Referral Manager

CENTRAL CITY COMMUNITY HEALTH CENTER INC•Monterey Park, CA

25d•$22 - $23•Onsite

About The Position

The Referral Manager is responsible for the overall leadership, operations, and performance of the referral department. This position oversees the Referral Coordinators while ensuring timely, accurate, and efficient coordination of patient referrals, authorizations, and transitions of care. The Referral Manager collaborates with clinical teams, external providers, and health systems to support patients—particularly those with complex medical, chronic, or psychosocial conditions—while ensuring compliance, quality standards, and continuity of care.

Requirements

Strong knowledge of healthcare systems including Medi-Cal, Medicare, managed care plans, and IPAs.
Leadership and team management skills with the ability to motivate and develop staff.
Strong organizational, analytical, and problem-solving abilities.
Ability to manage multiple priorities in a fast-paced environment.
Excellent communication and interpersonal skills.
Knowledge of medical terminology and referral processes.
Proficiency with EMR systems and Microsoft Office applications.
Ability to maintain confidentiality and compliance with HIPAA regulations.
High School diploma or GED required.
Minimum of 3–5 years of referral coordination or case management experience.
Minimum of 1–2 years of supervisory or leadership experience preferred.

Nice To Haves

Bachelor’s degree in healthcare administration, nursing, or related field preferred.
Licensed Vocational Nurse (LVN) or Registered Nurse (RN) strongly preferred.
Experience working with underserved populations preferred.
Bilingual in English/Spanish preferred.

Responsibilities

Provide direct supervision of Referral Coordinators, including hiring, training, coaching, and performance management
Oversee daily operations of the referral department to ensure timely processing, tracking, and completion of referrals
Develop and implement workflows, policies, and procedures to improve department efficiency and effectiveness
Assign and monitor staff workloads and ensure appropriate staffing coverage
Serve as escalation point for complex referral issues, denied authorizations, and patient concerns
Ensure coordination of referrals, admissions, discharges, and transitions to specialty care, hospitals, rehabilitation, and other facilities
Monitor referral lifecycle including eligibility, authorizations, scheduling, and follow-up
Ensure patients with complex medical or psychosocial needs receive appropriate case management services
Maintain effective communication between patients, providers, and external partners across the continuum of care
Ensure timely retrieval and review of specialist reports and documentation for provider follow-up
Ensure department compliance with HIPAA and all regulatory requirements in handling protected health information
Monitor referral tracking systems and ensure accurate data entry, reporting, and documentation
Develop and analyze referral metrics (e.g., turnaround times, completion rates, denial rates) to improve performance
Conduct audits to ensure quality, accuracy, and completeness of referral activities
Partner with providers, behavioral health staff, case managers, and external facilities to coordinate patient care
Maintain ongoing communication with hospitals, discharge planners, and community providers
Act as liaison between clinical teams and referral staff to ensure seamless care coordination
Promote culturally sensitive, patient-centered care for underserved populations