Senior Manager, Referrals-1

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We’re different than most primary care providers. We’re rapidly expanding and we need great people to join our team.

The Senior Manager, Referrals is responsible for providing support to ChenMed, et. al regarding internal and external member referral processes. The employee in this role is responsible for managing and maintaining referral tools, resources and reports and creating trainings to guide the Chenmed company's on referral processes. The Senior Manager, Referrals is the subject matter expert in Referrals processes for the organization.

ESSENTIAL JOB DUTIES/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.

KNOWLEDGE, SKILLS AND ABILITIES:

• 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

EDUCATION AND EXPERIENCE CRITERIA:

• 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