Remote Referral Management Lead (DoD Contract)

TriWest Healthcare Alliance Corp.; Phoenix (AZ); A distancia; USD 68.000 - 72.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical, Dental and Vision Coverage

Paid time off

401(k) Retirement Savings Plan (with 1

Short-term and long-term disability,基本

Descripción de la vacante

TriWest Healthcare Alliance Corp. is seeking a Referral Management Supervisor to direct RM services operations and oversee non-clinical data entry in the CareRadius system. You will ensure contract compliance and provide leadership to RM staff in a high-volume environment.

Requirements include U.S. citizenship and the ability to obtain a favorable DoD background investigation, plus 2+ years in an administrative or supervisory role within healthcare operations.

Formación

• High School Diploma or G.E.D.
• U.S. Citizenship
• Must be able to receive a favorable Interim and adjudicated final DoD background investigation
• 2+ years’ experience in an administrative setting such as health care operations
• Two or more years of supervisory experience in managed care/medical management systems

Responsabilidades

• Directs daily referrals management operations and supervises RM staff
• Ensures quality staff training and oversees orientation of new hires
• Plans and implements staff development activities
• Ensures RM procedures comply with contract requirements
• Assesses staff performance and conducts annual evaluations
• Functions as SME for information management in online medical management system
• Supports RM by serving in RM Specialist role when needed
• Resolves complex provider and beneficiary issues
• Represents RM on Utilization Management subcommittee as needed
• Collaborates with departments, providers and beneficiaries to ensure accurate documentation
• Participates in TriWest meetings and initiatives
• Prepares management reports and tracks department outcomes
• Keeps staff informed of procedural changes via meetings and updates

Conocimientos

Communication

Leadership

Multi-Tasking

Problem Solving

Information Management

Technical Skills

Coping / Flexibility

Educación

High School Diploma or GED

Herramientas

CareRadius

Microsoft Word

Microsoft Outlook

TriWest Intranet

Descripción del empleo

TriWest Healthcare Alliance Corp. is seeking a Referral Management Supervisor to direct RM services operations and oversee non-clinical data entry in the CareRadius system. You will ensure contract compliance and provide leadership to RM staff in a high-volume environment.

Requirements include U.S. citizenship and the ability to obtain a favorable DoD background investigation, plus 2+ years in an administrative or supervisory role within healthcare operations.