCE:

• Undergraduate degree and 6-8 years healthcare IT experience, or Graduate degree and 4-6 years healthcare IT experience
• An equivalent combination of education and experience, which provides proficiency in the areas of responsibility listed above, may be substituted for the above education and experience requirements.

LICENSES, ETC.:

• Not Applicable

AMERICANS WITH DISABILITIES STATEMENT:

• Must be able to perform all essential functions of this position with reasonable accommodation if disabled.

All your information will be kept confidential according to EEO guidelines.

AMERICANS WITH DISABILITIES STATEMENT:

Must be able to perform all essential functions of this position with reasonable accommodation if disabled.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed, as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Tufts Medical Center reserves the right to modify position duties at any time, to reflect process improvements and business necessity.

COVID-19 POLICY:

Please note that effective October 1, 2021, as a condition of employment at Tufts Medical Center, all employees and new hires must have received their complete dose of the COVID-19 vaccine, unless they have been granted an exemption.  

It takes a lot of very smart, hard-working and talented people to provide the level of care that we give to our patients. Tufts Medical Center is an internationally respected academic medical center and we pride ourselves not only on the sophistication of the care we deliver, but the compassionate way in which we provide it. And that starts with our employees.

The Tufts Health Sciences IRB is federally mandated to review, monitor, and approve biomedical and social, behavioral, and educational research involving human subjects. The goal of the IRB is to ensure compliance to federal and state regulations on use of human subjects in research at Tufts Medical Center (TMC) and Tufts University Health Sciences (including the USDA Human Nutrition Research Center).

The IRB committees consist of members who represent clinical research disciplines, such as medicine, pediatrics, surgery, dentistry and nursing; basic research disciplines, such as microbiology, physiology and pharmacology; and social science disciplines such as psychology. Institutional and administrative members include the Tufts Medical Center Vice President for Research Administration, the Tufts University Associate Vice Provost for Research Compliance, and Pharmacists. Members who are not affiliated with Tufts Medical Center and/or Tufts University Health Sciences represent the community at large.

There are two IRB committees, which each meet monthly. This position is part of an integrated team that supports the functions and activities of the IRB committees, IRB Chair and Vice-Chairs, and the research community.

PRINCIPAL DUTIES AND ESSENTIAL FUNCTIONS:

• Proficient with IRB Office procedures to provide high level support to the IRB committees, IRB Chair/Vice-Chairs, and research community.
• Coordinates exempt, expedited and convened meeting review of research, corresponds with Investigators and research teams to relay IRB Reviewer comments, and documents determinations appropriately.
• Knowledgeable about federal and state regulations as well as institutional policies related to the protection of human subjects.
• Pre-reviews IRB applications for consistency, completeness, and compliance with federal and state regulations and institutional policies before review by the IRB or designated IRB Reviewer. Notifies PI, as needed, of incomplete research applications that would delay the IRB review process.
• Generates and processes IRB correspondence. Prepares IRB approved material, and maintains accurate IRB office study documentation.
• Pre-reviews amendments and reportable new information for on-going IRB approved studies and generates correspondence (approval letters or requests for additional information) to study PIs.
• Maintains a list of documentation reviewed and notifies the reviewing Chair/Vice-Chair's IRB by including this list on the next agenda.
• Attends scheduled IRB meetings, as needed. Records the actions, discussion and deliberations of the IRB. Conveys the notice of the IRB comments in written correspondence to the study PI.
• Generates and processes approval letters for amendments, addenda, and modifications. Forwards validated materials, appropriately dated, to the study PI.
• Determines appropriate review procedures for information received by the IRB and appropriately triages, i.e., expedited, full committee.
• Maintains current and accurate information in the IRB office to ensure appropriate record retention.
• Attends seminars, workshops and conferences in order to gain insight into new trends in human research and to learn new approaches for the application of federal regulations, particularly in an atmosphere of changing regulations, advancing technology, and increasingly complex ethical questions.
• Assists in developing, recommending and implementing policies and procedures to enhance the efficiency of the IRB Office and IRB operations.
• Provides assistance to IRB leadership and office staff colleagues, as appropriate on special projects
• Communicate with Principal Investigators (PI) and/or research team members to obtain required materials and/or clarifications
• Render a preliminary judgment regarding disposition for review and provide additional information, resources, and guidance to IRB reviewer(s) to ensure compliance with institutional requirements and policies regarding submissions
• Contact PIs and/or research team members in a timely manner to request clarifications or revisions, as needed, based on the determinations of the IRB reviewer(s).
• Provides ongoing consultation to investigators on issues pertaining to human subject protections and the IRB review process. Provides advice on issues related to the development of human subject research protocols, consents, and IRB submissions. Advises investigators on regulations and institutional policies.
• Manages and coordinates continuing education program about human subject protections for IRB members, IRB staff and investigators.
• Presents education sessions and seminars, etc., for the research community.
• Leads in the development and implementation of job-related policies and procedures to enhance efficiency of office operations.
• Assists with internal IRB audits
• Leads development of web-based materials that support the IRB, including educational materials, policies and procedures.
• Provide positive and effective customer service that supports IRB operations.
• Mentors and trains IRB Office colleagues, as needed
• Maintains collaborative team relationships with peers and colleagues in order to effectively contribute to the working group's achievement of goals, and to help foster a positive work environment.
• Performs other similar job related duties as required or directed.
• Maintains patient confidentiality per HIPAA regulations and keeps study information in a safe and secure location. Adheres to FDA Good Clinical Practice Guidelines.

