Family HealthCare Network

Referral Services Manager

Family HealthCare Network  •  $72k/yr  •  Visalia, CA (Onsite)  •  3 months ago
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Job Description

Primary Accountability

The Referral Services Manager is responsible for managing operational aspects of the referrals and health information functions including related to, customer service, compliance, and staffing.


of Primary Responsibilities

  1. Provides management to departmental staff.
    1. Responsible for performance management of assigned staff, including recognition, performance evaluations, and formal coaching and counseling.
    2. Responsible for making recommendations regarding hiring or firing, and the advancement and promotion of assigned supervisors, and those supervisors’ assigned staff, or any other change status of assigned supervisors, and those supervisors’ assigned staff.
    3. Demonstrates core leadership behaviors and team one approach.
    4. Creates a culture of accountability and excellence.
    5. Develops and manages an action plan across assigned employee base to support the strategic direction and obtainment of goals of the organization, effectively leading change when necessary.
    6. Empowers staff through effective communication and talent building.
    7. Delegates appropriate departmental duties and responsibilities to assigned team members while ensuring department performance.
    8. Assists with the development of the departmental budget and monitors budget to ensure expenses do not exceed budget.
    9. Ensures regulatory compliance for assigned departments, and compliance with all workflows, policies, and procedures.
    10. Ensures employees receive instruction/training that is in compliance with training plan, including on the job training. Works with supervisor to ensure necessary remediation is taken.
    11. Recommends workflow, policy, and procedure changes based on observations from performance metrics, outcomes, and feedback from supervisor.
    12. Ensures department maintains compliance with all employee related reporting and tracking.
    13. Identifies and presents issues related to referrals and health information related functions to supervisor with recommendations for resolutions to implement.
    14. Supports a “culture of excellence” and the “Four Pillars of Excellent Customer Service”.
  2. Responsible for managing referral related functions.
    1. Ensures referrals are tracked and processed within expected timelines.
    2. Manages the productivity of the staff to ensure performance metrics are met.
    3. Ensures referral workflows are followed according to established policies and procedures.
    4. Responsible for ensuring compliance of the referral process.
    5. Manages the operations related to referrals and resources to ensure goals are met.
    6. Conducts internal audits of referrals to ensure compliance with Joint Commission, HRSA and other regulatory guidelines.
    7. Communicates to internal and external providers to ensure patients receive the needed specialty access.
  3. Manages and monitors referral workflows and performance to ensure adherence to appropriate referral sources and that clinical pathway workflows are followed at all times.
    1. Reviews referral data and specialist sources to evaluate appropriate access and cost effectiveness based on the patient’s insurance.
    2. Identifies and recommends strategies to reduce the cost of specialty care as part of operational/strategic goals.
    3. Ensures specialty database within the electronic health record is maintained current.
    4. Identifies and presents issues related to referrals and health information related functions to Director with recommendations for resolutions to implement.
    5. Develops and maintains a working knowledge and relationship with the professional community and their respective management teams in order to enhance effective specialty access for our patients.
  4. Responsible for managing health information related functions.
    1. Ensures medical releases, subpoenas and other health information related functions are processed within expected timelines.
    2. Manages the productivity of the staff to ensure performance metrics are met.
    3. Ensures health information related workflows are followed according to established policies and procedures.
    4. Responsible for ensuring compliance of all Health Information related requests and handling, including scanning procedures.
    5. Ensures random audits on completed to ensure compliance with health plan and other regulatory agencies.
    6. Maintains and manages the development and revisions of clinical forms for the health record.
    7. Ensures that appropriate indexing guidelines are created.
    8. Manages the appropriate retention of health records and coordinates needed purging of
      charts.
  5. Serves as an internal consultant on health information management issues including release of information, confidentiality, information security, information storage and retrieval, and record retention as well as authorship and authentication of health record documentation, standardization of medical vocabularies, and use of classification systems.
  6. Monitors changes in legislation and accreditation standards that affect health information management.
  7. Prepares weekly and monthly reports for respective areas
    1. Analyzes data to identify problem areas. Develops and implements strategies to ensure problem areas are addressed.
  8. Performs other duties as assigned.


of Primary Attributes

Professional & Technical Knowledge:

  1. Possesses specific advanced knowledge and skills, including written and verbal communication skills, computational, computer and technical skills, and mathematical knowledge frequently acquired through completion of a Bachelor’s Degree program with a recognized major or comparable experience that includes two years of experience in health records management, and;
  2. Four years of leadership experience or 5 years of progressively greater responsibility or significant contributions to projects and initiatives that demonstrate leadership skills; and
  3. Employees must have a thorough understanding of the theory of the profession in order to determine “why” things are done.

Technical Skills:

  1. Ability to prepare more complex documents in Microsoft Word, including creating tables, charts, graphs and other elements.
  2. Ability to use Microsoft Excel to analyze data, including the use of formulas, functions, lookup tables and other standard spreadsheet elements.
  3. Ability to develop sophisticated presentations in Microsoft PowerPoint, including the use of embedded objects, transitions and other elements.

Licenses & Certifications: RHIT or RHIA certification preferred.

Communications Skills:

  1. Job duties require the employee to effectively communicate, verbally and in writing, their opinions and extrapolations of information they collect and synthesize/analyze.
  2. Responsible for the resolution of conflicts that may arise because of disagreements between employees, between employees and customers/clients, or with the public, other legal entities or governmental authorities.
  3. Compiles, analyzes and prepares information in an effective written form, including correspondence, reports, articles or other documentation.
  4. Effectively conveys technical information to non-technical audiences.

Physical Demands: The physical demands here in this job description are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this position, the employee is regularly required to sit and use repetitive hand movement to type and grasp. The employee is frequently required to stand or walk; and the employee must occasionally lift and/or move up to 20 pounds.

Pay Scale:

Min Salary Rate: $71,552.23
Max Salary Rate: $114,483.56

Family HealthCare Network

About Family HealthCare Network

Family HealthCare Network (FHCN) is a nonprofit community-based organization that operates federally qualified health centers (FQHCs) throughout Fresno, Kings, and Tulare Counties. We are governed by a volunteer Board of Directors composed of community and business leaders. Family HealthCare Network is the third largest FQHC in California.

Family HealthCare Network has earned a reputation for excellence as the first freestanding ambulatory health center in Tulare County to be accredited by the Joint Commission. It also boasts a unique distinction as a community health center dually recognized by The National Committee for Quality Assurance (NCQA) as a Level-Three Patient Centered Medical Home and has received the Gold Seal of Approval® by The Joint Commission as a Primary Care Medical Home.

Today, FHCN has a comprehensive, patient-centered primary health care delivery model with 41 locations, 36 of which are clinical sites in Cutler-Orosi, Dinuba, Exeter, Farmersville, Fresno, Goshen, Hanford, Ivanhoe, Pixley, Porterville, Reedley, Selma, Springville, Strathmore, Squaw Valley, Terra Bella, Three Rivers, Traver, Tulare, Visalia, and Woodlake. Family HealthCare Network also operates a Mobile Health Center program, the Ventanilla de Salud Resource Center located in the Fresno Mexican Consulate, and a Resource Center in the community of Porterville.

Industry
Healthcare & Social Services
Company Size
501-1,000 employees
Headquarters
VISALIA, CA
Year Founded
1976
Website
fhcn.org
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