Managed Care Referral Specialist I (PDS)

Impact Lives, Impact Community

Family Health Centers of San Diego (FHCSD) is passionate about providing exceptional health care to all, especially underserved communities with limited health care options. Founded by a Latina grandmother / community advocate over 50 years ago in Barrio Logan, FHCSD has grown into one of the largest community health systems in the country. With over 90 sites , over 227,000 patients, and over 1.1 million healthcare visits last year, we provide a wide variety of health care and outreach services to a very diverse patient population. We are proud of our mission, our lasting community impact, and the cultural and individual diversity of our staff.

Responsibilities :

• Completes all required documentation accurately, in a timely manner, and thoroughly in accordance with department standards; in addition, documentation complies with patients' insurance requirements.
• Meets daily referral modification productivity standards for Referral Specialists, adhering to referral processes and guidelines.
• Per referral guidelines, provide appropriate clinical information to specialist.
• Performs other duties as assigned.
• Prepares and processes all referral and pre-authorization paperwork, including gatherings pertinent information as needed via EHR, from incoming phone / email / fax messages, or from clinical team. Contacts various clinics, facilities, and companies to obtain information to accurately complete referral / pre-authorization requests.

Requirements :

Traveling between sites and other locations is occasionally required. Must have a valid California driver's license, an automobile, and proof of minimum levels of car insurance as required under California law, although limits of $100,000 are recommended. An acceptable driving record is also required. California law requires all drivers to obtain a valid California driver's license within ten days of establishing residency. Reasonable accommodation may be provided on a case-by-case basis. Mileage and other reimbursement governed by policy.

Rewards :

The successful candidate will have a demonstrated commitment to community medicine and providing culturally competent care to the medically underserved.

In the spirit of pay transparency, we are excited to share the base range for this position, exclusive of fringe benefits.

$23.00 - $27.46

If you are hired at Family Health Centers of San Diego, your final base salary compensation will be determined based on factors such as geographic location, jurisdictional requirements, skills, education, and / or experience. In addition to these factors - we believe in the importance of pay equity and consider internal equity of our current team members as a part of any final offer. Please keep in mind that the range mentioned above is what we reasonably expect to pay for the role. Hiring at the maximum of the range would not be typical in order to allow for future and continued salary growth. We also offer a generous compensation and benefits package (more information on our benefits offerings is available here : FHCSD Wellness - Employee Hub (gobenefits.net)