JOB KNOWLEDGE AND SKILLS:

Requires high level skills including the following:

• Communication: Excellent verbal and written communication skills
• Customer Focused: Excellent customer service skills
• Cool Under Pressure: The ability to stay calm in high pressure situations; the ability to prioritize multiple competing tasks
• Empathy: The ability to understand and share the feelings of others
• Self-Directed: The ability to show initiative, work autonomously, and to organize oneself
• Team Player: The ability to work in and thrive within a team environment
• Flexibility and Adaptability: The ability to adapt to changing job demands
• Critical Thinking Skills: The ability to make reasoned judgments that are logical and well-thought out
• Attention to detail: The ability to demonstrate thoroughness and accuracy when accomplishing a task
• Coordination: strong organizational capabilities
• Connection and Collaboration: The ability to establish rapport, create a relationship of trust and build collaborative relationships
• Professionalism: The ability to respond to situations in an appropriate manner; behaving and knowing when to act according to the circumstances; professional discretion
• Computer skills: The ability to navigate comfortably with different software and applications

EDUCATION:

• Bachelor's degree or advanced degree

EXPERIENCE:

• 2 to 5 years (or equivalent) experience in a clinical research environment or IRB office required.
• An equivalent combination of education and experience which provides proficiency in the areas of responsibility listed above may be substituted for the above education and experience requirements

WORKING CONDITIONS/PHYSICAL DEMANDS:

• Office setting

AMERICANS WITH DISABILITIES STATEMENT:

Must be able to perform all essential functions of this position with reasonable accommodation if disabled.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Tufts Medical Center reserves the right to modify position duties at any time, to reflect process improvements and business necessity.

All your information will be kept confidential according to EEO guidelines.

AMERICANS WITH DISABILITIES STATEMENT:

Must be able to perform all essential functions of this position with reasonable accommodation if disabled.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed, as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Tufts Medical Center reserves the right to modify position duties at any time, to reflect process improvements and business necessity.

COVID-19 POLICY:

Please note that effective October 1, 2021, as a condition of employment at Tufts Medical Center, all employees and new hires must have received their complete dose of the COVID-19 vaccine, unless they have been granted an exemption.  

It takes a lot of very smart, hard-working and talented people to provide the level of care that we give to our patients. Tufts Medical Center is an internationally respected academic medical center and we pride ourselves not only on the sophistication of the care we deliver, but the compassionate way in which we provide it. And that starts with our employees.

GENERAL SUMMARY:

The Project Manager is a senior member of a research team within the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center. Working closely with the Principal Investigator, this position has responsibility for the management and execution of projects within the Center for Community -Engaged Medicine. The Project Manager will assist the Center Director in the effective management and execution of multiple grants and contracts.  

This person will provide leadership and guidance while overseeing the day-to-day operations of the Center. The largest program of the Center is the development and dissemination of HOPE – Healthy Outcomes from Positive Experiences. HOPE, grounded in science, builds from the formative role of positive experiences in human development to inspire fundamental changes in how we advance health and well-being for our children, families, and communities. HOPE believes all families should be treated with dignity; marginalized families and communities are not judged as broken, but are valued, respected, and heard.  For more information about the HOPE framework please visit positiveexperience.org.

This project involves multiple grants and contracts from philanthropic foundations, federal and state sources, and income generated through training and technical assistance.  HOPE has an active National Advisory Board, a newly formed Family and Community Expert (FACE) council, and an active website and social media presence.  In addition to the Center director and consultants, HOPE has six full-time staff members, half of whom work remotely.

The Project manager will provide organizational support for new projects in the expanding Center.  The Center is in the process of bringing in new faculty members with their own academic interests, and the project manager may be asked to provide support for these projects.

PRINCIPAL DUTIES AND ESSENTIAL FUNCTIONS:

• Organizing daily activities, including the daily morning team meeting and other internal communications.
• Coordinating the existing and planned networks, including both professional and community groups.
• Maintaining work flows and tracking deliverables for all grants and contracts.
• Supporting the development of contracts and grant applications.
• Manage relationships with outside vendors and consultants.
• Devising new programs that support the Center for Community-Engaged Medicine.
• Working with other departments within the Institute for Clinical Research and Health Policy Studies.
• Meeting with internal and external stakeholders to discuss program status, operations, and goal attainment.
• Working with business strategy consultants to expand the influence and sustainability of the Center.

JOB REQUIREMENTS:

• Experience managing complex programs.
• Excellent group facilitation skills
• Outstanding attention to detail and organizational skills required.
• Excellent judgment, highly professional manner with an ability to maintain sensitivity, confidentiality, and tactfulness.
• Demonstrated strong interpersonal skills, must work well independently and as a member of a team, and possess the ability to interact with a wide variety of personnel, departments, and organizations.
• Superior communication skills (both written and oral), organizational skills, project planning and management skills. Innovative, proactive, and motivated, with a focus on continuous improvement and a strong desire to succeed.
• Ability to take initiative and in turn function at a high level of independence as demonstrated by independent decision-making, ability to solve problems, know when to ask for guidance, and the ability to represent the Center.
• Supervisory experience preferred.
• MS Office software, database management/creation, data collection analysis experience, and overall computer proficiency required.
• Experience managing projects involving external funders (both public and private) preferred.

EDUCATION:

• Bachelor’s degree required.

