Shared Market Clinical - Referral Coordinator, Bilingual

Referral Coordinator, Bilingual

Job Summary:

The Referral Coordinator is responsible for supporting our members as they navigate the complex healthcare delivery system, ensuring every member receives the right care in the right setting. This individual will serve as a guide for the member and their families to ensure the member meets with the right specialists, inside or outside the center, in a timely manner. An ideal candidate will have a deep understanding of the healthcare ecosystem, have strong attention to detail, and be driven by a passion for providing quality care to seniors.

Duties/Responsibilities:

• Partner with ArchWell Health's multi-disciplinary care team to gain a deep understanding of each member's care needs, including identifying gaps and barriers to treatment 
• Coordinate referrals to external providers, vendors, and services to ensure care needs are met 
• Complete proper documentation for member referrals to ensure records are accurate and current 
• Build and nurture relationships with members and their families to successfully facilitate care coordination 
• Carry out all activities and provide ongoing monitoring as outlined in a member's care plan to ensure routine followup and progression is made on care plan goals 
• Adhere to HIPAA standards and confidentiality of protected health information (PHI) 
• Promote clear communication among care team and treating clinicians to ensure positive member outcomes  
• Assist members in problem solving potential issues related to the health care system, financial or social barriers (e.g., request interpreters as appropriate, transportation services or prescription assistance).  
• Be the system navigator and point of contact for members and families, with patients and families having direct access for asking questions and raising concerns.  
• Additional duties, as assigned 

Required Skills/Abilities:

• Deep understanding of the healthcare ecosystem, ideally with experience in benefits and insurance authorization
• Passion for helping senior members successfully carry out care plans
• Ability to work effectively with diverse populations including staff, providers, members, family members, insurance carriers, vendors, and the public
• Basic medical terminology
• Understanding of Medicare criteria for equipment and supplies
• Knowledge of CPT and ICD-10 codes
• Working knowledge of specialists and community resources to assist the member
• Strong communication and rapport-building ability among an interdisciplinary team
• Ability to multi-task and manage competing priorities with high attention to detail
• Proficient PC skills to include Microsoft Office

Education and Experience:

• H.S. Diploma or equivalent required; degree or college level coursework in healthcare preferred

• Must be bilingual (Spanish) and able to pass formal proficiency exam as part of the selection process
• 2 years of experience in referral management or care coordination
• Medical Assistant or medical administrative experience is helpful
• Experience with EMR systems, ideally eClinicalWorks or similar
• Embodies and serves as a role model of ArchWell Health’s Values:
• Be compassionate
• Strive for excellence
• Earn trust
• Show respect
• Stay resilient
• Always do the right thing

About ArchWell Health:

At ArchWell Health, we’re creating a community of caring designed to help our members stay healthy and engaged. By focusing on a strong provider-patient relationship, routine wellness, and staying active, our members enjoy a higher level of care and better quality of life after the age of 60. Everything we do is for seniors. We believe seniors should be heard, listened to, and given ample time by their physicians to live well later in life.

Our value-based care model is designed to prevent illnesses while keeping members healthy and happy in every aspect of their life. We deliver best-in-class primary care at comfortable, accessible neighborhood centers where older adults can feel at home and become part of a vibrant, wellness-focused community. We’re passionate about caring for older adults and united by the belief that caring has the power to change everything for our members.

ArchWell Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected classification