Referral Operations Leader: Optimize Care Coordination

North-Shore-Community-Healt; Salem (MA); On-site; USD 85,000 - 110,000; Full time

Benefits offered by this job

Health and wellness benefits

Tuition reimbursement

Loan forgiveness opportunities

Job summary

North Shore Community Health is seeking a Referral Operations Manager to oversee referral processes, verify insurance eligibility, and ensure timely completion of referrals. You will build new referral networks, optimize workflows, and lead special projects with a focus on care coordination and accreditation standards.

The role includes coaching the Referral Coordinators, monitoring KPIs, and maintaining strong relationships with referral partners to deliver high-quality care across NSCH service

Qualifications

• High School Diploma required.
• Minimum of three (3) years of experience in a healthcare setting.
• Minimum of five (5) years of customer service experience, preferably in a healthcare setting.
• Demonstrated leadership experience with multitasking capability.
• Prior supervisory experience preferred.
• Experience with Medicare, Medicaid, and managed healthcare.
• English/Spanish bilingual ability preferred.

Responsibilities

• Manage the work of the Referral Coordinators, verify appointments, process and track referrals, and schedule new patients.
• Track data on outgoing referrals and optimize care coordination, patient education, scheduling, tracking, and loop closure.
• Identify insurance verification issues with leadership and develop mitigation strategies.
• Identify gaps in referral networks and connect to new partners regionally to establish referrals.
• Maintain relationships with referral partners to ensure timely, high-quality care.
• Lead implementation for special projects and initiatives with support from leadership.
• Communicate changes to verification- and referral-related workflows and participate in clinical training.
• Monitor KPIs related to referrals and ensure staffing levels during operating hours.
• Provide coaching to Referral Coordinators and ensure they have the tools to perform.
• Oversee referral tracking procedures and ensure timely management of referrals.
• Onboard new Referral Coordinators and maintain accreditation competencies.
• Maintain up-to-date EHR information on local specialists and document referrals.

Skills

Organizational skills

Communication skills

Diversity awareness

Team collaboration

Attention to detail

Patient confidentiality

Education

High School Diploma

Job description

North Shore Community Health is seeking a Referral Operations Manager to oversee referral processes, verify insurance eligibility, and ensure timely completion of referrals. You will build new referral networks, optimize workflows, and lead special projects with a focus on care coordination and accreditation standards.

The role includes coaching the Referral Coordinators, monitoring KPIs, and maintaining strong relationships with referral partners to deliver high-quality care across NSCH service