Referral Coordinator

The Referral Coordinator is responsible for overseeing the intake and referral management function to ensure timely, accurate, and compliant access to care. This role requires hands-on expertise in referral coordination and serves as a key liaison between providers, patients, health plans, and internal clinical teams. The Referral Coordinator manages daily referrals for the health plan, coordinates appointments for members, and schedules member supplemental benefits such as transportation and companion care.

Responsibilities include:

• Overseeing the intake and referral process from receipt through completion, ensuring accuracy and adherence to turnaround times.
• Coordinating referrals with internal departments, external providers, and health plan partners to ensure timely access to services.
• Monitoring referral workflows to identify delays or issues impacting patient access and escalating as needed.
• Acting as a subject matter expert for intake and referral policies and workflows.
• Supporting staff development through education and feedback.
• Serving as a primary contact for providers, clinical leadership, and operational partners regarding referrals.
• Collaborating with clinical teams to resolve referral issues and coordinate care.
• Communicating with patients and caregivers on referral status and next steps.
• Ensuring compliance with organizational policies, payer requirements, and regulatory standards including HIPAA.
• Leading continuous improvement initiatives for workflow optimization.
• Ensuring referral documentation supports continuity of care and compliance.
• Partnering on system enhancements impacting referral workflows.

Qualifications:

• Associate degree or higher in healthcare administration or related field preferred.
• 3–5 years of experience in healthcare intake, referral coordination, care coordination, or utilization-related operations.
• Bachelor's degree and experience in managed care or utilization management preferred.
• Experience managing performance metrics and operational improvements.
• Familiarity with regulatory and accreditation requirements affecting intake and referrals.

Skills:

• Leadership, coaching, and team development.
• Organizational, analytical, and problem-solving abilities.
• Ability to manage competing priorities in a fast-paced environment.
• Professional written and verbal communication skills.
• Patient-centered and service-oriented with focus on access to care.