Referral Coordinator

Category

Admin Support Services

Position Type

Full-Time

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

Intake & Referral Operations

• Oversee the intake and referral process from receipt through completion, ensuring referrals are processed accurately and within established turnaround times.
• Coordinate referrals with internal departments, external providers, and health plan partners to ensure timely access to services.
• Monitor referral workflows to identify delays, barriers, or trends impacting patient access and escalate issues as appropriate.
• Serve as a subject matter expert for intake and referral processes, policies, and system workflows.

• Support staff development through ongoing education, feedback, and process reinforcement.

Communication & Collaboration

• Act as a primary point of contact for providers, clinical leadership, and operational partners related to intake and referral activities.
• Collaborate with clinical teams to resolve referral issues, clarify orders, and ensure appropriate care coordination.
• Support patient and caregiver communication regarding referral status, expectations, and next steps as needed.

Quality, Compliance & Performance Management

• Ensure intake and referral operations comply with organizational policies, payer requirements, and regulatory standards, including HIPAA.
• Identify opportunities for workflow optimization and lead continuous improvement initiatives.

Systems & Documentation

• Ensure referral documentation supports continuity of care, reporting needs, and compliance requirements.
• Partner with leadership on system enhancements or process changes impacting intake and referral workflows.

Required Qualifications

• Associate degree or higher in healthcare administration or a related field preferred.
• Minimum of 3–5 years of experience in healthcare intake, referral coordination, care coordination, or utilization‑related operations.

Preferred Qualifications

• Bachelor’s degree in healthcare administration, business, or a related field.
• Experience in managed care, utilization management, or population health environments.
• Demonstrated experience managing performance metrics and driving operational improvements.
• Familiarity with regulatory and accreditation requirements impacting intake and referrals.

Knowledge, Skills, and Abilities

• Strong leadership, coaching, and team development skills.
• Excellent organizational, analytical, and problem‑solving abilities.
• Ability to manage competing priorities in a fast‑paced, high‑volume environment.
• Clear, professional written and verbal communication skills.
• Patient‑centered, service‑oriented approach with a focus on access to care.