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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 proceduresStrong organizational, influencing and problem-solving skillsAbility to collaborate effectively with all levels of company personnelWritten and verbal communication skillsAbility to pay close attention to detail and to ensure accuracy of reports and dataProficient in Microsoft Office Suite products including Word, Excel, PowerPoint and Outlook, database, and presentation softwareAbility and willingness to travel locally, regionally and nationwide up to 5% of the timeSpoken and written fluency in EnglishThis job requires use and exercise of independent judgmentEDUCATION 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 basisMinimum six (6) years of related experience including a minimum four (4) years’ supervisory experienceExperience working with Physicians and Directors on a daily basisExperience reviewing data and making decision based of the dataExperience working in Medicare managed care environmentWe’re ChenMed and we’re transforming healthcare for seniors and changing America’s healthcare for the better. Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. We’re growing rapidly as we seek to rescue more and more seniors from inadequate health care.
ChenMed is changing lives for the people we serve and the people we hire. With great compensation, comprehensive benefits, career development and advancement opportunities and so much more, our employees enjoy great work-life balance and opportunities to grow. Join our team who make a difference in people’s lives every single day.
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