HarmonyCares is one of the nation’s largest home-based primary care practices. HarmonyCares is a family of companies all dedicated to providing high-quality, coordinated health care in the home. This includes HarmonyCares, HarmonyCares Medical Group, HarmonyCares Home Health and HarmonyCares Hospice.

Our Mission – To bring personalized, quality-based healthcare to the home of patients who have difficult accessing care.

Our Shared Vision – Every patient deserves access to quality healthcare.

Our Values – The way we care is our legacy. Every interaction counts. Go the extra mile. Empower and support each other.

Why You Should Want to Work with Us

Health, Dental, Vision, Disability & Life Insurance, and much more
401K Retirement Plan (with company match)
Tuition, Professional License and Certification Reimbursement
Paid Time Off, Holidays and Volunteer Time
Paid Orientation and Training
Day Time Hours (no holidays/weekends)
Great Place to Work Certified
Established in 11 states
Largest home-based primary care practice in the US for over 28 years, making a huge impact in healthcare today!

More details about the benefits we offer can be found at https://careers.harmonycares.com/benefits.

Responsibilities

The Referral Specialist, Specialty Programs is responsible for performing activities related to processing case management referrals as well as providing administrative assistance in support of the Complete Health Assessment (CHA) program. Responsibilities will include developing, implementing, and monitoring all case management referral related activities to ensure the CHA program meets all regulatory, compliance, and contractual requirements. This position will be responsible for facilitating communication between clinicians and various health plans in regard to case management referrals. Additional responsibilities will include accurate filing of regulatory documentation as well as supporting operational documentation needs.

Essential Duties and Responsibilities

Promptly report all case management referrals in accordance with the established process per payer
Review documentation, processes, and practices to ensure accuracy, continuity, and completeness
Facilitate communication with various health plans in regard to case management referrals
Manage tracking all referrals by payer, in accordance with payer and HarmonyCares policies and procedures
Responsible for monitoring provider passed scheduled visits and completion rates and effectively facilitate communication to provider for improvement
Will assist clinical team with distribution and collection of regulatory documents, licensing documents, and compliance modules.
Will support clinical-operations team as needed with various projects and tasks
Responsible for aggressively addressing and acting upon adverse events and action thresholds in area of responsibility
Accountable for outstanding customer service to all external and internal customers
Develop and maintain effective relationships through effective and timely communication
Perform routine office tasks necessary for the operation and presentation of the Complete Health Assessment team
Attend all required meetings and in-services
Support to the Clinical and Operations team as needed

In this role you may work with. . .

Clinicians
Clinical Team
Operations Team
Health Plans
Customers
Patients

Qualifications

Required Knowledge, Skills, and Experience

High School Degree
1+ year(s) of healthcare experience
Ability to coordinate complex activities across functional lines of operations, under tight timelines
Must be able to relate professionally and positively to physicians, providers, and staff with excellent communication, interpersonal, and time management skills

Preferred Knowledge, Skills and Experience

Associate’s degree
Proven, positive interactions with medical professionals and experience in scheduling patient appointments

Pay Transparency

Individual compensation packages are based on various factors unique to each candidate, including skill set, experience, qualifications, and other job-related considerations.

Notice

HarmonyCares and HarmonyCares Hospice are not affiliated with Harmony Hospice Care. HarmonyCares Hospice does not conduct business in OH. HarmonyCares Hospice conducts business in MI, VA, WI, TX, IN, IL.