Referral Services Manager

Family HealthCare Network•Visalia, CA

17h

About The Position

The Referral Services Manager is responsible for managing operational aspects of the referrals and health information functions, including customer service, compliance, and staffing. This role involves providing management to departmental staff, including performance management, hiring/firing recommendations, and fostering a culture of accountability and excellence. The manager will develop and manage action plans to support organizational goals, empower staff through communication and talent building, and delegate duties while ensuring department performance. Budget development and monitoring, ensuring regulatory compliance, and overseeing employee training are also key aspects of this position. The role requires identifying and presenting referral and health information-related issues with recommended resolutions to the Director. Additionally, the manager supports a "culture of excellence" and the "Four Pillars of Excellent Customer Service."

Requirements

Possesses proficiency in written and verbal communication, basic mathematics, computer applications, and technical systems.
Completion of a Bachelor’s Degree program with a recognized major and a minimum cumulative GPA of 2.5; or Comparable experience that includes two years of experience in health records management and completion of a high school diploma with a minimum cumulative GPA of 2.5, or General Educational Development (GED) with a minimum overall score of 162.5, and healthcare-related knowledge frequently acquired through completion of a trade school, para-professional, or certificate type program.
If an individual has completed a degree at a higher level than required by the role and had a stronger GPA in that program, they may provide proof of GPA from that degree in lieu of the high school diploma or Bachelor’s degree.
Have a minimum of four years of leadership experience or 5 years of progressively greater responsibility or significant contributions to projects and initiatives that demonstrate leadership skills.
Employees must have a thorough understanding of the theory of the profession in order to determine “why” things are done.
Have a minimum credit score of 650.
Ability to prepare more complex documents in Microsoft Word, including creating tables, charts, graphs and other elements.
Ability to use Microsoft Excel to analyze data, including the use of formulas, functions, lookup tables and other standard spreadsheet elements.
Ability to develop sophisticated presentations in Microsoft PowerPoint, including the use of embedded objects, transitions and other elements.
Job duties require the employee to effectively communicate, verbally and in writing, their opinions and extrapolations of information they collect and synthesize/analyze.
Responsible for the resolution of conflicts that may arise because of disagreements between employees, between employees and customers/clients, or with the public, other legal entities or governmental authorities.
Compiles, analyzes and prepares information in an effective written form, including correspondence, reports, articles or other documentation.
Effectively conveys technical information to non-technical audiences.
Regularly required to sit and use repetitive hand movement to type and grasp.
Frequently required to stand or walk.
Must occasionally lift and/or move up to 20 pounds.

Nice To Haves

RHIT or RHIA certification preferred.

Responsibilities

Provides management to departmental staff.
Responsible for performance management of assigned supervisors and their staff, including recognition, performance evaluations, formal coaching and counseling, and disciplinary actions.
Makes recommendations regarding hiring, firing, advancement, and promotion of assigned supervisors and their staff.
Demonstrates core leadership behaviors and a team-one approach.
Creates a culture of accountability and excellence.
Develops and manages an action plan across assigned employee base to support the strategic direction and obtainment of goals of the organization, effectively leading change when necessary.
Empowers staff through effective communication and talent building.
Delegates appropriate departmental duties and responsibilities to assigned team members while ensuring department performance.
Assists with the development of the departmental budget and monitors budget to ensure expenses do not exceed budget.
Ensures regulatory compliance for assigned departments, and compliance with all workflows, policies, and procedures.
Ensures department employees receive instruction/training that is in compliance with training plan, including on the job training to develop department employees and supervisor.
Works with supervisors to ensure necessary remediation is taken.
Recommends workflow, policy, and procedure changes based on observations from performance metrics, outcomes, and feedback from supervisor.
Ensures department maintains compliance with all employees related reporting and tracking.
Identifies and presents issues related to referrals and health information related functions to supervisor with recommendations for resolutions to implement.
Supports a “culture of excellence” and the “Four Pillars of Excellent Customer Service”.
Responsible for managing referral-related functions.
Ensures referrals are tracked and processed within expected timelines.
Manages the productivity of the staff to ensure performance metrics are met.
Ensures referral workflows are followed according to established policies and procedures.
Responsible for ensuring compliance with the referral process.
Manages the operations related to referrals and resources to ensure goals are met.
Conducts internal audits of referrals to ensure compliance with Joint Commission, HRSA and other regulatory guidelines.
Communicates to internal and external providers to ensure patients receive the needed specialty access.
Manages and monitors referral workflows and performance to ensure adherence to appropriate referral sources and that clinical pathway workflows are followed at all times.
Reviews referral data and specialist sources to evaluate appropriate access and cost effectiveness based on the patient’s insurance.
Identifies and recommends strategies to reduce the cost of specialty care as part of operational/strategic goals.
Ensures specialty database within the electronic health record is maintained current.
Identifies and presents issues related to referrals and health information related functions to Director with recommendations for resolutions to implement.
Develops and maintains working knowledge and relationships with the professional community and their respective management teams to enhance effective specialty access for our patients.
Responsible for managing health information related functions.
Ensures medical releases, subpoenas and other health information related functions are processed within expected timelines.
Manages the productivity of the staff to ensure performance metrics are met.
Ensures health information related workflows are followed according to established policies and procedures.
Responsible for ensuring compliance with all Health Information related requests and handling, including scanning procedures.
Ensures random audits on completed to ensure compliance with health plans and other regulatory agencies.
Maintains and manages the development and revisions of clinical forms for the health record.
Ensures that appropriate indexing guidelines are created.
Manages the appropriate retention of health records and coordinates needed purging of charts.
Serves as an internal consultant on health information management issues including release of information, confidentiality, information security, information storage and retrieval, and record retention as well as authorship and authentication of health record documentation, standardization of medical vocabularies, and use of classification systems.
Monitors changes in legislation and accreditation standards that affect health information management.
Prepares weekly and monthly reports for respective areas.
Analyzes data to identify problem areas.
Develops and implements strategies to ensure problem areas are addressed.
Responsible for adhering to the Attendance and Absenteeism Policy.
Ability to present to and work at any FHCN location, both at the beginning of a shift or during a shift, based on business need.
Performs other duties as assigned.