Senior Manager, Referrals

ChenMed • Maple Heights, OH

106d

About The Position

The Senior Manager, Referrals is responsible for providing support to ChenMed regarding internal and external member referral processes. The employee in this role is responsible for managing and maintaining referral tools, resources and reports and creating trainings to guide the Chenmed company's on referral processes. The Senior Manager, Referrals is the subject matter expert in Referrals processes for the organization. This role is a regional position and supports our offices in Ohio, Kentucky, and Georgia. Travel is required on a monthly basis.

Requirements

• Bachelor's degree in a healthcare-related field; additional experience above the minimum may be considered in lieu of the required education on a year-for-year basis.
• Minimum six (6) years of related experience including a minimum four (4) years' supervisory experience.
• Experience working with Physicians and Directors on a daily basis.
• Experience reviewing data and making decision based of the data.
• Experience working in Medicare managed care environment.

Nice To Haves

• Knowledge of ChenMed products, services, standards, policies and procedures.
• Strong organizational, influencing and problem-solving skills.
• Ability to collaborate effectively with all levels of company personnel.
• Written and verbal communication skills.
• Ability to pay close attention to detail and to ensure accuracy of reports and data.
• Proficient in Microsoft Office Suite products including Word, Excel, PowerPoint and Outlook, database, and presentation software.
• Ability and willingness to travel locally, regionally and nationwide up to 5% of the time.
• Spoken and written fluency in English.

Responsibilities

• Designs, coordinates, and implements training programs for new/existing employees (all levels) for referral processes.
• Leads Referral Managers by providing tools/reports and weekly/monthly meetings to discuss referral process and process updates.
• Supports Network Directors by providing feedback on Referral Manager performance.
• Implements strategic planning for referral coordination that contributes to medical cost reduction and improves organizational performance.
• Interviews Referral Manager candidates.
• Gives market leadership insights on PCP ratios, CPL usage/leakage, CC/RM performance-based data analysis.
• Strategizes and creates structure for referral teams for markets to improve referral outcomes.
• Participates in executive team and Network Director meetings to collaborate for referral improvements and solutions.
• Meets bi-weekly with corporate CMO to strategize/implement clinical/referral processes.
• Creates SOPs, Policy & Standards, Processes, Metrics & Compliance for Referral department.
• Reviews current referral processes by state and creates process improvements.
• Plans and oversees strategic referral projects to improve PCP/patient satisfaction.
• Establishes and implements organizational goals for referrals.
• Identifies issues, makes critical decisions and resolves time sensitive challenges within the referral function.
• Troubleshoots ChenMed process inquiries with internal and external tools.
• Oversees referral disenrollment.
• Builds and manages referral tools, BI tools, RITS enhancements and rollouts.
• Works closely with users and BI team on processes and implementations that are beneficial for the department.
• Collaborates with CSE and BI department on reporting.
• Organizes annual Referral Excellence Month and Referral Manager Conference.
• Performs other duties as assigned and modified at manager's discretion.

Benefits

• Great compensation.
• Comprehensive benefits.
• Career development and advancement opportunities.
• Great work-life balance.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Industry: Ambulatory Health Care Services
• Education Level: Bachelor's degree
• Number of Employees: 1,001-5,000 employees