EXPERIENCE:

• 5-7 years’ experience managing research projects and/or a demonstrated ability to coordinate and organize multiple activities requiring varying and often competing deadlines.

WORKING CONDITIONS/PHYSICAL DEMANDS:

• Normal office work environment.

All your information will be kept confidential according to EEO guidelines.

AMERICANS WITH DISABILITIES STATEMENT:

Must be able to perform all essential functions of this position with reasonable accommodation if disabled.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed, as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Tufts Medical Center reserves the right to modify position duties at any time, to reflect process improvements and business necessity.

COVID-19 POLICY:

Please note that effective October 1, 2021, as a condition of employment at Tufts Medical Center, all employees and new hires must have received their complete dose of the COVID-19 vaccine, unless they have been granted an exemption.  

It takes a lot of very smart, hard-working and talented people to provide the level of care that we give to our patients. Tufts Medical Center is an internationally respected academic medical center and we pride ourselves not only on the sophistication of the care we deliver, but the compassionate way in which we provide it. And that starts with our employees.

Under the general direction of the Coding Manager, this position reviews the medical record to verify diagnosis and procedures and Present on Admission Indicators.  The Coder abstracts the information by using the appropriate coding classification system.  Verifies codes for statistical and reimbursement purposes.
 
PRINCIPAL DUTIES AND ESSENTIAL FUNCTIONS:

• Performs a complete chart review.  Assigns ICD-10-CM, ICD-10 PCS and/or CPT codes in accordance with coding and reimbursement guidelines.
• Assists in obtaining final diagnosis and contacting physicians for clarification of documentation when needed.
• Verifies and abstracts specific clinical and demographic data:
  • Discharge disposition
  • Transfer destination
  • Date and responsible party for all procedures.
• Verifies the DRG assignment, paying special attention to DRG’s in which a comorbid condition or complication has been identified.
• Inputs the appropriate information into the hospital system discharge abstract.
• Refers appropriate charts for DRG Validation, prints the coding sheets and attaches it to the record for review based on Departmental Policy.
• Performs related duties such as answering and routing telephone calls and receiving people requesting information and services in the department.
• Participation in continuing education programs as requested by Management
• Participate in department staff training programs to develop skills that will achieve business goals and foster individual career growth.
• Assists in the implementation of the ICD-10 Coding Classification system.
• Trains clinic staff on the use of ICD-10 codes.
• Reconciles daily Inpatient reports and provides weekly feedback to Department Management 
• Performs or assists with other duties assigned by the Coding Manager.
• Assists in training of new personnel.
• Performs other similar and related duties as required or directed.

JOB KNOWLEDGE AND SKILLS:

• Working knowledge of ICD-9-CM and CPT coding system, DRG, APG, payment systems, medical terminology, anatomy and physiology.
• Excellent organizational and communication skills.
• Working knowledge of computers preferred

 
EDUCATION:

• Completion of coding certificate program required.

EXPERIENCE:

• An equivalent combination of education and experience, which provides proficiency in the areas of responsibility listed above, may be substituted for the above education and experience requirements.

LICENSES, ETC.:

• RHIT/RHIA or CCS Required

WORKING CONDITIONS/PHYSICAL DEMANDS:

• General office environment.
• Frequent use of a computer terminal.
• Frequent contact with physicians, nursing, administration, finance, and outside audit personnel.

All your information will be kept confidential according to EEO guidelines.

AMERICANS WITH DISABILITIES STATEMENT:

Must be able to perform all essential functions of this position with reasonable accommodation if disabled.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed, as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Tufts Medical Center reserves the right to modify position duties at any time, to reflect process improvements and business necessity.

COVID-19 POLICY:

Please note that effective October 1, 2021, as a condition of employment at Tufts Medical Center, all employees and new hires must have received their complete dose of the COVID-19 vaccine, unless they have been granted an exemption.  

It takes a lot of very smart, hard-working and talented people to provide the level of care that we give to our patients. Tufts Medical Center is an internationally respected academic medical center and we pride ourselves not only on the sophistication of the care we deliver, but the compassionate way in which we provide it. And that starts with our employees.

Under the supervision of the Precertification Supervisor, is responsible for obtaining precertification and verification of benefits with all insurance carriers for inpatient admissions, outpatient and day surgeries, GI procedures, radiology services, sleep studies and/or echocardiograms. Financially secures each account well in advance and escalates financial clearance concerns through prompt and closed-loop communication. Collaborates and reviews financial clearance data with the Precertification Supervisor and Manager to ensure proper authorization for all services.

PRINCIPAL DUTIES AND ESSENTIAL FUNCTIONS:

