Shared Market Clinical - Referral Coordinator

ArchWell Health • Cleveland, OH

2d

About The Position

The Referral Coordinator supports senior members as they navigate the healthcare delivery system, helping ensure they receive appropriate care in the right setting and in a timely manner. Working with ArchWell Health’s multidisciplinary care team, the coordinator helps members and their families connect with specialists and other providers, vendors, and services, and serves as a system navigator and point of contact for questions and concerns. The role includes identifying care gaps and barriers, coordinating referrals, maintaining accurate documentation, monitoring care-plan activities and follow-up, and promoting communication among care team members and treating clinicians. The coordinator also assists members with healthcare-system challenges and financial or social barriers, such as arranging interpreters, transportation, or prescription assistance, while protecting confidential health information and adhering to HIPAA standards.

Requirements

• High school diploma or equivalent.
• At least 2 years of experience in referral management or care coordination.
• Deep understanding of the healthcare ecosystem; experience with benefits and insurance authorization is ideal.
• 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 in an interdisciplinary team.
• Ability to multitask and manage competing priorities with high attention to detail.
• Proficient 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 people in the communities served, where necessary.

Responsibilities

• Partner with the multidisciplinary care team to understand each member’s care needs and identify gaps and barriers to treatment.
• Coordinate referrals to external providers, vendors, and services.
• Complete and maintain accurate, 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 address healthcare-system issues 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, allowing them to ask questions and raise concerns.
• Perform additional duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED