TuftsMedicine Referral Navigator - Remote​/Hybrid

Tufts Medicine is a leading integrated health system bringing together the best of academic and community health care to deliver exceptional, connected and accessible care experiences to consumers across Massachusetts. Comprised of Tufts Medical Center, Lowell General Hospital, Melrose/Wakefield Healthcare, an expansive home care network and a large clinically integrated physician network, Tufts Medicine has more than 15,000 dedicated employees and caregivers.

Reporting directly to the Halmark Health PHO (HHPHO) Central Services Manager. This role is responsible for “navigating” patients through our healthcare system by scheduling appointments with specialists at the point of contact to provide expedited and convenient service. Responsible for handling all inbound calls, requests and processing all insurance referrals for Hallmark Health PHO (HHPHO) & Lowell General Hospital PHO (LGPHO) Primary Care Providers (PCPs).

Communicates regularly with Primary Care Provider (PCP) and Specialty Provider offices and maintaining relationships with Emergency Departments and affiliated Urgent Care Centers. Responsible for handling all inbound calls and requests for the Provider Finder Line program and following up with patients in need of primary or specialty care. Responsible for following the HHPHO/LGPHO referral guidelines and working with the PCPs, PHO Medical Directors, office staff, and the patient to help direct care, when medically appropriate, to a specialist within the Tufts Medicine network and to Tufts Medicine services.

Supports our PCP offices by making outreach calls to help improve the Quality Measures/Scores of our patients to ensure they are getting the appropriate care they need.

• Competitive salaries & benefits that start on day one
• 403(b) retirement with company match
• Tuition reimbursement
• Free on‑campus parking
• Career growth opportunities
• Guaranteed hours and set schedule

Remote with an occasional onsite presence at Burlington/Lowell locations. This is primarily a remote position except for occasional on‑site practice meetings/trainings/team meetings; in addition, in the event technology or other disruptions prohibit remote work from being conducted successfully, working on‑site will be required to address the disruption.

Full‑Time, 40 Hours. Day Shift: 8:30am-5:00pm, Monday-Friday.

• High School graduate or equivalent
• One (1) year of health care experience in patient registration or physician office.

• Three (3) years of health care experience in patient registration or physician office.

• Responsible for maintaining relationships with Emergency Departments and affiliated Urgent Care Centers to ensure patients in need of a primary care provider or follow up specialty care are addressed.
• Responsible for handling all inbound calls and requests for the Provider Finder Line program and following up with patients in need of primary or specialty care.
• Responsible for following the HHPHO/LGPHO referral guidelines and working with the PCPs, PHO Medical Directors, office staff and the patient to help direct care, when medically appropriate, to a specialist within the Tufts Medicine network and to Tufts Medicine services.
• Supports our PCP offices by making outreach calls to help improve the Quality Measures/Scores of our patients to ensure they are getting the appropriate care they need.
• Utilizes effective customer service etiquette and skills in all phases of telephone and email communication.
• Responds immediately to patients or Primary Care Physician (PCP) requesting specialist appointments and works with offices to schedule at the point of initial contact to keep care well‑coordinated within the Tufts Medicine referral circle.
• Tracks number of appointments made and responsiveness and appointment availability by Specialty practice. Alerts Manager regarding appointment access issues or problems. Works to achieve/exceed performance goals set by the PHO (such as answer rates, average customer hold times, and number of contacts handled, etc.)
• Maintains excellent rapport and ongoing communication with the…