Referral Manager

Summary:  

The Referral Coordinator is Southeastern Integrated Care’s system navigator and point of contact for clients, families, multiple referral sources, payers, and our network of providers assuring clients have direct access to immediate and ongoing care and families, with patients and families having direct access for asking questions and raising concerns. May assume advocate role on our clients  behalf with the referral source and or payer to ensure approval of the necessary services for the client in a timely fashion. Is the primary communicator with all parties involved in the ongoing care and recovery of our clients. Through driving SEIC Vision and Mission, will assure all referrals and referral sources are managed through the entire cycle of care, with a sense of immediacy and urgency. Recognizes that ever referral is a life in need of saving, and assures the highest standards of care and practice are provided to the referral

Essential Responsibilities:

1. Ensure all methods of referrals are captured in EMR system- (i.e., electronic fax, QR codes, alpha and MCO calendars,  walk ins, phone, text, etc.
2. Engage client in treatment, educate ,counsel, motivate client to continue their journey in recovery
3. Immediately schedule appointment for intake -same day or 24 hours
4. Communicate with referral source prior to intake and post intake status of visit.
5. Identify all referral sources , names , numbers, emails inclusive of direct referral, care managers, hospital or DSS, payer source, etc.
6. Identify primary care doctor and if none schedule appointment with SEIC family practice service line
7. Review treatment recommendations of referral source, communicate to intake counselor, and Director of clinical Operations
8. Send out reminder calls, texts to client prior intake
9. Communicate with primary referral sources if client is a NO SHOW or reschedules.
10. Coordinate with referral sources to reengage clients who missed appointments.
11. Coordinate with SEIC community outreach person to find and re-engage client.
12. Communicate monthly with primary referral sources regarding attendance
13. Gather all referrals via walk-ins, fax , email , phone calls , QR code , alpha etc. and reach out to client.
14. Goals 95 percent of all clients referred are converted to admissions to services.
15. Verify coverage insurance options.
16. Communicate back with all referrals sources outcomes of CCA and treatment recommendations
17. Circle back with all referral sources regarding attendance in level of care for first month or too
18. Assure  all necessary consents, releases are prepared prior to client attending intake sessions. Assemble information concerning patient's clinical background and referral needs. Per referral guidelines, provide appropriate clinical information to intake counselor.

1. Maintain ongoing tracking and appropriate documentation on referrals to promote team awareness. The goal is for 95% of all referrals to be admitted to treatment.
2. Alongside Intake Counselor ensure complete and accurate registration, including patient demographic and current insurance information.
3. Review details and expectations about the referral with clients.
4. Assist clients with 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).
5. Identify and utilize cultural and community resources. Establish and maintain relationships with identified service providers
6. Actively participates in all clinical meetings as requested and remain an integral part of the treatment team, providing positive and influential information regarding the rapid and appropriate placement of all referred clients.
7. Collaborates with Clinical Operations Director and Intake Coordinator to assure all referrals are accurately assessed and started in the appropriate level of care in a timely fashion
8. And other duties as assigned by Clinical Director

 Job Qualifications and Skills:

• Master’s degree in public health, Healthcare Administration, Social Work, Psychology and 2-3 years of experience working in the healthcare field.  
• Demonstrated leadership skills including excellent oral and written communication skills.  
• Strong knowledge of healthcare clinical fundamentals, client safety standards, and performance improvement standards. 
• Strong client service focus, ability to work with diverse populations
• Effective verbal and written communication skills
• Comprehensive knowledge of EMR system
• Comprehensive knowledge of community resources
• Teamwork orientation
• Organized and able to manage competing priorities
• Good judgment
• Resourcefulness in problem solving
• Able to take and follow through with delegated tasks
• Computer skills and knowledge of applicable software programs.
• Flexibility with schedule    

Supervises: 

Referral Coordinator, Assessment Therapists, others as determined by Clinical Director

Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The work is typically performed in an office environment, with a moderate noise level.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Movements including but not limited to prolonged periods of sitting at a desk and working on a computer, occasional standing, walking, bending, and reaching are required.
• Regularly required to use hands to manage or feel; talk; see; and/or hear. Specific vision abilities required by this job include close vision and color vision.
• Must be able to lift up to 15 pounds at all times.