Head of Referral Management

ABC Home Medical Supply, Inc is one of the nation’s leading urological supply providers and serves as a one-stop shop with a comprehensive line of medical supplies and service that includes: Urological, Incontinence, Wound Care, and Ostomy.  ABC Medical is part of the JDS, Inc family of businesses.  Our service companies possess the knowledge and expertise to deliver first-class products and personalized home healthcare services.
 

Location: Nashville 
Department:  

Head of Referral Management

Summary: The Head of Referral Management provides leadership and manages the Referral Management department’s daily operations and provides strategic direction to the function in support of achieving overall business objectives.  Develops, leads, guides, motivates, and evaluates Referral Management team while implementing department and organizational policies and plans.

Responsibilities:

• Provides leadership, organization, and coordination of all Referral Management functions, including but not limited to all insurance and document verification activities, reporting, metric collection, communicating of payer rules, and streamlining processes where applicable.
• Continuous achievement of departmental Service Level Agreements (SLA’s)
• Ensures continuous improvements in Referral Management processes and procedures.
• Conducts analysis of Referral Management’s key performance indicators and provides trends and suggestions as part of ABC Medical’s Senior Management Team.
• Provides Referral Management department with direction based on analysis of reporting and in cort with departmental and organizational objectives
• Ensures strong processes are in place for collecting and examining all necessary documents to verify required compliance, completeness, and accuracy of data.
• Proactively monitors payer coverage rules to identify areas of risk that could lead to non-compliance and/or to bad debt.
• Leads direct reports though coaching, mentoring, direction, guidance, and motivation for their success and for them to effectively lead their respective direct reports.  Currently has three direct reports and a full department of forty.
• Develops strong relationships and collaborations with Referral sources and internal teams (e.g. Sales, New Customer Enrollment, Revenue Cycle Management, Contracts).
• Adheres to all company and departmental policies and procedures.
• Other duties as assigned

Work Experience Requirements

• Number of Overall Years Necessary: 8-12

• Indicate the type of work experence needed (ie..specific product line, industry or process)

• • Durable Medical Equipment (DME) experience strongly preferred
  • Advanced understanding of government and commercial payer requirements

Education Requirements

• • Bachelor degree or equivalent experience
  • Proven leadership experience 5+ years 

Specialized Skills/Technical Knowledge:

• • Brightree experience strongly preferred.
  • Strong analytical skills, attention to detail, and organization.
  • Advanced understanding of government and commercial payer requirements
  • Ability to lead organization through change.
  • Ability to delegate and develop others.
  • Strong oral and written communication skills.
  • Ability to work well in a team environment and effectively collaborate with other functions

Job Req ID: 33263