The Specialty Network Referral Consultant:
+ Provides personalized and effective customer service in themanagement of complex referrals for patients requiring high level specialty services.
+ Reviews confidential clinical information and determinesif requested/required services are available within the entire Sutter MedicalNetwork.
+ Works simultaneously with senior leaders, executive level teams and data analysts to develop and maintain strong referral patterns in an ever changing competitive market.
+ Is responsible for creating smooth and efficient referral workflows for externalsources, leveraging evolving technology and interoperability tools such asDIRECT, CareEverywhere and SutterLink.
+ Provides concierge service to our clinicians and patients by working with multidisciplinary teams, providing streamline access and minimizing confusion with a one-stop shop approach.
**Additional information about the position:**
+ Exempt level - High performer required.
+ 70% Referral concierge service
+ 10% Relationship management between referring entities and providers
+ 10% Department development and process improvements
+ 10% Quality and Subject Matter Expert Consultation and training (supporting SutterLink, Direct Secure Messaging and CareEverywhere technology).
+ This role does NOT perform authorizations.
+ Starting annual salary of $57,450 plus a comprehensive benefits package.
**Who is an Ideal Candidate?**
+ High performing driven individual.
+ High level relationship management experience.
+ Experience with public speaking - provide training and/or deliver presentations.
+ Looking for a challenge.
+ Critical thinker, able to "connect the dots".
+ Problem solver, has forethought of potential issues.
+ Has the ability to handle constant interruptions, but stay on task.
+ Has a thorough understanding of disease process, anatomy, and physiology.
To learn more about the Specialty Network Referral Service team:
To learn more about the Sutter Health Network in which you would support:
**MINIMUM POSITION REQUIREMENTS:**
+ Associate's degree or equivalent of 10+ years experience in the field required.
+ Completion of course(s) in Medical Terminology required.
+ Bachelor's degree in the healthcare field preferred.
+ A minimum of 3 years of previous experience in a hospital, physician office or case management setting required.
+ A minimum of 3 years of previous experience in working with database systems and telephone call center required.
+ A minimum of 3 years previous insurance experience required.
**Skills and Knowledge:**
+ Proficient/Advanced knowledge of community resources, Sutter Health resources, third party payers ( i.e., PPO, HMO, and Medicare Risk insurance plans) is required.
+ Working in-depth advanced knowledge of managed care requirements and processes is required.
+ Advanced working knowledge of all state Medicare and Medi-Cal guidelines and process is highly preferred.
+ Advanced knowledge of ICD-10 and CPT Coding preferred.
+ Demonstrate advanced knowledge of insurance authorization process required.
+ Advanced knowledge of patient registration process highly preferred.
+ Intermediate PC proficiency in word processing and database software applications required.
+ Effectively interacts with individuals from all levels of the organization.
+ Intermediate medical and managed care terminology required.
+ Advanced ability to organize and work independently with minimal direction in a fast paced environment required.
+ Advanced proficient understanding of patient flows, processes and advanced medical and technical terminology and practices required.
+ Advanced thorough understanding of disease process, anatomy, and physiology as necessary to assess referral requests and appropriate level/provider of care required.
+ Ability to communicate effectively, oral and written, with individuals possessing varying levels of comprehension required.
**Primary Location:** California, Greater Sacramento Area, Sacramento
**Organization:** Sutter Valley Hospital
**Employee Status:** Regular
**Employee Referral Bonus:** No
**Position Status:** Exempt
**Job Shift:** Variable
**Shift Hours:** 8 Hour Shift
**Days of the Week Scheduled:** Monday-Friday
**Weekend Requirements:** None
**Schedule:** Full Time
**Hrs Per 2wk Pay Period:** 80
All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, marital status, sexual orientation, registered domestic partner status, sex, gender, gender identity or expression, ancestry, national origin (including possession of a driver's license issued to individuals who did not present proof of authorized presence in the U.S.), age, medical condition, physical or mental disability, military or protected veteran status, political affiliation, pregnancy or perceived pregnancy, childbirth, breastfeeding or related medical condition, genetic information or any other characteristic made unlawful by local, state, or federal law, ordinance or regulation. External hires must pass a background check/drug screening. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state, and local laws, including but not limited to the San Francisco Fair Chance Ordinance.
Sutter Health values and supports the unique talents and strengths that each employee brings to our organization. As a result, you are empowered to apply your passion for healing in innovative ways to care for patients and their families.
Collaborating with the best and the brightest means a dynamic, fulfilling work experience for you – and excellent, personalized care for all those we serve.