Shared Market Clinical - Referral Coordinator

ArchWell Health•Kansas City, MO

11d

About The Position

The Referral Coordinator supports senior members as they navigate the healthcare delivery system and helps ensure they receive appropriate care in a timely manner. Working with ArchWell Health’s multidisciplinary care team, the coordinator learns each member’s care needs, identifies gaps and barriers, and guides members and their families to appropriate specialists, providers, vendors, and services. The role also includes documenting referrals, monitoring care-plan follow-up, helping resolve practical barriers to care, and promoting communication among members, families, care teams, and treating clinicians. The coordinator serves as a point of contact for members and families and handles protected health information in accordance with HIPAA standards.

Requirements

High school diploma or equivalent.
Two years of experience in referral management or care coordination.
Deep understanding of the healthcare ecosystem, ideally including benefits and insurance authorization.
Passion for helping senior members 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 that can assist members.
Strong communication and rapport-building skills within an interdisciplinary team.
Ability to multitask and manage competing priorities with high attention to detail.
Proficiency with PC skills, including Microsoft Office.

Nice To Haves

Degree or college-level coursework in healthcare.
Medical Assistant or medical administrative experience.
Experience with EMR systems, ideally eClinicalWorks or similar.
Fluency in Spanish or languages spoken by the communities served, where necessary.

Responsibilities

Partner with the multidisciplinary care team to understand members’ care needs and identify gaps and barriers to treatment.
Coordinate referrals to external providers, vendors, and services.
Complete accurate and current documentation for member referrals.
Build and nurture relationships with members and their families to facilitate care coordination.
Carry out activities and ongoing monitoring outlined in members’ care plans, ensuring routine follow-up and progress toward care-plan goals.
Adhere to HIPAA standards and maintain the confidentiality of protected health information.
Promote clear communication among the care team and treating clinicians to support positive member outcomes.
Help members resolve issues related to the healthcare system and financial or social barriers, including arranging interpreters, transportation services, or prescription assistance as appropriate.
Serve as a system navigator and point of contact for members and families, providing direct access for questions and concerns.
Perform additional duties as assigned.