Referral Management Specialist

1 week ago

Providence, Rhode Island, United States Brown Medicine Full time
Job Overview

SUMMARY:

The central management of routine referrals is crucial for developing a specialized, trained team dedicated to overseeing referrals. This approach aims to better prepare patients for their visits with specialists. Referrals will be processed within a 48-hour timeframe, contributing to healthcare cost savings by directing patients to 'In-Network' providers. This role will assist in establishing and maintaining a preferred provider directory while standardizing patient-centric workflows. Additionally, it involves cultivating relationships with payers to streamline prior authorizations and standardize referral documentation and attachments. The position is designed to minimize duplicate or unnecessary testing, prevent delays in diagnosis or treatment, and reduce lost referrals and access backlogs.

KEY RESPONSIBILITIES:

The incumbent will consistently uphold the values of patient care priority, dignity, collaboration, integrity, and quality in alignment with the mission to deliver compassionate, high-quality patient care, research excellence, and outstanding physician education. It is essential to be knowledgeable and act in accordance with the Compliance Program and Code of Conduct.

ESSENTIAL FUNCTIONS:

  • Manage referral processes in the electronic health record system for all care sites, including both primary and specialty care.
  • Ensure the completion of the referral request form.
  • Obtain prior authorization for referrals as necessary.
  • Confirm receipt and review of referrals.

1. Accepted with confirmation of appointment.

  1. Declined or redirected (not needed, incorrect specialty, lack of availability).

3. Patient defers making an appointment, declines, or cannot be reached (if the specialty is responsible for scheduling).

  • Schedule referral appointments for patients if not done directly.
  • Communicate with patients regarding referral appointment details, including provider, time, location, expectations, and necessary items to bring.
  • Track referral responses.
  • Document secondary referrals as needed.
  • Attach/scan consult notes to the medical record.
  • Close referrals upon completion.

QUALIFICATIONS:

  • Minimum of 3-5 years of experience in a medical office environment.
  • Experience with electronic clinical systems is preferred.
  • 1-3 years of experience specifically with referrals.

WORK ENVIRONMENT:

This role is situated in a clinical practice environment, which may involve exposure to communicable diseases, medicinal preparations, and hazardous materials. Frequent interaction with patients is expected, and the work may be stressful at times. Reasonable accommodations may be provided to enable individuals with disabilities to perform essential functions.

INDEPENDENT WORK:

The incumbent will operate independently within the established guidelines of the organization's policies and procedures.

SUPERVISORY ROLE:

No supervisory responsibilities are associated with this position.

EOE/F/M/Vet/Disabled

  • Referral Management Specialist

    1 week ago

    Providence, Rhode Island, United States Brown Medicine Full time

    Position OverviewSUMMARY: The central management of routine referrals is essential for developing a specialized, trained team dedicated to overseeing patient referrals. This approach aims to enhance patient preparedness for specialist consultations. Referrals will be processed within a 48-hour timeframe, contributing to healthcare cost savings by directing...

  • Referral Management Specialist

    1 week ago

    Providence, Rhode Island, United States Brown Medicine Full time

    Job OverviewSUMMARY: The central management of routine referrals aims to cultivate a specialized, trained team dedicated to overseeing referrals. This initiative is designed to better prepare patients for their consultations with specialists. Referrals will be processed within a 48-hour timeframe, promoting cost efficiency in healthcare by directing patients...

  • Referral Coordination Specialist

    2 weeks ago

    Providence, Rhode Island, United States Brown Urology Full time

    Job OverviewSUMMARY:The central management of routine referrals aims to cultivate a dedicated and trained team to oversee the referral process. This initiative is designed to better prepare patients for their consultations with specialists. Referrals will be processed within a 48-hour timeframe, contributing to healthcare cost savings by directing patients...

  • Referral Coordinator

    5 days ago

    Providence, Rhode Island, United States CharterCARE Health Partners Full time

    Job SummaryCharterCARE Health Partners is seeking a highly skilled Referral Coordinator to join our team. As a Referral Coordinator, you will play a critical role in ensuring the quality of the referral process is upheld to departmental and system standards.Key ResponsibilitiesDevelop and maintain collaborative relationships with providers and outpatient...

  • Maintenance Specialist

    2 days ago

    Providence, Rhode Island, United States Trinity Management LLC Full time

    About the Role:Trinity Management, LLC is seeking a skilled Maintenance Specialist to join our team. As a Maintenance Specialist, you will play a critical role in ensuring the upkeep and maintenance of our properties, providing a safe and comfortable living environment for our residents.Key Responsibilities:Fulfill work orders and perform basic mechanical...

  • Customer Engagement Specialist

    2 weeks ago

    Providence, Rhode Island, United States Cygnus Management Group Inc Full time

    Customer Engagement Specialist at Cygnus Management GroupCygnus Management Group is on the lookout for Customer Engagement Specialists to enhance our promotional marketing team. As a thriving marketing and sales organization in the Northeast, we are dedicated to delivering outstanding customer interactions and fostering sales growth for our esteemed...

  • Referral Coordinator

    3 days ago

    Providence, Rhode Island, United States CharterCARE Health Partners Full time

    Job SummaryCharterCARE Health Partners seeks a highly skilled Referral Coordinator to ensure the quality of the referral process is upheld to departmental and system standards. The ideal candidate will develop and maintain a collaborative relationship with providers and outpatient practices, ensuring accurate and timely referrals.Key ResponsibilitiesReview...