• Contacts insurance companies to obtain verification of insurance, eligibility, and level of benefits. Enters benefit information into hospital computer systems.
• Contacts patients, when necessary, for updates of financial and demographic information. Enters all data into hospital computer systems.
• Obtains financial data from a variety of sources including both in-state and out-of-state payers. Utilizes computer systems, payer eligibility sites & phone outreach.
• Arranges for coordination of benefits when more than one insurance carrier is involved.
• Updates financial/insurance plan codes within hospital computer systems according to eligibility responses.
• Seeks clinical approval of admission (precertification) for surgeries, admissions, procedures, imaging and all other in-scope services. Enters precertification information and proper documentation into hospital computer systems.
• Identifies procedures & services that are not covered services by individual insurance policies. Refers all identified financial risk concerns to the department, Patient Access leadership for immediate review and resolution.
• Collaborates with Financial Coordination colleagues regarding patients with identified financial risk concerns for resolution prior to services being rendered. Suggests postponement of elective services until financial arrangements are in place.
• Obtains all applicable clinical documentation when required by insurance payers for elective services and submits information to payers within a timely manner.
• Closely follow case statuses and communicates and/or documents pending and approved statuses within a timely manner.
• Immediately identifies denied claims and works closely with department leaders, coordinators and clinical team members toward their appeal and peer to peer workflow.
• Monitors their productivity and quality of workflow directly, reaching days out, productivity, and quality review goals.
• Acts as a resource to other departments of the hospital regarding precertification policies and resolution of accounts.
• Communicates clearly to Tufts MC team members and leadership status of financially at risk cases and resolution steps. Closely monitors at risk cases and provide timely updates.
• Maintains collaborative, team relationships with peers and colleagues in order to effectively contribute to the working group’s achievement of goals, and to help foster a positive work environment.
• Works closely with Case Management and Admitting colleagues to confirm level of care changes, particularly for unplanned or urgent admissions, and communicate level of care upgrades or downgrades with payers within a timely manner.
• Learns workflow changes and updates as they occur in real-time and maintains an openness to adopt updated workflows.
• Assists in the training and shadowing of new team members.
• Performs other similar and related duties as required or directed

JOB KNOWLEDGE AND SKILLS:

• Thorough knowledge of medical terminology.
• Thorough working knowledge of ICD-10 and CPT coding.
• Thorough working knowledge of payer precertification requirements and in-network and out-of-network payers.
• Thorough working knowledge and willingness to learn computer systems.
• Strong verbal and written communication skills. Must demonstrate a patient service focus.
• Excellent organizational skills and ability to prioritize work assignments. Ability to respond effectively to changing priorities and work processes.
• Ability to work independently and also participate in teams within the department and Tufts MC.

EDUCATION:

• Level of knowledge generally acquired through completion of an Associates degree or equivalent experience.

EXPERIENCE:

• Two to three years related experience in a hospital, physician office or financial setting.
• An equivalent combination of education and experience which provides proficiency in the areas of responsibility listed above may be substituted for the above education and experience requirements

WORKING CONDITIONS/PHYSICAL DEMANDS:

• Works in a normal office environment with little exposure to hazardous or unpleasant conditions.
• Some mental pressure due to time constraints.
• Interacts daily over the phone, email and online portals through correspondence with payers. Establishes and maintains working relationships with insurance companies to facilitate financial clearance workflow of Tufts MC services.
• Interacts with patients regarding issues dealing with confidential medical and financial information.
• Daily contact with clinicians, administrative coordinators, department leaders, Patient Access colleagues, Patient Access leadership and other personnel from various departments.

All your information will be kept confidential according to EEO guidelines.

AMERICANS WITH DISABILITIES STATEMENT:

Must be able to perform all essential functions of this position with reasonable accommodation if disabled.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed, as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Tufts Medical Center reserves the right to modify position duties at any time, to reflect process improvements and business necessity.

COVID-19 POLICY:

Please note that effective October 1, 2021, as a condition of employment at Tufts Medical Center, all employees and new hires must have received their complete dose of the COVID-19 vaccine, unless they have been granted an exemption.  

Tufts Clinical and Translational Science Institute (CTSI) (www.tuftsctsi.org), one of more than 60 organizations supported by the National Institutes of Health (NIH) Clinical and Translational Science Awards (CTSAs), was established in 2008 to transform the biomedical research process through education, promoting collaboration, and the provision of research infrastructure and support services. Tufts CTSI accelerates the translation of laboratory research into clinical use, medical practice, and health policy. In addition to its work with Tufts University, Tufts Medical Center, and other partner organizations, Tufts CTSI contributes to the national CTSA Consortium.

This is an exciting opportunity for the right applicant to make an impact on the future of health care by joining the Health Informatics Program at Tufts CTSI. You will join the team that facilitates open science, develops data assets, innovates new methods, and implements solutions and workflows for knowledge generation, sharing, and delivery to the point of care or dissemination to inform policies. We integrate health care and research support, and work with observational data generated from health care settings including EHR, location-based (GIS), claims, device and other data types.

You will join the team of likeminded individuals and will work on cutting edge initiatives such as extending the content and functionality of a clinical research data warehouse and cloud architecture development, you will have the opportunity to explore and contribute to development of the natural language processing (NLP) techniques to mine clinical data, support the research community locally and nationally through the research networks such as N3C, in their data needs with close input and oversight from senior technical team members.

If you are a developer who enjoys community engaged open source development and collaboration, takes initiative, and works well independently and as part of a team, apply today!

PRINCIPAL DUTIES AND ESSENTIAL FUNCTIONS:

Responsible for contributing to software development initiatives: 

Implementation

• Contributes to team projects, with the objective of becoming more technically proficient.
• Maintains existing policy and procedures for code reuse, documentation, and testing.
• Contributes to design documentation, and functional requirements and specifications with guidance.
• Works collaboratively with others in meeting user expectations and team deadlines.
• Demonstrates problem-solving skills within team environment and with end users.
• Adapts and self-teaches as needed to appropriately fulfill goals.  

Ongoing Enhancements and Support

• Participate in some after-hours on-call support, to troubleshoot and resolve system issues.
• With oversight from senior technical team members, lead projects of varying scope.

• Strong interpersonal skills demonstrated through prior work experience.
• The ideal candidate has strong software development skills; able to deploy and debug software of varying scope and stack; must be able to work in a team environment as a member and a facilitator; has the ability to manage own time effectively; and able to perform some work independently. Additionally, the candidate must be highly motivated and willing to learn and adopt to new, leading-edge technologies. The candidate must possess excellent analytical, problem-solving skills, along with strong oral and written communication and interpersonal skills. Lastly, the candidate must be comfortable interacting with colleagues within the Tufts CTSI network and within the broader research community.
   

JOB KNOWLEDGE AND SKILLS:

Specific skills and experience in the following areas are preferred:

• Strong working knowledge of either one of or all: R, Python, MS SQL. Knowledge of other languages is a plus.
• Knowledge of database development, database management, and data quality best practices.
• Knowledge of development and maintenance of small to medium-scale ETL processes, ETL tools, ideally within a biomedical environment.
• Familiarity with Natural Language Processing and data mining techniques.
• Familiarity with common data models in Health Sciences field.
• Familiarity with HL7, FHIR interface.
• The successful candidate must be comfortable using Windows- and Linux-based operating systems.
• Basic understanding of software development life cycle.
• Excellent customer service orientation.
• Flexibility and can-do attitude.

MINIMUM EDUCATION:

• Undergraduate degree required, advanced degree is desirable.

EXPERIENCE:

• 2-4 years healthcare IT experience.

An equivalent combination of education and experience, which provides proficiency in the areas of responsibility listed above, may be substituted for the above education and experience requirements

WORKING CONDITIONS 

• Consistent with a typical office work environment. Work requires frequent typing/computer keying. 

LOCATION

• Employees may work remotely but must be located within the United States. 

TERM

• This is a short term grant funded position with the possibility of extension. Tufts CTSI is grant-funded through April 2023, with the strong possibility of long term renewal.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Tufts Medical Center reserves the right to modify position duties at any time, to reflect process improvements and business necessity.

All your information will be kept confidential according to EEO guidelines.

AMERICANS WITH DISABILITIES STATEMENT:

Must be able to perform all essential functions of this position with reasonable accommodation if disabled.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed, as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Tufts Medical Center reserves the right to modify position duties at any time, to reflect process improvements and business necessity.

COVID-19 POLICY:

Please note that effective October 1, 2021, as a condition of employment at Tufts Medical Center, all employees and new hires must have received their complete dose of the COVID-19 vaccine, unless they have been granted an exemption.  

It takes a lot of very smart, hard-working and talented people to provide the level of care that we give to our patients. Tufts Medical Center is an internationally respected academic medical center and we pride ourselves not only on the sophistication of the care we deliver, but the compassionate way in which we provide it. And that starts with our employees.

Reporting to the Director of the Center for Health Solutions (CHS), this position supports CHS operations in key project and administrative functions to ensure smooth operations and continued program growth. The Project Coordinator II will coordinate a wide-range of research program functions within CHS. Working with the Director and with research faculty and staff, the Project Coordinator II will be responsible for the coordination and oversight of work timelines and staffing distribution of effort, will be the point of contact with funding agencies and collaborators, and will provide support to members of collaborating industry partners. The Project Coordinator II will also be responsible for providing administrative support to the CHS Center Director.

PRINCIPAL DUTIES AND ESSENTIAL FUNCTIONS:

• Provide administrative support to the Center Director including calendar coordination, travel planning, and assistance with tasks related to the Director’s clinical, research and teaching activities, including updating/maintaining the Director’s curriculum vitae and biosketch and CME credits.
• Assist the Center Director with Tufts Institutional Review Board (IRB) submissions and annual updates, as well as support new and ongoing research studies. Establish and maintain record keeping and filing systems to include electronic filing systems for correspondence, multiple research project-related materials, reference materials, articles, patient records, personnel files, etc.
• Coordinate, with Center Director and ICRHPS Research Administration, outgoing grant and contract proposals, new grants and contracts set ups, assigning of staff effort, and reporting.
• Coordinate the Center’s outreach initiatives, including contributing to hospital/regional/grant based reports, conference presentations/meetings, and e-newsletters. Responsibilities include summarizing data, assisting with presentations, arranging for conference locations, development and distribution of materials and communication, and organization of meetings, both onsite and offsite.
• Provide REDCap database support. Responsibilities include updating database instruments and creating reports.
• Conduct literature searches using the Internet.
• Oversee the day-to-day administrative activities of CHS, including facilities issues, copying, telephone, faxing
• Work as a “team player” to participate in research projects, or perform routine administrative work for other staff members in the Center as the need arises.  Participate in staff meetings.

JOB KNOWLEDGE AND SKILLS:

• Proficiency with MS Office, including the ability to develop spreadsheets, databases, presentations and reports
• Experience with electronic databases (e.g., REDCap, Endnote)
• Excellent organizational skills and superb attention to detail
• Excellent written and verbal communication skills to ensure clear and consistent communication with internal and external stakeholders.
• Strong interpersonal skills with the ability to build and strengthen positive relationships with internal and external stakeholders and staff, solid customer service orientation and ability to work in a team setting
• Ability to identify issues and implement effective resolution strategies to ensure smooth coordination of program and project requirements
• Basic financial analytical skills needed for assisting with the development of center grants and contracts, ability to understand research accounting principles
• Demonstrated ability to prioritize, manage multiple projects simultaneously and complete assignments in a timely manner required.
• Must be able to work in deadline situations.

EDUCATION:

• BA/BS required.

