Referral Manager

CLASSIFICATION: Hourly, Non-Exempty LOCATION: Corporate JOB SUMMARY : The Referral Manager is responsible for the overall leadership, operations, and performance of the referral department. This position oversees the Referral Coordinators while ensuring timely, accurate, and efficient coordination of patient referrals, authorizations, and transitions of care. The Referral Manager collaborates with clinical teams, external providers, and health systems to support patients—particularly those with complex medical, chronic, or psychosocial conditions—while ensuring compliance, quality standards, and continuity of care.

ACCOUNTABLE TO : Managed Care Manager JOB DUTIES: Responsible for training and procedural guidance of the referral department, which facilitates access to appropriate health services by assisting team members with the coordination of referrals, admissions, discharge and/or transfer of patients to specialty care, including the following: Provide direct supervision of Referral Coordinators, including hiring, training, coaching, and performance management Oversee daily operations of the referral department to ensure timely processing, tracking, and completion of referrals Develop and implement workflows, policies, and procedures to improve department efficiency and effectiveness Assign and monitor staff workloads and ensure appropriate staffing coverage Serve as escalation point for complex referral issues, denied authorizations, and patient concerns Ensure coordination of referrals, admissions, discharges, and transitions to specialty care, hospitals, rehabilitation, and other facilities Monitor referral lifecycle including eligibility, authorizations, scheduling, and follow-up Ensure patients with complex medical or psychosocial needs receive appropriate case management services Maintain effective communication between patients, providers, and external partners across the continuum of care Ensure timely retrieval and review of specialist reports and documentation for provider follow-up Ensure department compliance with HIPAA and all regulatory requirements in handling protected health information Monitor referral tracking systems and ensure accurate data entry, reporting, and documentation Develop and analyze referral metrics (e.g., turnaround times, completion rates, denial rates) to improve performance Conduct audits to ensure quality, accuracy, and completeness of referral activities Partner with providers, behavioral health staff, case managers, and external facilities to coordinate patient care Maintain ongoing communication with hospitals, discharge planners, and community providers Act as liaison between clinical teams and referral staff to ensure seamless care coordination Promote culturally sensitive, patient-centered care for underserved populations Special Knowledge, Skills, Abilities and Attributes: Strong knowledge of healthcare systems including Medi-Cal, Medicare, managed care plans, and IPAs.

Leadership and team…

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