Major Responsibilities: Coordinates the verification of in-network insurance coverage for applicable stem cell transplant treatment for each potential transplant candidate once referred by hematology/oncology clinics. Submits documentation for benefit exception reviews and appeals. Working with the multidisciplinary team and out of network insurance companies on continuations of care, and single contracts.     1)Collects necessary patient information from clinical out-patient coordinators to research insurance viability for ALGH transplant program.     2)Coordinates the collection of demographic and insurance information of siblings to be HLA-typed for potential donor match to transplant patient.     3)Coordinates confirmation between patients, in-patient and out-patient practices regarding approval of patient regarding benefits for transplant.     4)Contacts appropriate insurance companies to determine patient eligibility for transplant confirming ALGH as an approved transplant provider.     5)Provides needed clinical information to clinicians providing care for patients at physician offices or institutions. Coordinates retrieval of required protocol data     1)Contributes to the design of data collection forms used by the different departments within the transplant program. Oversees their review and revision by appropriate staff, and distribution when necessary.     2)Coordinates retrieval and maintenance of patient records and implements process for ongoing review and compilation of records per standards.     6)Insures that information is organized and maintained confidentially per guidelines and that all events are adequately documented.     7)Demonstrates the ability to process and submit reports collaborating with regulatory bodies and within the required time frames.     8)Contributes to development and implementation of an internal computerized database for managing and analyzing program information.     4)Abstracts both internal and external data that can be developed into departmental flow sheets and informational graphs for educational presentations and required regulatory documentation submissions.     5)Coordinates internal and external audits, including patient-specific source documentation per regulations, as well as audits that monitor proper and safe conduct of the transplant program, such as, indicators and outcomes, patient survival data and recovery data, adverse events, and variances to name a few.     3)Maintain and updates program’s Standards of Procedures (SOPs), coordinating review calendar assignments with team members through hospital’s electronic document system. Works with program director, manager and team members to introduce new SOPs as needed to maintain program efficiency and patient safety. Plans, Coordinates and Oversees all Quality Management Activities.     1)Acts as liaison between transplant program and hospital’s Quality Management Director and Department. Coordinates on-going systematic developments, implementations and evaluations of program’s Quality Management Plan that lead to measurable improvement in health care services and the health status of targeted patient groups.     9)Assists in maintaining favorable visibility of transplant program on the internet through placements and listing in national bone marrow transplant organizations like FACT, NMDP, Be-the-Match.org, and Center for International Blood and Marrow Transplant Research (CIBMTR).     2)Assists with communication and education of transplant staff, scheduling of appropriate speakers to present to transplant staff, and distribution of applicable news articles, and scholarly papers.     10)Works with hospital’s legal and risk management departments as needed to ensure patient safety and accurate reporting of transplant patient events and the development of consents used for treatments.     4)Works closely with Transplant Program Manager in preparation for annual accreditations not limited to Foundation for the Accreditation of Cellular Therapy (FACT), National Marrow Donor Program (NMDP), Illinois Department of Public Aid, and insurance groups on an annual basis. These preparations enable the accrediting agency or business group to quickly and efficiently review the program documentation in order to gain accreditation status both locally and nationally.     3)Responsible for the planning and facilitation of all team, committee and quality management meetings. This involves maintaining meeting schedules, monitoring attendance, ensuring that all meeting elements are prepared for distribution, reviewed by various team members and reported on in a timely fashion.     5)Maintains familiarity with applicable accreditation guidelines.     6)Oversee maintenance of transplant office administration records, including physician and team appointments, team member competencies, team members responsibilities to the transplant program, and records and minutes of all transplant meetings, as well as educational opportunities.     7)Coordinates the provision of appropriate ongoing information to physician, nursing and ancillary staff for implementing protocol revisions. Facilitates ongoing inservices as needed.     8)Helps maintain Bone Marrow Transplant (BMT) website and work with outside hospital departments to keep website current. Work to keep content on internal BMT website accurate and updated. Assisted in the creation of new external BMT website for the facility. Participates in the development and implementation of the bone marrow transplant programs.     1)Actively participates in the quality improvement and quality management programs including FACT and NMDP. Acts as intermediary between transplant facility and FACT personnel to address accreditation and transplant guideline issues.     2)Explores and recommends activities aimed at improving bone marrow transplant processes. Including investigating, resolving patient and donor billing issues.     3)Attends and participates in department meetings and process improvements.     4)Responsible for staying well-informed of transplant and quality management developments.     5)Coordinates unrelated donor searches and tracks the entire search process from initial search process to transplantation. This includes that requests are appropriate and review the recipients and donor typing information to ensure it is correct. Identifying primary and back-up donor and submission of the requests including physical exams and workups.     6)Attends continuing education programs to attain or meet certification requirements. Keeps informed transplant institutional changes     7)Assists in production of both internal and external bone marrow transplant presentations that include analytic data and graphs as well as comparison data between program and other outside facilities.     8)Acts as back-up for other Coordinator’s duties when necessary.

Education/Experience Required:BS or BA in health related field or equivalent experience 2 years experience in health care setting.

Knowledge, Skills & Abilities Required:Be able to use a computer, Word, Excel & Power pnt programs efficiently.N/A

Physicial Requirements and Working Conditions: Use of personal computers and printers Ability to travel throughout the LGH campus and to off campus offices Ability to act quickly during eligibility, plan of care modification, and serious adverse event processes Ability to work in a fast paced environment with established time constraints



This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.