Provider Liaison - Manning - Referrals

El Rio Health•Tucson, AZ

36d

About The Position

JOB PURPOSE: The Provider Liaison provides support to the Referral Department and reports directly to the Referral Operations Manager (ROM). Represents the El Rio Referral Department in professional and strategic relationships with referred to internal and external specialty groups, health systems, hospitals, inpatient/outpatient facilities, physicians and physician groups, and executive level opportunities. The tasks and responsibilities of the Provider Liaison will vary from week to week and would involve everything from answering the phone to assisting with hands-on patient care and/or processing of referrals. The Provider Liaison will serve as a resource for healthcare professionals through fostering relationships within Tucson and the surrounding communities. Displaying clinical expertise, problem solving, empathy, sales like ability, excellent verbal and written communicator, professional, and friendly demeanor. Coordinating meetings, lunches, and educational sessions between El Rio Health providers and specialty groups and updating the El Rio Referral Department of available services within the healthcare community to coordinate quality care to all El Rio Patients. The primary goal of the El Rio Health Provider Liaison is to support El Rio's Mission of providing comprehensive, quality health care that is affordable and accessible to all who may have healthcare needs, by successfully performing the primary essential functions. The following functions and responsibilities will contribute to El Rio Health to achieve its KEY RESULTS: World Class Experience for staff and patients Healthier patients and employees Positive Financial Result

Requirements

Associate's Degree in Healthcare Administration, Business Administration, Marketing, Sales, Nursing, Social Work, Communication, or related field from an accredited college or university.
Three (3) years as a referral clerk or in medical office experience or experience working with physicians/medical staff
Three (3) years with Customer Service
Two (2) years in sales, marketing, and/or professional relations
Level I fingerprint clearance card: current valid and in good standing or have applied for it within seven working days after beginning employment.
Employees in this position are required to have reliable transportation that can meet any operational reassignments of the organization during the workday. If an employee is driving during work hours, the employee is required to possess a valid driver's license and must comply with Arizona vehicle insurance requirements.

Nice To Haves

Bachelor's Degree in Healthcare Administration, Business Administration, Marketing, Sales, Nursing, Social Work, Communication, or related field from an accredited college or university.
Five (5) years as a referral clerk or in medical office experience or experience working with physicians/medical staff
Five (5) years with Customer Service
Four (4) years in sales, marketing, and/or professional relations
Bilingual (English/Spanish) with the ability to speak, read and write in both languages.

Responsibilities

Promotes El Rio Connect to external referred to providers/groups, assists in training on portal, ensures active utilization of portal is met.
Assists in developing, maintaining, and updating El Rio Preferred Specialist Resource List.
Develops and maintains friendly and professional relationships of trust and integrity with external specialty groups, facilities, hospitals, physician offices, personal care homes, assisted living facilities, and other community referral sources.
Meets regularly with community partners and external referral sources regarding available services for El Rio Patients.
Initiates, establishes, and maintains ongoing communications with the referred to providers/groups and/or their office staff, including peer-to-peer discussions, community events, cross-business collaborations, routine visits, follow-up visits, emails, and phone calls.
Liaisons between El Rio and external referred to specialty groups to ensure referrals are being received and services are being completed.
Researches new or existing specialty groups and develops strategic relationships.
Drives continual growth of referral loop closure through advocacy with referral sources.
Assists in El Rio internal specialty growth through referrals.
Alerts and informs the Referral Department and other El Rio staff to new servicing competitors, external referred to providers/groups planning to market, retire, create a new practice, leave practice, add/remove services, and other industry changes.
Strategical use professional concepts and company objectives to resolve complex referral issues and ensure feedback is communicated and followed up with to the appropriate El Rio Departments and external referred to providers/groups.
Determines barriers within the community external referred to providers/groups to improve patient appointment times, quality care provided, quick and timely availability to El Rio patients.
Assists in improving referral process between El Rio and external referred to providers/groups, and gain insight into services provided and accepted insurances.
Serves as the referral liaison between internal and external providers, managers, and health plan representatives.
Facilitates meetings with external specialists and health plan representatives to ensure Referral Clerks are up to date on referral processes, guidelines, and other relevant services within the community.
Assists with department meeting/s preparations. May present on topics such as community external referred to providers/group's services provided, referral training, referral and/or external referred to providers/group's updates, changes in processes, education on healthcare treatment options, etc.
Generates referral related reports and assists the Referral Operations Manager (ROM) with other department reporting measures and dashboards.
Maintains an exceptional level of customer service; address and resolves complaints and other referral issues involving El Rio staff, providers, insurances, and/or patient inquiries.
Attends and participates in all referral's representative meetings, referral workgroups, and other meetings regarding the Referral Department.
Demonstrates expertise in the referral process and provides support and guidance to Referral Clerks and external referred to providers/groups as needed.
Shares information regarding El Rio Health services in the community.
Reduces expenses by promoting the proper use and care of clinic equipment.
Provides training for the referral department and other El Rio staff to ensure efficient referral and authorization processes, close the loop efforts, and facilitates educational topics on external referred to providers/groups services.
Maintains an organized referral manual with current listings of all health plans, specialists, and other community resources. Assist in updating department training materials and resources as needed.
Provides quality customer service to patients who require a referral to a specialist.
Arranges appointments; notifies patient and/or family of appointment date and any special instructions regarding the specialist's appointment.
Maintains standards for productivity, timeliness, and accuracy of all referrals.
Complies with approved quality control policies and procedures.
Maintains patient confidentiality by controlling the environment and information being disclosed to authorized individuals ensuring HIPAA and corporate compliance requirements at all times.
Maintains a clean, safe, and hygienic work environment in compliance with all Policies and Procedures including but not limited to work areas, workstations, examination rooms, hand washing, infection prevention and control etc. for this position.
Demonstrates an understanding of and proficiency with the application of all compliance and reporting requirements respective to Joint Commission Certification (JCC) standards.
In support of the Mission and Vision of El Rio Health, will at all times represent themselves as a professional role model of El Rio Health serving as a positive informational source for members of the community.
Supports El Rio Health by participating in community events which promote good health, and which contribute to a broader awareness and understanding of El Rio Health and the many services provided to the community.
Participates in all appropriate health care activities related to El Rio Health on a local, state, and national level to maintain and enhance El Rio's image with health agencies, professional associations, and the general public.
Ensures and supports the cost-effective use of materials, supplies, and equipment by limiting waste of all organizational supplies and resources.
In accordance with policies and procedures ensures that documentation of hours worked is completed accurately, as well as signed-off/approved in a timely manner.
Employees must maintain their skills proficiency with El Rio Health operating systems and/or software programs by adapting to changing requirements and successfully learning and demonstrating new skills in response to software, system, and program improvements or upgrades.
Performs other duties as assigned.