Supervisor, Referrals

We’re unique.  You should be, too.

We’re changing lives every day.  For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts?  Do you inspire others with your kindness and joy?

We’re different than most primary care providers. We’re rapidly expanding and we need great people to join our team.

The Manager, Referrals is a customer-service and leadership-focused position working directly with patients and their families, insurance representatives, doctors and other medical personnel in a dynamic and professional environment to provide the highest level of quality healthcare to all patients.

ESSENTIAL JOB DUTIES/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.

KNOWLEDGE, SKILLS AND ABILITIES:

• Understanding of the communities served by ChenMed, including the complexities of Medicare programs to patients in the healthcare marketplace
• Ability to determine proper resolution of problems based on defined alternatives
• Able to use Microsoft Office Suite products including Excel, Word, PowerPoint and Outlook
• Ability and willingness to travel locally and regionally up to 50% of the time
• Spoken and written fluency in English

EDUCATION AND EXPERIENCE CRITERIA:

• High School diploma or GED required
• One (1) to three (3) years of healthcare experience such as care coordinator, referral coordinator in a clinical setting, preferably within the Medicare HMO population