Shared Market Clinical - Referral Coordinator

ArchWell Health•Tucson, AZ

12d

About The Position

ArchWell Health is a healthcare provider focused on improving the lives of senior members through neighborhood clinics and wellness-oriented care. The Referral Coordinator helps members navigate the healthcare system and access appropriate care in a timely manner, serving as a guide and point of contact for members and their families. The coordinator works with the multidisciplinary care team to understand member needs, identify gaps and barriers, coordinate external referrals, maintain accurate records, and monitor progress on care-plan goals. The role also supports members with healthcare-system issues and financial or social barriers, promotes communication among clinicians and the care team, and follows HIPAA requirements for protecting health information. Additional duties may be assigned.

Requirements

High school diploma or equivalent required.
Two 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 within 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 documentation for member referrals and keep records accurate and current.
Build relationships with members and families to facilitate care coordination.
Carry out activities and ongoing monitoring in member care plans, ensuring routine follow-up and progress toward goals.
Adhere to HIPAA standards and protect the confidentiality of protected health information.
Promote clear communication among the care team and treating clinicians.
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, enabling them to ask questions and raise concerns.
Perform additional duties as assigned.