Referral Coordinator – Supervisor

Referral Coordinator – Supervisor

Requirements

• Knowledge of products, services, standards, policies and procedures in a healthcare environment
• Network Management experience/understanding
• Understanding of cost as it relates to Medicare parts A, B and D
• Proficient in Microsoft Excel, Outlook and Word
• Written and oral fluency in English
• Ability to effectively communicate with employees, patients and other individuals in a professional and courteous manner
• Ability to pay close attention to detail and to ensure accuracy of reports and data
• Bachelor’s degree preferred; relevant, equivalent experience may be substituted for education on a year-for-year basis
• Minimum five (5) years’ supervisory experience of teams greater than three (3) employees
• Experience working with Physicians and Directors on a daily basis
• Experience reviewing data and making decision based of the data
• Experience working in Medicare managed care environment

Responsibilities

• Provides extraordinary customer service to all internal and external customers (including patients and other Chen Medical team members) at all times.
• Manages, coaches and provides training to Care Coordinators; ensures they are following company processes. Training can also include other roles as needed.
• Implements new processes per Referral COE.
• Conducts monthly Care Coordinator meetings and weekly visits to medical centers.
• Assists Care Coordinators with solving issues pertaining to referrals.
• Collaborates with Office Managers to conduct performance evaluations of Referrals Team Members.
• Addresses / resolves any customer-service issues.
• Works closely with the Management Team and Administrators in relation to strategic business planning.
• Manages Referral Approval Process- Use Referral Approval Process Checklist.
• Communicates alternative/approvals to Referral Coordinator.
• Follows up with MMD/Specialist/MND if no response after 24hours.
• Calls and follows up with patients regarding alternatives; uses messaging scripts to speak with patients regarding alternatives.
• Processes New Patient Referral Exception from Sales Team (if applicable to your market).
• Prepares and runs referral team meeting- Create agenda for meeting. Gather info from Medical Director /Network Director /Referral Manager.
• Prepares Referral Team Meeting Minutes and send minutes to Operation Director, Market Medical Director, Market Network Director and Referral COE via email after meetings.
• Communication with Network Director regards to PPL- Report any errors, concerns or feedback in regard to PPL providers.
• Analyzes Referral Workflow Report.
• Generates Weekly Analysis Report and send to Care Coordinators.
• Builds and maintains effective long-term relationships and higher level of satisfaction with key specialists with support from network director or associate director.
• Conducts site visits to service providers, resolves issues, educates staff/providers on policies and certifies specialists with support of network director or associate director.
• Establishes consistent and strong relationships with specialists’ provider offices.
• Collaborates with network leaders to identify network gaps.
• Identifies root cause of problems and trends; participates in developing solutions.
• Works with provider’s and organization staff to resolve the issue and monitor recurrence.
• Ensures all elective procedures are entered into HITS prospectively.
• Works with tier2/tier 3 specialist to make sure our patients are seen working with the Network Director when necessary.
• Looks for trends and referral patterns -work with Network Director- Example: overutilization and dissatisfaction.
• Manages Specialist Schedules- Open, close and blocks schedules when advised by Network Director to do so.
• Covers for Care Coordinator as needed.
• When needed meet with specialist office and Network Director.
• Manages time for Care Coordinators with Center Managers.
• Maintains PPL in conjunction with Network Director.
• Other duties as assigned and modified at manager’s discretion.

Preferred Qualifications

No preferred qualifications provided.