Medical Referrals & Networking Manager

Referral management responsibilities

• Develop and improve with the help of medical director the current and standardized referral policies and workflows.
• Ensure ongoing tracking and appropriate documentation on referrals
• Ensure that referrals are addressed in a timely manner
• Ensure a positive patient experience and optimal operational results
• Support his team in managing consultation/patient referrals and authorizations
• Lead a team of referral coordinators and admins and making sure they understand and work per the developed guidance on referrals.
• Develop an annual plan of the expected referrals based on the previous health needs and expected financial capacity of the organization
• Develop biweekly, monthly, quarterly, and annual reports for the referral section
• Manage with the team of referral coordinators routine visits to contracted health care providers
• Answer team questions and recommends corrective measures to address users complaints.
• Participates in the selection, orientation and training of referral personnel.
• Support in developing and implementing digitalized system as required by the organization
• Point of contact for patients and specialists for any medical questions or rising concerns. Assist in problem solving potential medical issues related to their referrals.

Medical networking responsibilities

• Establish the medical network management strategic vision, objectives, and policies and procedures.
• Identifies and utilizes community resources; establishes relationships with service providers to create a charity-based pool of services.
• Identifies areas of opportunity to improve Provider Satisfaction and Provider Experience.
• Prepare and analyze information to evaluate the need for additional providers or charitable services
• Participate in regular meetings with providers to review customer feedback, issue resolution, and changes to provider products.
• Monitor Provider Performance action plans and tracks provider performance improvement.