Retina Drug Program Supervisor

We are seeking a Retina Drug Program Supervisor who will provide direct oversight and close management of the Retina division’s Retina Drug Coordinators. Train staff, meet compliance standards, and ensure Retina Drug Coordinators facilitate all aspects of the pre-authorization intravitreal injection process. Oversee/assure that the Retina Division staff has obtained necessary patient insurance authorizations for the administration of various drugs. Monitor changes in CPT and HCPCS coding and insurance changes with Wilmer Billing Office; communicate any changes with all stakeholders on a timely basis. Exercise independent judgement and decision making on a regular basis.

Specific Duties & Responsibilities:

• Provide direct oversight of the Retina division’s Retina Drug Coordinators.
• Train existing and new staff.
• Ensure compliance standards are met and Retina Drug Coordinators facilitate all aspects of the pre-authorization intravitreal injection process.
• Emphasize importance of obtaining insurance authorizations prior to administration of drugs to Retina Drug Coordinators and to Physicians.
• Communicate and coordinate with Wilmer Billing Office regarding changes in CPT and HCPCS coding.
• Work with Wilmer Billing Office to maintain billing accuracy through encounter verification i.e., clinic schedules, encounter information in EPIC.
• Monitor insurance policy updates regarding new and existing drugs.
• Ensure all stakeholders are aware of insurance changes related to program including Retina Drug Coordinators, Physicians, relevant Clinic Managers, and Assistant Administrators.
• Submit medical information to insurers as instructed by physicians and Retina Clinic Manager.
• Develop and maintain standard operating procedures about obtaining authorizations.
• Follow limiting coverage guidelines for diagnosis coding by using LCD/NCD/payer policy information and assign appropriate modifiers based on departmental policy.
• Ensure diagnosis codes are appropriate for each retina drug prior to claim submission.
• Research billing and documentation questions or problems submitted by faculty, department, billing staff, and others to ensure compliance with specific payer regulations and CPA policies and procedures.
• Maintain knowledge of JHU Professional Billing Services rules and regulations.
• Participate in ongoing educational activities.
• Perform timely reviews of employee performance.

Minimum Qualifications

• High School Diploma / GED.
• Four years related experience, including previous lead or supervisory experience.
• Additional education may substitute for up to one year of required experience to the extent permitted by the JHU equivalency formula.

Preferred Qualifications

• Certified Professional Coder certification (or department approved certification).
• Experience in medical billing and demonstrated analytical skills.
• Working knowledge of Epic medical record platform.
• Experience within the Johns Hopkins patient-oriented community.

Classified Title: Clinic Supervisor
Job Posting Title (Working Title): Retina Drug Program Supervisor
Role/Level/Range: ATO 37.5/03/OF
Starting Salary Range: Min $40,950 - Max $71,175 Annually ($67,860 targeted; Commensurate with experience)
Employee group: Full Time
Schedule: Monday-Friday, 8:30 am - 5:00 pm
Exempt Status: Exempt
Location: School of Medicine Campus
Department name: ​​​​​​​SOM Oph Retina Service
Personnel area: School of Medicine 

Total Rewards
The referenced salary range is based on Johns Hopkins University’s good faith belief at the time of posting. Actual compensation may vary based on factors such as geographic location, work experience, market conditions, education/training and skill level. Johns Hopkins offers a total rewards package that supports our employees' health, life, career and retirement. More information can be found here: https://hr.jhu.edu/benefits-worklife/

Please refer to the job description above to see which forms of equivalency are permitted for this position. If permitted, equivalencies will follow these guidelines:
JHU Equivalency Formula: 30 undergraduate degree credits (semester hours) or 18 graduate degree credits may substitute for one year of experience. Additional related experience may substitute for required education on the same basis. For jobs where equivalency is permitted, up to two years of non-related college course work may be applied towards the total minimum education/experience required for the respective job.

**Applicants who do not meet the posted requirements but are completing their final academic semester/quarter will be considered eligible for employment and may be asked to provide additional information confirming their academic completion date.

The successful candidate(s) for this position will be subject to a pre-employment background check. Johns Hopkins is committed to hiring individuals with a justice-involved background, consistent with applicable policies and current practice. A prior criminal history does not automatically preclude candidates from employment at Johns Hopkins University. In accordance with applicable law, the university will review, on an individual basis, the date of a candidate’s conviction, the nature of the conviction and how the conviction relates to an essential job-related qualification or function.

The Johns Hopkins University values diversity, equity and inclusion and advances these through our key strategic framework, the JHU Roadmap on Diversity and Inclusion .

Accommodation Information

If you are interested in applying for employment with The Johns Hopkins University and require special assistance or accommodation during any part of the pre-employment process, please contact the Talent Acquisition Office at [email protected] . For TTY users, call via Maryland Relay or dial 711. For more information about workplace accommodations or accessibility at Johns Hopkins University, please visit accessibility.jhu.edu .

Johns Hopkins has mandated COVID-19 and influenza vaccines, as applicable. The COVID-19 vaccine does not apply to positions located in the State of Florida. Exceptions to the COVID and flu vaccine requirements may be provided to individuals for religious beliefs or medical reasons. Requests for an exception must be submitted to the JHU vaccination registry. For additional information, applicants for SOM positions should visit https://www.hopkinsmedicine.org/coronavirus/covid-19-vaccine/ and all other JHU applicants should visit https://covidinfo.jhu.edu/health-safety/covid-vaccination-information/ .

The following additional provisions may apply, depending on campus. Your recruiter will advise accordingly.

The pre-employment physical for positions in clinical areas, laboratories, working with research subjects, or involving community contact requires documentation of immune status against Rubella (German measles), Rubeola (Measles), Mumps, Varicella (chickenpox), Hepatitis B and documentation of having received the Tdap (Tetanus, diphtheria, pertussis) vaccination. This may include documentation of having two (2) MMR vaccines; two (2) Varicella vaccines; or antibody status to these diseases from laboratory testing. Blood tests for immunities to these diseases are ordinarily included in the pre-employment physical exam except for those employees who provide results of blood tests or immunization documentation from their own health care providers. Any vaccinations required for these diseases will be given at no cost in our Occupational Health office.

Note: Job Postings are updated daily and remain online until filled.