EXPERIENCE:

• 3-5 years’ experience, preferably in a research setting

An equivalent combination of education and experience which provides proficiency in the areas of responsibility listed above may be substituted for the above education and experience requirements.

WORKING CONDITIONS/PHYSICAL DEMANDS:

• General office environment.

All your information will be kept confidential according to EEO guidelines.

AMERICANS WITH DISABILITIES STATEMENT:

Must be able to perform all essential functions of this position with reasonable accommodation if disabled.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed, as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Tufts Medical Center reserves the right to modify position duties at any time, to reflect process improvements and business necessity.

COVID-19 POLICY:

Please note that effective October 1, 2021, as a condition of employment at Tufts Medical Center, all employees and new hires must have received their complete dose of the COVID-19 vaccine, unless they have been granted an exemption.  

It takes a lot of very smart, hard-working and talented people to provide the level of care that we give to our patients. Tufts Medical Center is an internationally respected academic medical center and we pride ourselves not only on the sophistication of the care we deliver, but the compassionate way in which we provide it. And that starts with our employees.

The professional registered nurse possesses and applies the skills and knowledge necessary for the delivery and management of patient care from admission through discharge. The professional registered nurse is knowledgeable of current trends in healthcare including but not limited to advances in technology, pharmacology, treatment care modalities, quality and patient safety. The professional registered nurse serves as a patient and family advocate while facilitating a cooperative and collaborative environment among all health care providers. The professional registered nurse is responsible for the planning, delivery and management of patient/family centered care utilizing the nursing process and adhering to the standards of nursing practice embedded in research, evidence based practice and/or best practices. The professional registered nurse at Tufts Medical Center provides clinical excellence, which fosters and supports an environment central to our patient and family centered model of care.

PRINCIPLE DUTIES AND RESPONSIBILITIES

Nursing Process: Utilizes theoretical and evidence-based knowledge in partnering with patients and their families to assess, plan, implement and evaluate age appropriate care.

Assess:

• Collaborates with patient, family/significant others and other disciplines to identify expected outcomes based on synthesis of data and diagnosis
• Identifies cultural needs (i.e. language, etc) to develop a care plan that enhances the health care experience

Plan:

• Develops individualized outcomes-based care plans incorporating the patient and family's readiness and barrier to learning
• Orchestrates and validates a plan of care for each shift
• Initiates interdisciplinary patient/family meetings to facilitate communication regarding the plan of care
• Communicates and coordinates the patients discharge plan utilizing unit-based and community resources to ensure a seamless transition for the patient and their family
• The plan of care utilizes principles and concepts of project, organizational or systems management

Implement:

• Implements the plan in a safe and timely manner
• Documents the implementation and any modifications, including changes or omissions, of the identified plan
• Collaborates with nursing colleagues and others to implement the plan
• Utilizes evidence-based interventions and treatments specific to the diagnosis or problem
• Provides and coordinates health teaching which is required by individuals, families and groups to maintain an optimal level of health
• Documents per hospital and regulatory requirements/policies, all aspects of care, including but not limited to, treatments/procedures performed and patient response

Evaluate:

• Evaluates the effectiveness of the planned strategies in relation to patient responses and the attainment of expected outcomes and knowledge
• The nurse uses the evaluation process to update the plan of care as dictated by the patient response and/or if desired outcomes have not been achieved

Professional Performance:

Clinical Practice: The professional registered nurse demonstrates and applies the skill and judgement necessary to implement the nursing plan of care, nursing interventions and procedures necessary for the care of the patient and family based upon critical thinking skills and a spirit of inquiry.

• The plan of care is evidence based and utilizes research when appropriate

• Incorporates new knowledge and strategies to initiate change in nursing care practices
• Demonstrates the knowledge and skills necessary to provide age appropriate culturally and ethnically sensitive care to all patients and families
• Performs procedures and treatments using nursing knowledge and judgment, according to established unit/practice area guidelines and professional standards
• Safely administers and assesses the patient response to medication utilizing essential knowledge of pharmacology and Hospital and Department Standards of Care
• Maintains clinical competency with respect to technology and utilizes equipment in a safe manner
• Performs as an advocate and as an educator for patients and families

Quality:The professional registered nurse provides high quality in an efficient and a safe manner. The professional nurse utilizes data trends to support and improve clinical practice.

• Participates in hospital and/or unit based patient safety and quality activities and uses principles to support and improve patient outcomes (unit-based, hospital-wide, The Joint Commission, NPSGs, NDNQI, Patient First and other local, state and federal patient safety initiatives
• Participates in performance improvement activities through data collection, analysis and evaluation
• Champion for quality, safety, regulatory, and patient-family satisfaction

Collaboration:Facilitates cooperative and collaborative relationships among the various disciplines and departments to ensure effective quality patient care delivery

• Maintains a collaborative work relationship with peers and colleagues in order to create a positive and professional work environment
• Supports collaboration with nursing colleagues and other disciplines to implement plan of care by participation in nursing, physician, and case management reporting rounds
• Delegates responsibilities to others with an understanding of their roles, knowledge and capabilities

Service Excellence:The professional nurse influences others by establishing a climate for optimal patient care, mutually supportive collegial relationships, and professional development.

• Treats both internal and external customers with courtesy, respect and caring behavior
• Promotes a safe, clean, therapeutic environment for patients, families and staff
• Acknowledges cultural differences that exist among staff and patients
• Identifies customer service needs on the unit
• Presents self in a professional and calm manner
• Provides responsible and efficient use of resources

Professional Development: The professional registered nurse participates in lifelong learning activities that assist in developing and maintaining their continuing competence, enhance their professional practice and support achievement of their career goals.

