Job Title: Referral Coordinator

The Referral Coordinator will be an important component of ConvenientMD’s Value-Based Care/Population Health strategy. The Referral Coordinator is responsible for supporting Advanced Primary Care (APC) and Population Health operations through scheduling and tracking members throughout their journey. The Referral Coordinator collaborates with PCP, Specialists, and Population Health Team to ensure appropriate, coordinated service delivery. This position is located in the primary care clinic to ensure communication is seamless between the primary care office, urgent care operations, outside providers, and the population health team.

Primary Responsibilities:

• Assist patients with navigating the healthcare system to access care at preferred specialist offices or sites of service (labs, imaging, infusion, pharmacies, outpatient or inpatient procedures) by using appropriate preferred lists.

• With assistance from CMD Network Manager influence patients to select appropriate specialists or sites of service based off preferred lists generated from payer or provider data sets.

• Schedule specialist visits on behalf of patients.
• Track member follow through with specialist referrals and site of service recommendations and educate when appropriate ensuring that all parties have the necessary documentation and referrals completed.

• Coordinate bi-directional exchange of medical charts or other relevant medical information between PCP, Specialist or other provider sites of service.

• Ensure prior authorization approval requirements are met and coordinate the process with payers.
• Document all patient care activities, patient progress, and treatment recommendations in the electronic health record and population health documentation system.

• Actively supports the clinic (staff, providers, patients, vendors) to ensure value-based care is delivered successfully.

To be considered for this position, applicants need to meet the qualifications listed in this posting. Required Qualifications:

• Associate’s Degree required, Bachelor’s Degree Preferred
• Ability to prove technical knowledge of Microsoft Excel; ability to quickly learn Clinical Applications
• Strong communication skills with patients, providers and other healthcare professionals

Preferred Qualifications:

• Experience working in a provider practice or managing referrals
• Prior authorization experience
• Strong understanding of medical terminology and CPT Coding