Salt River Pima-Maricopa Indian Community
Scottsdale, Arizona, United States
Referral Coordinator Supervisor
Posted 6 days ago · Full time
Job Description
Definition
Position Summary: Under the general supervision of the Senior Nurse Manager Case Management (SNMCM) the Referral Coordinator Supervisor directly supervises the Referral Coordination and oversees daily tasks. Monitors compliance with policies and procedures. Ensures referral coordinator goals and objectives are met, including appropriate and timely processing of specialty referrals. Coordinates distribution of workload assists in monitoring productivity and performs functions of Referral Coordinator as part of the team in processing time sensitive referrals obtaining prior authorizations, in collaboration with multidisciplinary team in the delivery of consistent quality care to meet the needs of patient. This is a FLSA Non-Exempt position
Essential Functions: (Essential functions may vary among positions, but may include the following tasks, knowledge, abilities, skills and other characteristics. This list of tasks is ILLUSTRATIVE ONLY and is not intended to be a comprehensive listing of tasks performed by all positions in this classification
Examples of Tasks
1. Document follow-up in patient's chart verify receipt of consultation, diagnostic and other required reports.
2. Act as liaison with referral providers and agencies; establish relationships with outside entities to improve referral processes.
3. Assist in project data collection, analysis, and reports Ensure all referral requests and follow-up care are kept up-to-date and current in status
4. Make assignments for referral coordinators Oversee referral coordinators.
5. Keep Utilization Review RN Case Manager informed of issues and needs of Referral Coordinator staff.
6. Recommend process changes to increase efficiency and reduce waste during referral process to Utilization Management RN, Case Manager.
7. Approve time off requests, timecards/hours and related tasks Coordinate distribution of workload and assist in monitoring productivity.
8. Assist with difficult/time sensitive cases in obtaining appropriate care for the patient
9. Assist in and recording of referral activities Manage and maintain referral specialist list
10. Monitor appropriate documentation in templates
11. Track and report on outstanding referrals to Utilization Review, Case Manager RN
12. Lead contact for troubleshooting patient or provider inquiries and concerns to keep Utilization Review, Case Manager RN informed of problem areas or barriers to compliance.
13. HIPAA/Compliance: Maintain privacy of all patients, employee and volunteer information and access such information only on a need to know basis for business purposes.
14. Serves as point person for multidisciplinary evaluation process to include patient scheduling, third party communications and internal communications
15 .Performs other job-related duties as assigned to maintain and enhance departmental operations.
Knowledge, Skills, Abilities and Other Characteristics:
Minimum Qualifications
Education & Experience: High School Diploma or GED. Medical terminology experience preferred.
At least one (2) year of related work experience is required.
Certifications : Graduate of an approved Medical Assistant program preferred.
Equivalency: Any equivalent combination of education and/or experience that would allow the candidate to satisfactorily perform the duties of this position, will be considered.
Underfill Eligibility : An enrolled Community Member whom closely qualifies for the minimum qualifications for a position may be considered for employment under SRPMIC Policy 2-19, Underfill.
Special Requirements
"SRPMIC is an Equal Opportunity/Affirmative Action Employer" Preference will be given to a qualified: Community Member Veteran, Community Member, Spouse of Community Member, qualified Native American, and then other qualified candidate.
In order to obtain preference, the following is required: 1) Qualified Community Member Veteran (DD-214) will be required at the time of application submission 2) Qualified Community Member (must provide Tribal I.D at time of application submission),3) Spouse of a Community Member (Marriage License/certificate and spouse Tribal ID or CIB is required at time of application submission), and 4) Native American (Tribal ID or CIB required at time of application submission).
Documents may be submitted by one of the following methods:
1) attach to application
2) fax (480) 362-5860
3) mail or hand deliver to Human Resources.
Documentation must be received by position closing date.
The IHS/BIA Form-4432 is not accepted.
Your Tribal ID/CIB must be submitted to HR-Recruitment-Two Waters.
Benefits:
The SRPMIC offers a comprehensive benefit package including medical, dental, vision, life, disability insurance, and a 401(k) retirement plan. In addition employees enjoy vacation and sick leave and 13 paid holidays.
Position Summary: Under the general supervision of the Senior Nurse Manager Case Management (SNMCM) the Referral Coordinator Supervisor directly supervises the Referral Coordination and oversees daily tasks. Monitors compliance with policies and procedures. Ensures referral coordinator goals and objectives are met, including appropriate and timely processing of specialty referrals. Coordinates distribution of workload assists in monitoring productivity and performs functions of Referral Coordinator as part of the team in processing time sensitive referrals obtaining prior authorizations, in collaboration with multidisciplinary team in the delivery of consistent quality care to meet the needs of patient. This is a FLSA Non-Exempt position
Essential Functions: (Essential functions may vary among positions, but may include the following tasks, knowledge, abilities, skills and other characteristics. This list of tasks is ILLUSTRATIVE ONLY and is not intended to be a comprehensive listing of tasks performed by all positions in this classification
Examples of Tasks
1. Document follow-up in patient's chart verify receipt of consultation, diagnostic and other required reports.
2. Act as liaison with referral providers and agencies; establish relationships with outside entities to improve referral processes.
