Referral Management Coordinator
What you'd do
About the Position: This position is located at West Point, New York. The position works in a building separate from the main hospital but on West Point and is co-located with the call center and the referral center. The hours are an 8-hour work day from 0800-1630 with a 30-min lunch. This is a Direct Hire Solicitation
Major duties
Coordinate care through appointing referrals internal to the hospital based on capabilities and capacity and deferring referrals to the network when required. Maintain positive and clear communication with nurse case managers, group practice managers, providers, and the clinical support division to ensure the patients needs and hospital requirements are followed throughout the process. Communicate directly with the patient to address referral concerns and questions and works directly with Humana to resolve any issues. Educate staff, healthcare professionals, and beneficiaries on consult tracking procedures. Gather medical and personal information relevant to program eligibility and beneficiary needs in order to coordinate appropriate care.
What you need to qualify
Who May Apply: Only applicants who meet one of the employment authority categories below are eligible to apply for this job. You will be asked to identify which category or categories you meet, and to provide documents which prove you meet the category or categories you selected. In order to qualify, you must meet the education and/or experience requirements described below. Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community; student; social). You will receive credit for all qualifying experience, including volunteer experience. Your resume must clearly describe your relevant experience; if qualifying based on education, your transcripts will be required as part of your application. Additional information about transcripts is in this document. To Qualify for the GS-06: Specialized Experience: One year of specialized experience which includes receiving, investigating, processing, or providing feedback on telephonic or walk-in inquiries concerning medical care provided to beneficiaries through civilian health care facilities or providers. This definition of specialized experience is typical of work performed at the next lower grade/level position in the federal service (GS-05). To Qualify for the GS-07: Specialized Experience: One year of specialized experience which includes reviewing referrals for completeness, accuracy, and compliance; maintaining external care request database ; and using Electronic Health Record(EHR) database or similar program. This definition of specialized experience is typical of work performed at the next lower grade/level position in the federal service (GS-06). Some federal jobs allow you to substitute your education for the required experience in order to qualify. For this job, you must meet the qualification requirement using experience alone--no substitution of education for experience is permitted.
Before you apply
Federal applications are different: your resume should be 3–5 pages and mirror the language of this announcement. Read our federal resume guide first — it's the #1 reason qualified people get screened out.
Don't miss the next one.
Get an email the moment a similar federal job opens — postings can close in as little as 5 days.