Referral Services Manager

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Primary Accountability

The Referral Services Manager is responsible for managing operational aspects of the referrals and health information functions including customer service, compliance, and staffing.

• Provides management to departmental staff.
  • Responsible for performance management of assigned staff, including recognition, performance evaluations, and formal coaching and counseling.
  • Responsible for making recommendations regarding hiring or firing, and the advancement and promotion of assigned supervisors and their staff.
  • Demonstrates core leadership behaviors and a “team one approach.”
  • Creates a culture of accountability and excellence.
  • Develops and manages an action plan across the assigned employee base to support the strategic direction and obtainment of goals, leading change when necessary.
  • Empowers staff through effective communication and talent building.
  • Delegates appropriate departmental duties and responsibilities to assigned team members while ensuring department performance.
  • Assists with the development of the departmental budget and monitors budget to ensure expenses do not exceed budget.
  • Ensures regulatory compliance for assigned departments and with all workflows, policies, and procedures.
  • Ensures employees receive instruction/training that is in compliance with training plan, including on‑the‑job training. Works with supervisor to ensure necessary remediation is taken.
  • Recommends workflow, policy, and procedure changes based on observations from performance metrics, outcomes, and feedback from supervisor.
  • Ensures department maintains compliance with all employee‑related reporting and tracking.
  • Identifies and presents issues related to referrals and health information functions to supervisor with recommendations for resolutions.
  • Supports a “culture of excellence” and the “Four Pillars of Excellent Customer Service.”
• Responsible for managing referral‑related functions.
  • Ensures referrals are tracked and processed within expected timelines.
  • Manages the productivity of staff to ensure performance metrics are met.
  • Ensures referral workflows are followed according to established policies and procedures.
  • Responsible for ensuring compliance of the referral process.
  • Manages the operations related to referrals and resources to ensure goals are met.
  • Conducts internal audits of referrals to ensure compliance with Joint Commission, HRSA and other regulatory guidelines.
  • Communicates to internal and external providers to ensure patients receive needed specialty access.
• Manages and monitors referral workflows and performance to ensure adherence to appropriate referral sources and that clinical pathway workflows are followed at all times.
  • Reviews referral data and specialist sources to evaluate appropriate access and cost effectiveness based on the patient’s insurance.
  • Identifies and recommends strategies to reduce the cost of specialty care as part of operational/strategic goals.
  • Ensures specialty database within the electronic health record is maintained current.
  • Identifies and presents issues related to referrals and health information functions to Director with recommendations for resolutions.
  • Develops and maintains a working knowledge and relationship with the professional community and their respective management teams in order to enhance effective specialty access for our patients.
• Responsible for managing health‑information related functions.
  • Ensures medical releases, subpoenas and other health‑information related functions are processed within expected timelines.
  • Manages the productivity of staff to ensure performance metrics are met.
  • Ensures health‑information related workflows are followed according to established policies and procedures.
  • Responsible for ensuring compliance of all health‑information requests and handling, including scanning procedures.
  • Ensures random audits are completed to ensure compliance with health plans and other regulatory agencies.
  • Maintains and manages the development and revisions of clinical forms for the health…