Referrals Manager

The Referrals Manager leads Gracelights 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:

1. Directs day-to-day operations of the Referrals and Medical Records departments including workflows policies procedures and service standards.
2. Supervises referral coordinators and medical records staff: hires trains schedules coaches evaluates and manages performance; distributes workload to meet turnaround and productivity targets.
3. 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.
4. 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.
5. 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.
6. Prepares monthly department reports and dashboards for leadership and recommends process changes based on the data.
7. Manages the department budget and staffing levels; identifies opportunities to reduce delays and improve productivity including through technology.
8. Owns the departments use of Epic referral management tools managed care portals and LANES; optimizes configuration tracking and reporting with IS.
9. Maintains working relationships with managed care organizations specialty providers hospitals and imaging centers to improve authorization turnaround and specialty access.
10. 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.
11. Performs all other duties as assigned.

• Three or more years of experience in referral management medical records patient access or healthcare operations; bachelors 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.