3. Assist in project data collection, analysis, and reports Ensure all referral requests and follow-up care are kept up-to-date and current in status
4. Make assignments for referral coordinators Oversee referral coordinators.
5. Keep Utilization Review RN Case Manager informed of issues and needs of Referral Coordinator staff.
6. Recommend process changes to increase efficiency and reduce waste during referral process to Utilization Management RN, Case Manager.
7. Approve time off requests, timecards/hours and related tasks Coordinate distribution of workload and assist in monitoring productivity.
8. Assist with difficult/time sensitive cases in obtaining appropriate care for the patient
9. Assist in and recording of referral activities Manage and maintain referral specialist list
10. Monitor appropriate documentation in templates
11. Track and report on outstanding referrals to Utilization Review, Case Manager RN
12. Lead contact for troubleshooting patient or provider inquiries and concerns to keep Utilization Review, Case Manager RN informed of problem areas or barriers to compliance.
13. HIPAA/Compliance: Maintain privacy of all patients, employee and volunteer information and access such information only on a need to know basis for business purposes.
14. Serves as point person for multidisciplinary evaluation process to include patient scheduling, third party communications and internal communications
15 .Performs other job-related duties as assigned to maintain and enhance departmental operations.
Knowledge, Skills, Abilities and Other Characteristics:
- Knowledge of the history, culture, laws, rules, customs and traditions of the SRPMIC.
- Knowledge of the purpose, current issues, projects, organization, policies, and employee responsibilities of the division to which assigned.
- Knowledge of health care policies and procedures.
- Knowledge of, and respect and sensitivity to cultural differences.
- Knowledge of patient care and referral best practices, familiarity with verifying eligibility requirements.
- Knowledge of confidentiality policies and regulations, as it pertains to position duties.
- Knowledge of training and development opportunities and the ability to enhance job knowledge.
- Skill in treating others with respect and upholds organizational values.
- Skill in taking responsibility for action, consequences, and handling situations with integrity.
- Skill in learning and adapting new skills to the job.
- Skill in identifying and resolving problems in a timely manner.
- Skill in working in team or group problem solving situations, changes approach/method to best fit the situation.
- Skill in applying feedback to improve performance, demonstrating accuracy and thoroughness.
- Ability to be consistently present and punctual.
- Ability to ensure work responsibilities are managed and coordinated during absences.
- Ability to maintain integrity in work products.
- Ability to communicate with tact and consideration effectively both in writing and verbally, while being a good listener.
- Ability to manage difficult or emotional situations, responding promptly to needs and solicits feedback.
- Ability to be open and objective to the views of others, including giving and welcoming feedback.
- Ability to identify ways to improve and promote quality and efficiency, on personal work as well as processes and procedures of the job.
- Ability to respond to requests for service and assistance timely.
- Ability to work collaboratively in a team environment, asking and offering assistance when needed.
- Ability to work actively to resolve conflicts.
- Ability to adapt to changes in the work environment and adjust accordingly.
- Ability to prioritize and plan work activities, efficiently use time and set goals/objectives.
- Ability to follow instruction, take direction of management and adhere to policy and procedures.
Minimum Qualifications
Education & Experience: High School Diploma or GED. Medical terminology experience preferred.
At least one (2) year of related work experience is required.
Certifications : Graduate of an approved Medical Assistant program preferred.
Equivalency: Any equivalent combination of education and/or experience that would allow the candidate to satisfactorily perform the duties of this position, will be considered.
Underfill Eligibility : An enrolled Community Member whom closely qualifies for the minimum qualifications for a position may be considered for employment under SRPMIC Policy 2-19, Underfill.
Special Requirements
- Employment is contingent upon successful completion of an extensive background check and drug screening. Employees in, and applicants applying for, jobs providing direct services to children are subject to the "Community Code of Ordinances", Chapter 11, "Minors", Article X. "Investigation of Persons Working With Children".
"SRPMIC is an Equal Opportunity/Affirmative Action Employer" Preference will be given to a qualified: Community Member Veteran, Community Member, Spouse of Community Member, qualified Native American, and then other qualified candidate.
In order to obtain preference, the following is required: 1) Qualified Community Member Veteran (DD-214) will be required at the time of application submission 2) Qualified Community Member (must provide Tribal I.D at time of application submission),3) Spouse of a Community Member (Marriage License/certificate and spouse Tribal ID or CIB is required at time of application submission), and 4) Native American (Tribal ID or CIB required at time of application submission).
Documents may be submitted by one of the following methods:
1) attach to application
2) fax (480) 362-5860
3) mail or hand deliver to Human Resources.
Documentation must be received by position closing date.
The IHS/BIA Form-4432 is not accepted.
Your Tribal ID/CIB must be submitted to HR-Recruitment-Two Waters.
Benefits:
The SRPMIC offers a comprehensive benefit package including medical, dental, vision, life, disability insurance, and a 401(k) retirement plan. In addition employees enjoy vacation and sick leave and 13 paid holidays.
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