What are the responsibilities and job description for the Referral Specialist, Specialty Programs position at HarmonyCares?
Overview
HarmonyCares is one of the nation’s largest home-based primary care practices. HarmonyCares is a family of companies all dedicated to providing high-quality, coordinated health care in the home. This includes HarmonyCares, HarmonyCares Medical Group, HarmonyCares Home Health and HarmonyCares Hospice.
Our Mission – To bring personalized, quality-based healthcare to the home of patients who have difficult accessing care.
Our Shared Vision – Every patient deserves access to quality healthcare.
Our Values – The way we care is our legacy. Every interaction counts. Go the extra mile. Empower and support each other.
Why You Should Want to Work with Us
- Health, Dental, Vision, Disability & Life Insurance, and much more
- 401K Retirement Plan (with company match)
- Tuition, Professional License and Certification Reimbursement
- Paid Time Off, Holidays and Volunteer Time
- Paid Orientation and Training
- Day Time Hours (no holidays/weekends)
- Great Place to Work Certified
- Established in 11 states
- Largest home-based primary care practice in the US for over 28 years, making a huge impact in healthcare today!
More details about the benefits we offer can be found at https://careers.harmonycares.com/benefits.
Responsibilities
The Referral Specialist, Specialty Programs is responsible for performing activities related to processing case management referrals as well as providing administrative assistance in support of the Complete Health Assessment (CHA) program. Responsibilities will include developing, implementing, and monitoring all case management referral related activities to ensure the CHA program meets all regulatory, compliance, and contractual requirements. This position will be responsible for facilitating communication between clinicians and various health plans in regard to case management referrals. Additional responsibilities will include accurate filing of regulatory documentation as well as supporting operational documentation needs.
Essential Duties and Responsibilities
- Promptly report all case management referrals in accordance with the established process per payer
- Review documentation, processes, and practices to ensure accuracy, continuity, and completeness
- Facilitate communication with various health plans in regard to case management referrals
- Manage tracking all referrals by payer, in accordance with payer and HarmonyCares policies and procedures
- Responsible for monitoring provider passed scheduled visits and completion rates and effectively facilitate communication to provider for improvement
- Will assist clinical team with distribution and collection of regulatory documents, licensing documents, and compliance modules.
- Will support clinical-operations team as needed with various projects and tasks
- Responsible for aggressively addressing and acting upon adverse events and action thresholds in area of responsibility
- Accountable for outstanding customer service to all external and internal customers
- Develop and maintain effective relationships through effective and timely communication
- Perform routine office tasks necessary for the operation and presentation of the Complete Health Assessment team
- Attend all required meetings and in-services
- Support to the Clinical and Operations team as needed
In this role you may work with. . .
- Clinicians
- Clinical Team
- Operations Team
- Health Plans
- Customers
- Patients
Qualifications
Required Knowledge, Skills, and Experience
- High School Degree
- 1 year(s) of healthcare experience
- Ability to coordinate complex activities across functional lines of operations, under tight timelines
- Must be able to relate professionally and positively to physicians, providers, and staff with excellent communication, interpersonal, and time management skills
Preferred Knowledge, Skills and Experience
- Associate’s degree
- Proven, positive interactions with medical professionals and experience in scheduling patient appointments
Posted Max Pay Rate
Posted Min Pay Rate
Pay Transparency
Individual compensation packages are based on various factors unique to each candidate, including skill set, experience, qualifications, and other job-related considerations.Notice
HarmonyCares and HarmonyCares Hospice are not affiliated with Harmony Hospice Care. HarmonyCares Hospice does not conduct business in OH. HarmonyCares Hospice conducts business in MI, VA, WI, TX, IN, IL.
