RN Clinical Referral Specialist PD

Brown Medicine•Providence, RI

3d•$36 - $71•Onsite

About The Position

SUMMARY: The Clinical Referral Specialist reports to the Clinical Manager. Under general supervision, coordinates the effective and efficient patient flow regarding appointment scheduling with specialist and testing per physician request. Reviews all referrals for appropriateness and determines proper provider placement. Follows patient’s status within the cycle of provider care to ensure continuity of services utilizing and prompt access to providers. Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include: Instill Trust and Value Differences Patient and Community Focus and Collaborate RESPONSIBILITIES: The Clinical Referral Specialist will focus on improving the health status of the people of the region through the provision of customer-friendly, geographically accessible, and high-value services within the environment of a comprehensive, integrated academic health system. The Clinical Referral Specialist is responsible for knowing and acting in accordance with the principles of the Brown University Health Corporate Compliance Program and Code of Conduct. The Clinical Referral Specialist develops and maintains working knowledge of outpatient medical practice to maximize operational effectiveness. Oversees the daily work queues Appropriately assigns tasks, trains, establishes deadlines for patient appointments and monitors bookings. The clinical referral specialist will review the clinical background of all referrals to determine the most appropriate provider with whom to book an appointment. This may require outreach to referring physicians and patients as well as other clinical facilities for additional information. Responsible for management of EPIC In-Basket Provides weekly/timely updates to department leadership on issues to include escalation of in-house provider or caregiver questions, requests, or concerns regarding the status of a patient’s ordered service or care coordination. Focused on access, the Clinical Referral Specialist provides guidance on triaging patient phone calls and appointment scheduling, manages patient flow to ensure a prompt, organized, and pleasant patient experience. Recommends opportunities and operational improvements for increased efficiency. The Clinical Referral Specialist is responsible for clinical liaison activities within the Referral Management Department. The Clinical Referral Specialist manages all clinically complex health referrals. Represents CVI via telephone with referrals for patient care from physicians, hospitals, insurance case managers and all other referral sources. Responds to phone calls, electronic transmissions, e-mails, and faxes regarding clinically complex referrals with a customer friendly service orientation. Reviews physician orders and follows up with referral source for clarifications or additional information if needed. Reviews patient records and performs an assessment of patient’s clinical specialist need. Works with Ambulatory team to develop pre appointment workflow and tests as needed to prepare patients for visits. Identifies opportunities for process improvement focused on improved patient access. Identifies objections, concerns or other entry barriers and provides information in response to address those issues. Participates in the development of policies and procedures for referral management and actively assists in problem solving with and between departments to ensure the clinical intake function is collaborative and effective. Maintains positive professional relations with support personnel through appropriate and timely response for information or paperwork necessary for key clinical ad billing functions. Displays a positive and professional image and attitude in all relationships with patients, families, peers and in the community. Participates in the Quality Performance Improvement (QAPI) program. Demonstrates flexibility in meeting the needs of the department and responds positively to changes in workflow. Promotes teamwork by demonstrating willingness to assist others in meeting the needs of all individuals and collaborating effectively with the interdisciplinary team and other departments throughout the organization. Completes annual competency requirements. Consistently communicates requests, suggestions, concerns, or problems to the CVI leadership team. Consistently completes assigned responsibilities in required time frame and accepts additional duties and responsibilities as requested by Director of Referral Management. Consistently maintains a professional appearance. Protects patient health information according to the HIPPA rule and related Aultman policies. Participates in unit management meetings and recommends fiscal/patient care objectives, standards, and goals.Participates in the formation of policy, procedures, and standards, organizational committees, and compliance to TJC standards. Performs other duties as assigned.

Requirements

Licensure as Registered Nurse in the State of Rhode Island by the Rhode Island Board of Nursing or licensure as a Registered Nurse in accordance with the Nurse Licensure Compact agreement of the National Council of State Boards of Nursing.
Bachelor's in Nursing with current license to practice as a Registered Nurse in the state of Rhode Island.
Certified in Basic Cardiac Life Support (BLS).
Maintains an active CEU/Education file.
Must be a registered nurse with a minimum of 5 years recent cardiology ambulatory clinical experience.
Experience in coordinating/processing health referrals.
Clinical knowledge and critical thinking ability to effectively plan and provide coordination of patient care
Exceptional interpersonal and customer service skills; must be able to effectively solve unique problems as they arise or identify when to consult the supervisor.
Knowledge of cardiology subspecialties.
Understanding of patient requirements for general cardiology and sub specialties.
Demonstrated problem-solving abilities and excellent telephone, interpersonal and written communication skills.
Strong commitment to teamwork and customer service, both internally and externally, is required.
Strong/proven data entry and general computer skills.

Responsibilities

Coordinates the effective and efficient patient flow regarding appointment scheduling with specialist and testing per physician request.
Reviews all referrals for appropriateness and determines proper provider placement.
Follows patient’s status within the cycle of provider care to ensure continuity of services utilizing and prompt access to providers.
Oversees the daily work queues
Appropriately assigns tasks, trains, establishes deadlines for patient appointments and monitors bookings.
Reviews the clinical background of all referrals to determine the most appropriate provider with whom to book an appointment.
Responsible for management of EPIC In-Basket
Provides weekly/timely updates to department leadership on issues to include escalation of in-house provider or caregiver questions, requests, or concerns regarding the status of a patient’s ordered service or care coordination.
Provides guidance on triaging patient phone calls and appointment scheduling, manages patient flow to ensure a prompt, organized, and pleasant patient experience.
Recommends opportunities and operational improvements for increased efficiency.
Manages all clinically complex health referrals.
Represents CVI via telephone with referrals for patient care from physicians, hospitals, insurance case managers and all other referral sources.
Responds to phone calls, electronic transmissions, e-mails, and faxes regarding clinically complex referrals with a customer friendly service orientation.
Reviews physician orders and follows up with referral source for clarifications or additional information if needed.
Reviews patient records and performs an assessment of patient’s clinical specialist need.
Works with Ambulatory team to develop pre appointment workflow and tests as needed to prepare patients for visits.
Identifies opportunities for process improvement focused on improved patient access.
Identifies objections, concerns or other entry barriers and provides information in response to address those issues.
Participates in the development of policies and procedures for referral management and actively assists in problem solving with and between departments to ensure the clinical intake function is collaborative and effective.
Maintains positive professional relations with support personnel through appropriate and timely response for information or paperwork necessary for key clinical ad billing functions.
Displays a positive and professional image and attitude in all relationships with patients, families, peers and in the community.
Participates in the Quality Performance Improvement (QAPI) program.
Demonstrates flexibility in meeting the needs of the department and responds positively to changes in workflow.
Promotes teamwork by demonstrating willingness to assist others in meeting the needs of all individuals and collaborating effectively with the interdisciplinary team and other departments throughout the organization.
Completes annual competency requirements.
Consistently communicates requests, suggestions, concerns, or problems to the CVI leadership team.
Consistently completes assigned responsibilities in required time frame and accepts additional duties and responsibilities as requested by Director of Referral Management.
Consistently maintains a professional appearance.
Protects patient health information according to the HIPPA rule and related Aultman policies.
Participates in unit management meetings and recommends fiscal/patient care objectives, standards, and goals.
Participates in the formation of policy, procedures, and standards, organizational committees, and compliance to TJC standards.
Performs other duties as assigned.