Referrals Manager

Gracelight Community Health; Los Angeles (CA); On-site; USD 73,000 - 90,000; Full time

Benefits offered by this job

Stipend for business cell phone

Job summary

Gracelight Community Health in Los Angeles, CA invites a Referrals Manager to lead the centralized Referrals and Medical Records departments. You will ensure timely referrals and authorizations, secure release and retention of records, and drive productivity, quality, and customer service across both teams.

You'll supervise staff, manage workflows, and collaborate with providers, health center leadership, managed care, revenue cycle, quality, IS, and compliance to close referral loops and reduce

Qualifications

• 3+ years in referral management, medical records, patient access, or healthcare operations.
• Bachelor’s degree in healthcare administration or related field preferred.
• Bilingual English/Spanish strongly preferred.

Responsibilities

• Directs day-to-day operations of Referrals and Medical Records departments, including workflows, policies, procedures, and service standards.
• Supervises referral coordinators and medical records staff: hires, trains, schedules, coaches, evaluates, and manages performance; distributes workload to meet turnaround and productivity targets.
• Ensures referrals and authorizations are processed accurately and on time in compliance with payer requirements, and that no referral is lost between order and completed specialty visit.
• Ensures medical records are released, stored, and retained in accordance with HIPAA, California law, HRSA requirements, and organizational policy, and that records requests meet turnaround standards.
• Sets departmental KPIs and monitors performance on referral turnaround, authorization completion, referral aging and closure, records turnaround, productivity, and customer service; identifies gaps and leads corrective action and quality improvement.
• Prepares monthly department reports and dashboards for leadership and recommends process changes based on the data.
• Manages the department budget and staffing levels; identifies opportunities to reduce delays and improve productivity, including through technology.
• Owns the department's use of Epic, referral management tools, managed care portals, and LANES; optimizes configuration, tracking, and reporting with IS.
• Maintains working relationships with managed care organizations, specialty providers, hospitals, and imaging centers to improve authorization turnaround and specialty access.
• Works with providers, health center leadership, Patient Access, Revenue Cycle, Quality, and Compliance to resolve referral and records issues affecting patient care, and support audits, surveys, and managed care reviews.
• Performs all other duties as assigned.

Skills

Referral management

Medical records

Team supervision

HIPAA compliance

Data reporting

Epic EHR

Excel advanced

Bilingual English/Spanish

Education

Bachelor’s degree in healthcare administration or related field

Tools

Epic EHR

LANES

Referral management systems

Managed care portals

Job description

Job Details

Job Location: Corporate Headquarters - Los Angeles, CA 90017 Position Type: Full Time Education Level: Not Specified Salary Range: $72,578.00 - $90,252.00 SalaryTravel Percentage: Local Travel Site to Site Job Shift: DayJob Category: Administration

The Referrals Manager leads Gracelight's centralized Referrals and Medical Records departments. The role is accountable for timely completion of specialty referrals and authorizations, accurate and compliant release and retention of medical records, and the productivity, quality, and customer service performance of both departments. The Manager supervises departmental staff, owns the workflows and systems that move referrals and records, and works with providers, health center leadership, managed care, revenue cycle, quality, and IS to close referral loops and reduce delays.

ESSENTIAL JOB DUTIES AND RESPONSIBILITIES:

• Directs day-to-day operations of the Referrals and Medical Records departments, including workflows, policies, procedures, and service standards.
• Supervises referral coordinators and medical records staff: hires, trains, schedules, coaches, evaluates, and manages performance; distributes workload to meet turnaround and productivity targets.
• Ensures referrals and authorizations are processed accurately and on time in compliance with payer requirements, and that no referral is lost between order and completed specialty visit.
• Ensures medical records are released, stored, and retained in accordance with HIPAA, California law, HRSA requirements, and organizational policy, and that records requests meet turnaround standards.
• Sets departmental KPIs and monitors performance on referral turnaround, authorization completion, referral aging and closure, records turnaround, productivity, and customer service; identifies gaps and leads corrective action and quality improvement.
• Prepares monthly department reports and dashboards for leadership and recommends process changes based on the data.
• Manages the department budget and staffing levels; identifies opportunities to reduce delays and improve productivity, including through technology.
• Owns the department's use of Epic, referral management tools, managed care portals, and LANES; optimizes configuration, tracking, and reporting with IS.
• Maintains working relationships with managed care organizations, specialty providers, hospitals, and imaging centers to improve authorization turnaround and specialty access.
• Works with providers, health center leadership, Patient Access, Revenue Cycle, Quality, and Compliance to resolve referral and records issues affecting patient care, and support audits, surveys, and managed care reviews.
• Performs all other duties as assigned.

Qualifications

• Three or more years of experience in referral management, medical records, patient access, or healthcare operations; bachelor's degree in healthcare administration, health information management, business, public health, or a related field preferred.
• Two or more years of supervisory experience managing staff performance.
• Working knowledge of Medi-Cal and Medicare managed care authorization processes, referral coordination, HIPAA, and California medical records law.
• Experience with an electronic health record (OCHIN Epic preferred), referral management systems, managed care portals, and LANES.
• RHIT or RHIA certification preferred.
• Ability to build reports and dashboards and analyze departmental performance data; advanced Excel.
• FQHC or community health center experience preferred.
• Bilingual English/Spanish strongly preferred.
• Personal cell phone available for business use; stipend provided per policy.
• Employment is conditioned on background check, Title XXII clearance, OIG/SAM screening, and health screening.