  • Painter II

    3 days ago

    Providence, Rhode Island, United States Davenport Management Inc. Full time

    Job SummaryDavenport Management Inc. is seeking a skilled Painter II - Residential Improvements Specialist to join our team. As a key member of our maintenance and repairs team, you will be responsible for performing a wide range of tasks to ensure the quality and integrity of our residential properties.Key ResponsibilitiesTask Preparation: Daily routine to...

  • Cybersecurity Grants Management Specialist

    1 week ago

    Providence, Rhode Island, United States RI Temps, Inc. Full time

    Job OverviewPosition Title: Cybersecurity Grants Management SpecialistPOSITION SUMMARYThe Cybersecurity Grants Management Specialist plays a crucial role within the Rhode Island State Police/Joint Cyber Task Force. This position focuses on the administrative oversight of the Joint Cyber Task Force (JCTF) under the guidance of the Lieutenant of the Computer...

  • Senior IT Risk Management Specialist

    2 weeks ago

    Providence, Rhode Island, United States Radiant Digital Full time

    Job OverviewWe are seeking a Senior IT Risk Management Specialist to join our team at Radiant Digital.The details of the position are outlined below:Position: Senior IT Risk Management SpecialistWork Arrangement: HybridThis role requires a proactive and meticulous professional in risk management to identify and evaluate risks that may affect the...

  • Grants and Financial Management Specialist

    2 weeks ago

    Providence, Rhode Island, United States Brown University Full time

    Position Overview:The Department of BioMed Research Administration is in search of a dedicated professional to fill the role of either a Grants and Financial Coordinator or a Grants and Financial Specialist. The specific position will be determined based on the qualifications of the selected candidate.Grants & Financial Coordinator (Grade 8):The Grants...

  • Certified Risk Management Specialist

    2 weeks ago

    Providence, Rhode Island, United States iTekPeople Inc Full time

    Job OverviewWe are seeking a Certified Risk Management Specialist to enhance our risk management strategies at iTekPeople Inc. The ideal candidate will be responsible for developing and implementing effective processes, policies, and procedures to mitigate risks.Key Responsibilities:Assist in the formulation of comprehensive processes and policies.Support...

  • Senior IT Risk Management Specialist

    2 weeks ago

    Providence, Rhode Island, United States Radiant Full time

    We are seeking a Senior IT Risk Management Specialist to join our team at Radiant.Position Overview: As a key member of our organization, you will play a crucial role in identifying and evaluating risks that may affect our operations, projects, and compliance.Key Responsibilities:1. Develop and refine processes, policies, and procedures related to risk...

  • Client Relations Specialist

    2 weeks ago

    Providence, Rhode Island, United States Greenlining Management Full time

    About Us: Greenlining Management is a distinguished consulting firm specializing in sales and marketing within the telecommunications sector. Our mission is to empower prominent brands by optimizing their profitability and enhancing their market presence through innovative revenue-generating strategies.Position Overview: We are in search of a motivated...

  • Junior Marketing Coordinator

    2 weeks ago

    Providence, Rhode Island, United States Greenlining Management Full time

    As a Marketing Support Specialist at Greenlining Management, you will be integral to our innovative approach in the realm of experiential marketing. We collaborate with a variety of clients to enhance their brand visibility and foster meaningful connections with their audience through tailored experiences.Your role as an Entry-Level Brand Engagement...

  • Client Relationship Specialist

    2 weeks ago

    Providence, Rhode Island, United States Provident Bank Full time

    POSITION SUMMARY: As a Client Relationship Specialist at Provident Bank, your primary responsibility is to cultivate and maintain relationships with clients and potential clients. This role involves understanding, identifying, and addressing their financial requirements while ensuring a positive experience during every interaction at the branch. The...

  • Tax Compliance Specialist

    2 weeks ago

    Providence, Rhode Island, United States Federal Emergency Management Agency Full time

    DutiesOverview of Divisions:The Appeals (AP), Large Business and International (LB&I), Small Business Self-Employed (SB/SE), and Tax Exempt and Government Entities (TE/GE) divisions play critical roles in the tax compliance landscape.Position Responsibilities:As a Tax Compliance Specialist, you will be responsible for preparing audit statements, including...

  • Customer Engagement Specialist

    2 weeks ago

    Providence, Rhode Island, United States Greenlining Management Full time

    About Us: Greenlining Management is a recognized leader in the marketing and customer service sectors. As we continue to expand, we are seeking a driven and adaptable entry-level Customer Experience Representative to support our daily customer service and marketing initiatives.Your Role: In this position, you will embody the spirit of teamwork and...

  • FEMA Recovery Specialist

    2 weeks ago

    Providence, Rhode Island, United States RealStreet Full time

    RealStreet Company - Exciting Opportunities AvailableIn alignment with FEMA's Public Assistance initiative, we are in search of highly skilled and experienced professionals to support disaster recovery operations.RealStreet is seeking qualified candidates for various positions within the architectural, engineering, and construction (AEC)...

  • FEMA Recovery Specialist

    2 weeks ago

    Providence, Rhode Island, United States RealStreet Full time

    RealStreet Company - Exceptional Career OpportunitiesIn alignment with FEMA's Public Assistance initiative, we are seeking highly skilled and experienced professionals to contribute to disaster recovery operations.RealStreet is in search of qualified candidates to fill diverse positions within the architectural, engineering, and construction (AEC)...