The Laboratory Genetic Counselor will work with other medical professionals including technologists, genetic counselors, laboratory managers, and directors to provide genetic testing consultation and technical support to Duke University Health System providers, staff, and laboratory professionals. This position will report to the DUHS Clinical Laboratories Director of Business Operations and Strategic Development and will utilize specialized clinical genetics knowledge to implement processes to review and improve genetic testing utilization; to classify and interpret genetic variation detected by Duke clinical laboratories as part of a multidisciplinary team; and to assist with the teaching of laboratory technologists, residents, and fellows.
Duties and Responsibilities of this Level
Genetic Testing Consultation
The laboratory-based Genetic Counselor will provide genetic testing information to providers, care teams, staff, and genetic testing advisory groups regarding the appropriate use of tests, test methodologies, test limitations and accuracy, potential testing outcomes and follow-up, sample requirements, sample stability, and interpretation of results. They will function as a resource to providers regarding genetic disorders and the appropriate available testing. Establish and maintain a Genetic Testing Consultation program that will enable providers to request laboratory genetic testing consult assistance through the current EPIC system.This individual will be responsible for providing genetic testing consultation to our Duke Health Providers. They will monitor test utilization and provide appropriate assistance to ensure cost-effective laboratory genetic testing while maintaining testing quality and exceptional patient care.
Utilization Optimization
The laboratory Genetic Counselor will perform retrospective audits of genetic testing utilization to identify trends and formulate a recommended action plan to facilitate utilization improvements. This individual will help lead and participate in workgroups and meetings related to genetic testing. They will assist in the formation of genetic testing advisory groups that will include representation from multidisciplinary services to develop and maintain appropriate workflows and policies associated with tests for common clinical presentations. They will assist laboratory staff in maintaining a current laboratory test formulary that clearly communicates necessary information regarding testing requirements, storage and specimen stability, and acceptable volumes along with any specific test utilization information.
They will also assist the Duke Molecular Pathology Genetics and Genomics (MPGG) department and the Duke Referral Laboratory with Providers and appropriate genetic consultation and test utilization. In this role within MPGG, they will participate in pre-analytical triaging of test orders to minimize duplicate testing, and to ensure that the right test is being ordered for the right patient, at the right time, and on the right specimen.
Laboratory Operational Support
The laboratory Genetic Counselor will assist laboratory Directors and Managers in the development of clinical and laboratory policies for new laboratory genetic test ordering, CPT coding, billing and reimbursement. They will assist laboratory personnel and providers with the appropriate selection of reference laboratories for genetic testing by reviewing the sensitivity, specificity, cost, and turnaround time of the test provided. They will assist laboratory Directors and Managers in the evaluation of new reference laboratories to ensure CLIA licensure as well as specific laboratory quality, turnaround times, ease of use, cost, billing appropriateness and reporting. They will assist the Laboratory Directors and Managers in identifying testing needs through test utilization review and continuous genetic testing education. They will assist the laboratory personnel and Directors in the resolution of technical problems and questions for all genetic testing and will be the primary point of contact for facilitating the review for Anatomic Pathology-related genetic testing requests.
The laboratory Genetic Counselor will provide variant analysis support for copy number variants detected by chromosomal microarray analysis as well as nucleotide variants detected by NGS and targeted gene assays. They will also assist in final report generation. The genetic counselor will work with other Providers to ensure that appropriate germline testing is performed internally or by an external vendor, when potential germline variants are detected by somatic testing performed within MPGG. They will support the MPGG directors and fellows addressing questions regarding previously reported variants and any new information regarding clinical significance of the variant, as well as questions regarding billing and testing status updates.
Education and Development
The laboratory Genetic Counselor is required to stay current on all appropriate laboratory protocols; maintain accessibility to all current best practices in laboratory genetic testing and their clinical utilization; develop necessary educational and training guides, and workflow charts to meet the needs of the laboratory staff, care teams, advisory groups and providers; provide periodic lectures to laboratory staff and other medical professionals regarding current trends in genetics and genetic testing; attend national, state and local genetic meetings to maintain awareness of current genetic testing and methodology trends including variant classification and annotation; maintain knowledge of all current and relevant ICD 10 codes for medical necessity; maintain skills within EPIC Beaker to provide the ordering templates to collect all pertinent clinical information and consult communication to laboratory staff and providers.
Minimum Qualifications
Education
Master's degree in Genetic Counseling from an American Board of Genetics Counseling (ABGC) accredited program
Experience
Board Certification or eligible by the American Board Of Genetic Counselors (ABGC).
Degrees, Licensures, Certifications
Board Certification or eligible by the American Board Of Genetic Counselors (ABGC).
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