Insurance Referral Manager

  • IDEAL Personnel Services
  • Boca Raton, FL, USA
  • Jul 12, 2018
Full time Executive

Job Description

Job Description

Health Services Referral Manager

Summary:

Seeking a seasoned Health Services Referral Manager. The ideal candidate is a hands-on manager who is responsible for the administration of the Medical Centers of Excellence (MCE) Program. The MCE Manger leads a team of Referral Coordinators by providing support, advice, and guidance to staff. Monitors and manages the MCE referral process to ensure adherence of company and MCE facility policy, accepted practice and procedures, as well as, HIPAA and privacy standards, etc. . Liaise with all parties associated with or inquiring about the MCE Program to ensure consistent application of processes and sets appropriate expectations.

Essential Duties and Responsibilities:

  • Provides direct oversight of the day-to day MCE Program operations and supervision of the program staff.
  • Trains, mentors and coaches staff members with a focus on delivering top quality care and customer service.
  • Oversees, establishes and updates program policies and standard operating procedures (SOPs) while ensuring adherence by MCE Program staff.
  • Provides administrative services to physicians/staff on recommendations from MCE facilities related to coordination of referral with specialists. DOES NOT PROVIDE ANY CLINICAL ADVICE OR GUIDANCE.
  • Creates and conducts presentations and/or training materials for MCE staff, new hires, affiliated physicians, affiliated MCE facilities, etc. Demonstrates knowledge and understanding of HIPAA and privacy standards effectively; identifies and safeguards the organization from potential breaches, including the development of action plans and protocols to ensure compliance.
  • Regularly creates, analyzes, maintains and presents significant metrics on MCE Program benchmarks, trends, audits, compliance, etc. in the form of report(s) or other materials to department and organizational leadership.

REQUIREMENTS

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education/Knowledge/Skills/Abilities:

  • Bachelor's degree (B.A.) from four-year college or university and at least 4 years related business experience, and a minimum of two years in a managerial capacity with direct reports; or equivalent combination of education and experience where two years related experience equals one year of schooling.
  • Related and proven experience as a manager in a similar corporate managerial role focused on: Coordination of, or management of, a team in a clinical / non-clinical setting that handled medical record gathering and appointment scheduling as requested by medical professionals for their patients.
  • Possesses a strong understanding of medical terminology and the anatomy and physiology of the body.
  • Superior organizational skills with the ability to prioritize multiple tasks, projects and assignments in a fast-paced, highly pressurized, rapidly expanding dynamic corporate environment.
  • Ability to identify, handle and resolve problems creatively while being driven by a desire for continuous improvement.
  • Outstanding interpersonal skills, ability to coach and mentor staff, as well as, the ability to work effectively in a team environment.

Location: Boca Raton, FL

Schedule: Monday - Friday Fulltime

Salary: $55-60K - GREAT BENEFITS

Company Description IDEAL Personnel Services is one of the leading Staffing Agencies in South Florida dedicated solely to fulfilling your temporary and permanent staffing needs. As professionals in the industry, we are confident in our ability to find the most qualified IDEAL personnel for all your short term and long term positions in their respective field.