Responsibilities:
— Set standard metrics and goals for Referral Management team members for referral processing, documentation management, Benefit Verification (BV), and Prior Authorization (PA) processing.
— Develop and support LUX Infusion’s culture within the Referral Management departments.
— Establish training protocols for new employees and evaluate performance against metrics and goals, implementing corrective actions or training plans as needed.
— Create communication processes for Referral Management team members to engage internal and external stakeholders to gather missing or inaccurate information.
— Collaborate closely with internal department leadership to ensure optimal continuity of patient referral activities.
— Provide administrative and leadership support for accreditation-related processes or data collection involving Intake or Referral departments.
— Work with referral and pharmacy operations management peers to support successful end-to-end referral processes.
— Review department alignment with SLAs regularly, identify trends, and take necessary actions.
— Support staffing and resource adjustments to meet referral volumes and organizational growth goals.
— Maintain effective communication with intake and Patient Services specialist teams regarding leadership updates impacting people, processes, and technology.
— Serve as a point of escalation for issue management related to Intake & Referral Specialists.
— Assign duties and manage employee performance, including productivity reviews, job descriptions, performance evaluations, disciplinary actions, and personnel paperwork.
— Prioritize and manage multiple tasks and projects concurrently.
— Be flexible with scheduling and able to work overtime; occasional overnight travel by car or plane may be required.
Requirements:
— 5-7 years managing patient referral and prescription activities in infusion or specialty therapies.
— 3-5 years experience in infusion or specialty therapy reimbursement or payer processes.
— 3-5 years supporting prescriber, healthcare setting, patient, and field communications related to referral or prescription services.
— 1-3 years successful management or leadership of department employees.
— Strong customer service skills for internal and external customers, meeting quality standards and evaluating satisfaction.
— High School Diploma or equivalent required; Bachelor's Degree preferred.
— Advanced computer and internet skills, including Microsoft Office (Excel, Word, Access Database).
— Knowledge and understanding of financial information and reporting.
— Willingness to travel up to 5% for business purposes.
— Preferred: 1-3 years people management experience overseeing pharmacy intake or referral process teams.
— Strong knowledge of infusion therapies, patient qualification steps, and ability to lead teams through these processes.
— General knowledge of payer contracts for infused therapies and operational requirements.
— Strong knowledge of specialty prescription and referral documentation workflows and provider communication needs.
— Strong working knowledge of medical and pharmacy terminology.
— General knowledge of intake requirements for insurance payors including Medicare, Medicaid, Medicare D, Commercial, and pharmacy plans.
— Ability to communicate effectively, inspire and motivate staff at all levels.
— Strategic and proactive thinking.
— Ability to maintain accurate records and prepare reports and correspondence.
— Organizational and coordination skills.
— Ability to set priorities and assign work.
— Ability to identify opportunities for process improvement and implement changes.
— Excellent verbal, written, and group presentation skills.
— CPR knowledge.
Benefits:
— Purpose-driven leadership work with real patient impact.
— Patient-first, clinician-led culture.
— Collaborative and supportive teammates valuing high standards and empathy.
— Opportunity to grow with an organization building meaningful infusion care.
Additional Information:
— Salary range: $100,000 to $110,000 USD per year.
— Physical demands include occasional standing, walking, sitting, use of hands, reaching, climbing stairs, balancing, stooping, kneeling, crouching, crawling, talking, and hearing.
— May occasionally lift/move up to 25 pounds.
— Specific vision abilities required.
— Employees must participate annually in legal and ethical compliance training and adhere to company policies.
— LUX Infusion is an Equal Opportunity Employer.
— Reasonable accommodations available for individuals with disabilities.
To apply: https://weworkremotely.com/remote-jobs/lux-infusion-director-of-referral-services
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