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 management skills with the ability to motivate and develop staff.
- Strong organizational, analytical, and problem-solving abilities.
- Ability to manage multiple priorities in a fast-paced environment.
- Excellent communication and interpersonal skills.
- Knowledge of medical terminology and referral processes.
- Proficiency with EMR systems and Microsoft Office applications.
- Ability to maintain confidentiality and compliance with HIPAA regulations.
Education and Experience Requirements
- High School diploma or GED required.
- Bachelor's degree in healthcare administration, nursing, or related field preferred.
- Licensed Vocational Nurse (LVN) or Registered Nurse (RN) strongly preferred.
- Minimum of 3-5 years of referral coordination or case management experience.
- Minimum of 1-2 years of supervisory or leadership experience preferred.
- Experience working with underserved populations preferred.
- Bilingual in English/Spanish preferred.
Working Conditions
- Fast-paced clinical/office environment with frequent interaction with patients and healthcare professionals.
- Prolonged sitting and computer use.
- May require occasional lifting up to 40 pounds.
Central City Community Health Center offer a dynamic work environment with competitive salaries and benefits. Central City Community Health Center provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Central City complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities.