Shared Market Clinical - Referral Coordinator

ArchWell Health•Cleveland, OH

About The Position

ArchWell Health is an innovative healthcare provider focused on improving the lives of senior members through accessible neighborhood clinics and wellness-focused care. The Referral Coordinator supports members as they navigate the healthcare system and helps ensure they receive appropriate care in a timely manner. Working with the multidisciplinary care team, this person guides members and their families to specialists and other services, inside or outside the center, and helps address barriers to care. The role requires a strong understanding of the healthcare ecosystem, careful attention to detail, and a commitment to helping seniors receive quality care. The coordinator serves as a system navigator and point of contact for members and families, facilitating communication, referral follow-up, and progress toward care-plan goals while maintaining HIPAA standards and protecting confidential health information.

Requirements

Deep understanding of the healthcare ecosystem, ideally including benefits and insurance authorization.
Passion for helping senior members successfully 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.
High school diploma or equivalent required.
Two years of experience in referral management or care coordination.

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 ArchWell Health’s multidisciplinary care team to understand members’ care needs and identify gaps or barriers to treatment.
Coordinate referrals to external providers, vendors, and services to meet members’ care needs.
Complete accurate and current documentation for member referrals.
Build and maintain relationships with members and their families to facilitate care coordination.
Carry out and monitor activities outlined in members’ care plans, ensuring routine follow-up and progress toward care-plan goals.
Adhere to HIPAA standards and protect 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, providing direct access to ask questions and raise concerns.
Perform additional duties as assigned.