• The professional registered nurse maintains current licensure and adheres to the Massachusetts Nurse Practice Act
• Assumes responsibility for participating in educational opportunities to support and meet clinical competency requirements
• Seeks out educational and professional resources
• Develops professionally as a self-directed, motivated learner
• May assume charge nurse functions in collaboration with unit leadership
• Seeks out advanced certification opportunities and ongoing education opportunities
• Precepts and mentors newly hired staff and nursing students
• Investigates available technology and resources to apply evidence based practice and research into daily professional activities
• Provides leadership at the bedside as a delegator, collaborator, facilitator, and communicator
• Promotes unit and organizational growth through a shared governance model

Communication:The professional registered nurse seeks out and shares job related information that supports a culture of respect and responsibility.

• Assumes responsibility and ownership for professional conduct
• Accepts responsibility for positive and productive communication skills
• Attends and actively participates in staff meetings. Accepts responsibility for reading staff meeting minutes when not able to attend
• Accepts responsibility for reading emails to keep current with unit and hospital based information

JOB KNOWLEDGE AND SKILLS

• Possesses and applies the skills and knowledge necessary to provide care to patients throughout the life span, with consideration of aging processes, human development stages and cultural patterns in each step of the care process.
• Ability to provide care for a designated group of patients according to unit guidelines and hospital policies, procedures and protocols.

AGE SPECIFIC COMPETENCIES

• Has the skills and knowledge to provide care to the age groups of the population served including:
• Knowledge of growth and development
• Ability to interpret age specific data and response to care
• Provide age appropriate communication

EDUCATION

• Bachelors Degree required, Bachelors Degree in Nursing strongly preferred.
• BLS Certification required

EXPERIENCE

• Varies according to unit requirements and needs.

LICENSE

• Current Massachusetts Registered Nurse License

PHYSICAL DEMANDS/WORKING CONDITIONS

• Prolonged, extensive, or considerable standing/walking
• Lifts, positions, pushes and/or transfer patients and equipment
• Considerable reaching, stooping, bending, kneeling, crouching
• Frequent exposure to hazardous chemicals, sick patients, bodily substances, noise and possible exposure to radiation, lasers, electric shock, etc.
• Regularly exposed to the risk of bloodborne diseases and other transmissible infections
• Contact with patients under wide variety of circumstances
• Subject to varying and unpredictable situations
• Handle emergency and crisis situations
• Subjected to irregular hours
• May have contact with hazardous materials

All your information will be kept confidential according to EEO guidelines.

AMERICANS WITH DISABILITIES STATEMENT:

Must be able to perform all essential functions of this position with reasonable accommodation if disabled.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed, as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Tufts Medical Center reserves the right to modify position duties at any time, to reflect process improvements and business necessity.

COVID-19 POLICY:

Please note that effective October 1, 2021, as a condition of employment at Tufts Medical Center, all employees and new hires must have received their complete dose of the COVID-19 vaccine, unless they have been granted an exemption.  

It takes a lot of very smart, hard-working and talented people to provide the level of care that we give to our patients. Tufts Medical Center is an internationally respected academic medical center and we pride ourselves not only on the sophistication of the care we deliver, but the compassionate way in which we provide it. And that starts with our employees.

This position provides support to the Manager of Precert/Auth by acting in the capacity of a Supervisor, coordinating the work of an assigned group of Patient Access Coordinators, within the Precertification unit and/or Referral Management unit and/or the Pre-Registration unit.

Responsible for the accurate and timely security of authorizations and referrals within the scope of Precertification and Referral Management units, including insurance verification and notification. Additionally responsible for data integrity of all accounts within all units, including Pre-Registration.

PRINCIPAL DUTIES AND ESSENTIAL FUNCTIONS:

• Demonstrate interpersonal skills necessary to provide leadership to the teams; collaborate with Manager and Director in support of Tufts Medical Center (MC) and Tufts Medical Center Professional Organization (PO) goals and objectives.
• Assist Manager in coordinating the work of an assigned group of employees by appropriately triaging accounts.
• Supports Manager with daily activities of patient access areas for all inpatient and outpatient MC and PO services.
• Reviews and works/coordinates work on denials related to missing referrals/authorizations and registration.
• Research weekly report sets, present trending and issues, and develop workplan with Manager to correct issues.
• Reviews and modifies work design to reach desired outcomes and achieve metrics.
• Oversees activities to ensure goals/metrics and objectives are met by specific target dates.
• Supports Manager in the development, implementation and maintenance of Patient Access policies and procedures.
• Establishes and produces reports regarding staff productivity and volume.
• Performs Quality Reviews on all staff.
• Takes developmental measures with Manager’s support for staff errors, performance issues, and Human Resource issues. Ensuring consistency, standardization, and integrity of data.
• Evaluates, documents, and communicates performance of direct reports, and address underperformance of direct reports, as necessary, with Manager’s support.
• Facilitates regularly scheduled team meetings to review performance, share new policies and procedures, and keep employees informed about departmental issues.
• Orders supplies and maintains inventory system of supplies. Reports expenditures to the Manager on a regular basis.
• Maintains a high level of compliance with internal controls.
• Respects and maintains confidentiality regarding patient/ guarantor financial data and patient medical data consistent with HIPAA standards.
• Actively participates in strategic meetings with Director and other leadership.
• Performs other similar job related duties as required or directed.

JOB KNOWLEDGE AND SKILLS:

• Must have a working knowledge of laws governing both hospital and third party regulations and procedures.
• Must have excellent interpersonal skills to communicate with patients regarding sensitive and confidential medical and financial information.
• Must be able to develop and maintain professional, service-oriented working relationships with senior leadership, patients, physicians, co-workers and employees.
• Thorough knowledge and understanding of health care delivery systems with special emphasis on the referral management process for managed care providers.
• Ability to work in a fast paced environment, with focus on team building.

System Experience:

• Siemens (Invision) Preferred
• Microsoft Word Required
• Microsoft Excel Required
• Microsoft PowerPoint Required
• Microsoft Access Preferred

EDUCATION:

• Associates degree

EXPERIENCE:

• Three years of experience in Revenue Cycle, preferably Patient Access or Patient Billing.
• Two years of Supervisory experience.

WORKING CONDITIONS/PHYSICAL DEMANDS:

• Normal office work environment.
• Work requires computer keying.

All your information will be kept confidential according to EEO guidelines.

AMERICANS WITH DISABILITIES STATEMENT:

Must be able to perform all essential functions of this position with reasonable accommodation if disabled.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed, as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Tufts Medical Center reserves the right to modify position duties at any time, to reflect process improvements and business necessity.

COVID-19 POLICY:

Please note that effective October 1, 2021, as a condition of employment at Tufts Medical Center, all employees and new hires must have received their complete dose of the COVID-19 vaccine, unless they have been granted an exemption.  

It takes a lot of very smart, hard-working and talented people to provide the level of care that we give to our patients. Tufts Medical Center is an internationally respected academic medical center and we pride ourselves not only on the sophistication of the care we deliver, but the compassionate way in which we provide it. And that starts with our employees.

Job Summary:

The Payment Variance Analyst, under the supervision of Manager of Payment Integrity, performs extensive analysis and various follow-up activities to ensure the integrity of billing and reimbursement of medical services provided by the hospital are accurate and appropriate. Responsibilities include identifying payment variances and working internally and externally to resolve such issues in order to recover underpayments.

Essential Responsibilities:

•  Identify and analyze payment variances, working closely with third party payers to resolve issues and ensure correct reimbursement.  Present recommendations to Manager regarding billing, charge, and coding issues
• Work with other hospital departments, including, but not limited to, Patient Accounts, Health Information Management, Continuity of Care, and clinical areas to ensure revenue integrity.
• Identify and bring contract rate discrepancies as well as missing payment or claim files to the attention of the supervisor and/or manager.
• Analyze and gather supporting documentation to process appeals to third parties, and follow up with payers accordingly
• Perform research and analysis related to billing and reimbursement.  Maintain current knowledge in the areas of third party billing, reimbursement schedules and methodologies, coding, payer contracts, billing and payment rules and regulations, and hospital billing compliance.
• Research and assess third party denials in the contract management system, reporting trends to the Manager.
• Evaluate and take appropriate action on third party audit results and/or retractions, including validating audit findings and reimbursement, summarizing the results of the review, and proposing and assisting with next steps if applicable.
• Produce ad-hoc reports for leadership team.
• Perform special projects and other duties, as assigned.

Proficiencies

• Ability to work independently and use critical thinking.
• Detailed knowledge of reimbursement schemes for predominant payers.
• Detailed knowledge of regulatory requirements, particularly Medicare and Medicaid.
• Detailed knowledge of CPT, HCPCS, revenue codes and ICD-10 CM.
• Computer skills; MS Office including Word, PowerPoint, Excel and Outlook; Windows operating system and Internet.

Abilities

Due to its service focus, this position requires strong interpersonal and communication skills, well-developed analytic and organizational skills, critical –thinking and the ability to meet deadlines.

Education

Bachelor’s degree from a recognized college or university in business, healthcare or a closely related field. At least 3 years-experience in Patient Accounts or related accounting field, Managed Care, Reimbursement or Third party Payer work.

An equivalent combination of education and experience, which provides proficiency in the areas of responsibility listed above, may be substituted for the above education and experience requirements.

Knowledge/Skills

• Experience in EPIC installations preferred
• Knowledge of third-party requirements, state and federal regulations.
• Knowledge of payer enrollment processes.
• Knowledge of government and commercial payer requirements for accurate and compliant charging and billing of hospital inpatient, outpatient, surgical and ancillary services. 
• Knowledge of CPT, HCPCs, and revenue codes.
• Experience with Microsoft Office (Outlook, Word, Excel, Power point, Access).
• Knowledge and understanding of hospital revenue cycle operations (registration, charge capture, health information management, claims, payment posting) 
• Knowledge of regulatory publications, how to access and interpret.
• Knowledge of medical terminology. 
• Strong analytical and problem-solving skills
• Ability to work independently, prioritizing and organizing their work. 
• Strong verbal and written communication skills.
• Ability to project manage small to medium projects

All your information will be kept confidential according to EEO guidelines.

AMERICANS WITH DISABILITIES STATEMENT:

Must be able to perform all essential functions of this position with reasonable accommodation if disabled.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed, as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Tufts Medical Center reserves the right to modify position duties at any time, to reflect process improvements and business necessity.

COVID-19 POLICY:

Please note that effective October 1, 2021, as a condition of employment at Tufts Medical Center, all employees and new hires must have received their complete dose of the COVID-19 vaccine, unless they have been granted an exemption.