Senior Manager – Referrals

Senior Manager – Referrals

Requirements

• Knowledge of ChenMed products, services, standards, policies and procedures
• Strong organizational, influencing and problem-solving skills
• Ability to collaborate effectively with all levels of company personnel
• Written and verbal communication skills
• Ability to pay close attention to detail and to ensure accuracy of reports and data
• Proficient in Microsoft Office Suite products including Word, Excel, PowerPoint and Outlook, database, and presentation software
• Ability and willingness to travel locally, regionally and nationwide up to 5% of the time
• Spoken and written fluency in English
• This job requires use and exercise of independent judgment
• Bachelor’s degree in a healthcare-related field; additional experience above the minimum may be considered in lieu of the required education on a year-for-year basis
• Minimum six (6) years of related experience including a minimum four (4) years’ supervisory experience
• Experience working with Physicians and Directors on a daily basis
• Experience reviewing data and making decision based of the data
• Experience working in Medicare managed care environment

Responsibilities

• Designs, coordinates, and implements training programs for new/existing employees (all levels) for referral processes.
• Leads Referral Managers by providing tools/reports and weekly/monthly meetings to discuss referral process and process updates. Leads weekly 1:1’s and monthly meetings with Referral Managers.
• Supports Network Directors by providing feedback on Referral Manager performance. Recommends performance improvement plans for underperforming referral managers.
• Implements strategic planning for referral coordination that contributes to medical cost reduction and improves organizational performance.
• Interviews Referral Manager candidates. Maintains and promotes the awareness of the corporate values to help develop Referral Managers for career growth and future success.
• Gives market leadership insights on PCP ratios, CPL usage/leakage, CC/RM performance-based data analysis.
• Strategizes and creates structure for referral teams for markets to improve referral outcomes.
• Participates in executive team and Network Director meetings to collaborate for referral improvements and solutions.
• Travels to markets as needed to provide support.
• Meets bi-weekly with corporate CMO to strategize/implement clinical/referral processes.
• Creates SOPs, Policy & Standards, Processes, Metrics & Compliance for Referral department.
• Reviews current referral processes by state and creates process improvements.
• Plans and oversees strategic referral projects to improve PCP/patient satisfaction.
• Establishes and implements organizational goals for referrals. Responsible and accountable for the performance of all referral departments within the organization.
• Identifies issues, makes critical decisions and resolves time sensitive challenges within the referral function.
• Troubleshoots ChenMed process inquiries with internal and external tools. Examples: Web IVR issues, Dashboard EMR, BI Tools (RITS) etc.
• Oversees referral disenrollment. Reviews disenrollment report and analyzes who disenrolled due to referral issues. Recommends actions to mitigate disenrollment.
• Builds and manages referral tools, BI tools, RITS enhancements and rollouts.
• Works closely with users and BI team on processes and implementations that are beneficial for the department as well as IT support for Dashboard enhancements.
• Troubleshoots RITS issues.
• Collaborates with CSE and BI department on reporting.
• Organizes annual Referral Excellence Month and Referral Manager Conference.
• Performs other duties as assigned and modified at manager’s discretion.

Preferred Qualifications

No preferred qualifications provided.