Job description

Job Description:

Baptist Health Medical Group is looking for a Network Referral Optimization Manager to join our Operations team. This is a remote opportunity that must reside in KY or IN.

This role will focus on identifying, analyzing, and mitigating instances where patients are referred outside of Baptist’s network. They will oversee the referral management and governance structure quickly addressing potential leakage issues and provide solutions to achieve leakage goals. To achieve these goals, the person in this role will serve as the subject matter expert (SME) on referral workflows, guidelines and structure.

They will provide best practice recommendations based on analysis of potential referral leakage within the BHMG physician network, hospital systems, and outpatient service areas. Collaborative efforts for these recommendations will include relationships with not only BHMG physicians and practices but will also include operational leaders across the Baptist Health system, Patient Connection Hub (PCH), technology teams, metric teams, and training teams.

Essential Duties:

Perform data analysis for key specialty areas or service lines using a comprehensive study of diagnosis codes, leakage reason codes, and referral patterns.
Review current reporting methodologies around ED and diagnostic referrals and develop processing for reviewing, reporting, and action planning to drive leakage reduction and intersystem utilization of services.
Focus on projects that analyze both access and scheduling challenges, as well as referral delays in key specialty or priority areas highlighting referral barriers and challenges.
Regularly reporting referral leakage data to leadership, highlighting areas of concern and proposing actionable solutions.
Promote awareness and adoption of a cross-market approach to referral scheduling.
Expand and improve current digital referral workflows to offer patients greater control, choice, and flexibility.
Works with the Nurse Transfer Center to partner on review of challenges or barriers preventing transfer completion within the Baptist Health Network.
Work closely with the Data Analytics support team to develop and refine data pathways.
Manage the bi-annual affiliation and monthly Null/Not Leveled review process, serving as a liaison between the Epic team and referral market representatives.
Organize the distribution of market-specific affiliation lists to market representatives and practice management.

Qualifications:

Bachelor’s degree in Healthcare or Business; Master’s degree in a related field preferred
4+ years in a leadership role within medical practice operations with experience working directly with Senior Leadership
Knowledge of ambulatory scheduling workflows and/or referral processes preferred
Project Management Professional (PMP), Lean Six Sigma accreditation, Green/Black Belt preferred
Epic experience preferred