The Referral Manager 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 DUTIES AND RESPONSIBILITIES:
- Provides extraordinary customer service to all internal and external customers (including patients and other Chen Medical team members) at all times.
- Manages, coach and provide training to Referral Coordinators.
- Assures referral coordinators are following company processes.
- Implements new processes per Referral COE.
- Conducts Monthly Referral Coordinator meetings.
- Assists referral coordinators with solving issues as it pertains 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.
- Manages and Review Notification Emails, ensure email notifications are accurate.
- Generates approval email- Follow approval email template with details for approval.
- Responds to Workflow requests- Communicate alternative/approvals to Referral Coordinator.
- Follows up with MMD/Specialist/MND if no response after 24hours.
- Calls and Follows up with patients in regards to alternatives- Use messaging scripts to speak with patients in regards to alternatives.
- Other responsibilities may include:
- Processes New Patient Referral Exception from Sales Team (if applicable to your market).
- Prepares and run 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 regards to PPL providers.
- Trains Referral Managers (if applicable to your market) - Evaluate and recommend.
- Analyzes referral reports.
- Referral Workflow Report.
- Referral to Order Report.
- Generates Weekly Analysis Report and send to Referral Coordinators.
KNOWLEDGE, SKILLS AND ABILITIES:
- Knowledge of products, services, standards, policies and procedures in a healthcare environment.
- Network Management experience/understanding.
- Understanding of cost as it relates to Medicare part A and B.
- Skill in oral communication (English required).
- 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.
Additional Job Description
EDUCATE AND EXPERIENCE CRITERIA:
- Bachelor’s degree.
- Minimum five (5) years supervisory experience.
- Proficient in Microsoft Excel, Outlook and Word.
- 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.
- Experience managing teams greater than (3) employees.