Manager of Referral Management RN

Job Overview

This position assures that the daily workflow of the Referral Department and Transitions of Care is progressive and consistent. This position manages expectations of referral sources and customer service issues with the referral community and problem solves with clinical teams to remove barriers to admit patients to the agency. Sets priorities with respect to referral processing, triages clinical issues and/or requests, delegates appropriate tasks, and acts as a resource to the Referral Department team. Oversees a team of Care Coordinators in the hospital and community setting.

Job Description

Minimum Qualifications:

1. Successful completion of Nursing Program.

2. Registered Nurse (RN) or Licensed Practical Nurse (LPN) license.

3. Previous clinical and management experience.

Location: Lowell, MA

Hours: Full Time- Days

Duties and Responsibilities: The duties and responsibilities listed below are intended to describe the general nature of work and are not intended to be an all-inclusive list. Other duties and responsibilities may be assigned.

• Provides effective guidance to entire Referral Department and Transitions of Care team, clinical and administrative team regarding clinical and administrative issues, prioritization and workflow management.

• Collaborates with Director of Referral Management and Transitions of Care and Human Resources to effectively interview and make recommendations for qualified candidates for vacant Referral and Liaison Department positions.

• Collaborates with Director of Referral Management and Transitions of Care to provide feedback regarding Referral Management Specialist, Referral Specialist performance, Transitions of Care staff, their accounts, growth and account management.

• Works cooperatively with the Director of Referral Management and Transitions of Care to improve processes and efficiencies within the department.

• Identifies, reports, and acts on referral source and referral request concerns by communicating with department Director, as well as other agency leaders as appropriate.

• Acts as a role model and mentor for Referral Department and Transitions of Care team, as well as new employees.

• Provides warm hand-off communication to Referral Nurse Specialist assuming lead role, and others as appropriate.

• Serves as a resource for referral sources and the community regarding services provided, third party regulations, determination of home care eligibility, and appropriateness for home health or hospice.

• Provides resource information if patient/client is not eligible or not appropriate for home care or hospice.

• Gathers necessary information and uses clinical expertise to manage timely and accurate referral processing, with a focus on medically complex referral requests and works with transition of care team to ensure safe and timely discharges and documentation.

• Reviews admitting department operations and systems to ensure compliance with applicable standards.

• Provides input to strategic decisions on agency growth that affect the functional area of responsibility.

• Capable of resolving escalated issues arising from operations, referral management and transitions of care and requiring coordination with other departments.

• Demonstrates a knowledge and understanding of what to report to the supervisor or Vice President of Quality Improvement when concerns of corporate compliance arise.

• Ensures compliance within guidelines set forth by regulatory agencies (JCAHO, DPH, ERISA etc.) and demonstrates compliance with Home Health Foundation policies and procedures.

• Practices confidentiality principles set by the agency and federal HIPAA guidelines.

• Participates in all mandatory in-services.

What we Offer:

• PTO accrual effective day 1
• Tuition Reimbursement
• Dental, Vision, Health Insurance Day 1- no waiting period
• Mileage reimbursement