The Referrals Manager will be responsible for the direct supervision and the day to day operations of the Referrals department for Lowell Community Health Center (Lowell CHC). Ensures patient satisfaction and the accurate and timely resolution for pending referrals including those ordered by the Lowell CHC providers, and requests made by external specialty groups. Will develop, implement and apply policy and procedures to guide and support the functional area, and will ensure that referrals staff are oriented, trained and functioning effectively to perform their duties and responsibilities consistent with industry standards of care. Acts as a liaison for Wellforce Care Plan and/or external parties on matters related to referrals, specialist appointments, diagnostic imaging, prior authorizations and testing for the health center.
II. Essential Duties and Responsibilities
The assigned duties and responsibilities include but are not limited to:
* Provide excellent customer service to all patients and staff
* Develop and update departmental standard operating procedures
* Generate reports and tracking mechanisms to assess departmental performance
* Work with other Lowell CHC departments to improve processes and implement new initiatives
* Participate in designated Lowell CHC committees and projects
* Develop and maintain working relationships with those involved with clinical operations and serve as liaison between the Referrals departments and members of the clinical teams.
* Creates and/or maintains all payor/membership/authorization websites for insurance verification and referral authorizations for the staff
* Ensure the collection and updating of necessary patient demographic information
* Maintain needed forms and office supplies required for front desk area offices/order supplies as needed
* Facilitates the resolution of patient/staff grievances/complaints, following Lowell CHC guidelines and policies where required.
* Responsible for the direct supervision and/or process of all referrals, specialist appointments, prior authorizations and testing for all the providers within this practice
* Maintains accountability for the accuracy and timeliness of the entire process thru communication and diligent monitoring
* Assist in recruiting, interviewing and hiring qualified staff candidates
* Coach, mentor and teach staff to ensure that they performing to their highest potential
* Provide timely and relevant performance evaluations to staff in accordance with Lowell CHC policy and supervisor expectations
* Disseminates and interprets information to assure that new and existing employees are familiar with policies, procedures, and expectations for their job role
* Establish an environment which fosters teamwork and open communication
* Ensure that staff follow all applicable policies and procedures
* Works collaboratively with the PHO to ensure all referrals (in network and out) are processed completely and correctly in a timely manner
* Assist in the budget development and management of the department
A bachelor or associate's degree in business or a healthcare related field is required. The following traits are desired:
* Strong organizational skills * Ability to multi-task priorities * Strong leadership and facilitation skills * Team oriented * Ability to manage change * Ability to make administrative/procedural decisions and judgments. * Ability to react calmly and effectively in emergency situations. * Ability to communicate technical information to non-technical personnel. * Ability to communicate effectively, both verbally and in writing. * Ability to diffuse and resolve problematic situations * Ability to plan and prioritize your own work and other people's * Accuracy with record keeping * Bilingual in English/Spanish and/or Portuguese preferred.
A minimum of three to five years' experience in an ambulatory care or inpatient setting is desirable. A minimum of three years of management experience is required. Excellent computer skills are highly desired. Experience with an electronic medical record system is also desired.
The manager will make departmental decisions within their scope of responsibility and in accordance with Lowell CHC policies and procedures.
VI. Independent Action
The manager will exercise an overall moderate level of independent action. Functions within scope of responsibility will allow manager to exercise a high level of independent action. Functions outside the scope of responsibility or clinical expertise will require a lower level of independent action as other individuals will be required to assist
The manager is accountable for everything the department does or fails to do in accordance with Lowell CHC policies and procedures. This applies to day-to-day administrative functions. The manager is also accountable for achieving performance expectations established by their supervisor.
The manager will need to work closely with other departments to achieve departmental success. The manager will effectively and openly communicate with the multi-disciplinary team and other health care professionals. The manager will maintain a collaborative work relationship with peers in order to create a positive work environment
The manager will work with external agencies to establish effective communications for the benefit of our mutual patients.
IX. Manual and Visual Skills
The manager will be required to use a computer for extended periods of time.
X. Physical Environment
The physical environment is typical of an ambulatory care setting. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level is usually moderate.
XI. Physical effort
While performing the duties of this job, the employee's physical effort may require the ability to stand, walk frequently, use hands, reach with arms and hands, talk and hear. The employee frequently is required to sit. The employee may be asked to lift and/or move up to 15 pounds.
XII. Occupational Risks
The duties of this job may subject the employee to potential exposure to occupational risks such as contagious contamination with infected bodily fluids. Universal precautions and techniques are included in orientation.
XIII. Character of Supervision
The manager will receive regular administrative supervision from the Patient Services Director and the Chief of Operations in the absence of the Director.
XIV. Scope of Vision
The manager will have direct supervisory responsibility for departmental staff within their scope of responsibility.
Other Job Information (if applicable): Work Schedule Monday - Friday 8:00am - 4:30pm
Hours may vary due to department needs, meetings, trainings etc.