Internal Referral Specialist

Job Title:  Internal Referral Specialist

Reports To: CHIC Supervisor 

Status/Hours: Non Exempt

  1. Referrals Policy and Procedure

PURPOSE

To establish guidelines for processing internal referrals within the La Maestra Community Health Centers.

DEFINITION

Internal referrals are referrals made to departments within La Maestra Community Health Centers, i.e. OB-GYN to Mental Health, Women’s Health to Family Practice, Optometry and Imaging services as well.

POLICY

It is the policy of the La Maestra Community Health Centers to provide guidelines, known to all clinic employees, for internal referrals done within the La Maestra Community Health Centers.

PROCEDURE

  1. INTERNAL REFERRALS
  1. The Primary Care Physician will initiate the referral by documenting within NextGen electronic health records (EHR).
  1. Verbal orders will not be accepted as an official referral.
  2. The Care Team Specialist will schedule the appointment with the appropriate department.
  3. The appropriate department will follow up with the patients once appointment has been made.
  4. The Internal Referral Specialists will close the loop of the referral:
  5. Will verify if appointment was kept.
  6. If appointment is kept, the referral specialist will verify that proper documentation is sent to the referring provider via the Provider Approval Queue [PAQ].
  7. For dental, the referral will be considered closed once the patient attends their appointment.
  1. If appointment is not kept:
  2. Two reminder phone calls will be made to the patient to remind and reschedule the patient if needed. A telephone template must be used by the internal referral specialist to document attempts made.
  3. If unable to reach the patient a 3rd attempt will be made by sending them a letter from the document library in NextGen.
  4. If patient refuses to keep the appointment, a referral alert will be sent to the referring provider. The internal referral specialist will document that patient refused and close the loop on NextGen and i2i.
  1. REPORTING AND FOLLOW UP
  2. The internal referral specialist will run daily referral reports of all referral ordered and follow up pending referrals.

 

  1. Internal Referral Specialist Job Description

Summary

 

The Internal Referral Specialist is responsible for providing comprehensive case management for patients. Receives referral reports from physicians and medical assistants, calls and responds to patients’ needs in person or by telephone.

Responsibilities

 

  • Responsible for assessment, case plan development and advocacy.
  • Interviews patients to ascertain nature of referral visit. Records information on standard forms and logs.
  • Communicates with physicians or department /site which the patient is being referred from medical care. Routes form to appropriate physician or office for action.
  • Compiles referrals for records, by category, department office, and disposition.
  • Notifies supervisors of patterns of poor provision of service.
  • Maintains up to date reference materials and files.
  • Communicates with patients to make appointments.
  • Meet minimum requirement of 20 referrals per day.
  • Maintain effective communication and working relationships with other employees and patients.
  • Attend staff meetings.
  • Performs other duties as assigned.

 

 

Patient Centered Medical Home Essential Responsibilities (Principals)

  • Collaborate with individual patients, their personal physicians, and when appropriate the patient’s family to ensure accessible, comprehensive, compassionate, and culturally competent care
  • Facilitate care by registries, information technology, health information exchange and other means to assure that patients get the indicated care when and where they need and want it in a culturally and linguistically appropriate manner.
  • Ensure all decisions respect patients’ wants, needs, and preferences and that patients have the education and support they require to make decisions and participate in their own care.
  • Continually strive to attend to each patients “whole person,” in the context of the patient’s personal and medical history and life circumstances, rather than focusing on a particular disease, organ, or system

 

Job Requirements

 

Education:  High School Diploma or GED

Certification Preferred:  Medical Assistant Certificate.

 

Experience: 1-2 years’ experience in physician office or hospital setting as a medical assistant, patient services representative, or similar experience.

 

Verbal and Written Skills to perform the job:  Bilingual (English/Spanish). Familiarity with basic word processing, spreadsheet, and database applications.  Accurate keyboarding skills.

Technical knowledge and skills required to perform the job:  Excellent verbal, written and interpersonal communication skills and the demonstrated ability to work with diverse individuals and groups.  Demonstrate high levels of self-initiation and direction. Knowledge of communities we serve. Knowledge and experience working in medical settings and interacting collaboratively with medical teams.  Skill in analyzing situations and making timely decisions.

 

Physical and Mental Requirements:  Work involves sitting, talking, hearing, using hands to handle, feel or operate objects, tools, or controls, and reaching with hands and arms. The employee may be required to push, pull, lift, and/or carry up to 20 pounds. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Interested Applicants please submit Cover Letter and resume to:
Human Resources Department
Email: employment@lamaestra.org | Fax: 619-269-1291

La Maestra Community Health Centers is an equal opportunity employer and does not
discriminate on the basis of race, religion, color, sex, national origin, age, sexual orientation, gender, disability or any other legally protected status.

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