Lahey Health Referral Management Registered Nurse in Wakefield, Massachusetts
Welcome to the Beth Israel Lahey Health Performance Network (BILHPN). BILHPN is a clinically integrated network of physicians, clinicians, and hospitals committed to providing high-quality, cost-effective care to the patients and communities they serve, while effectively managing medical expense. Leveraging best practices in population health management and data analytics, BILHPN improves care quality and patient health outcomes across Beth Israel Lahey Health through population health initiatives. BILHPN brings together the expertise of more than 4,500 providers across Eastern Massachusetts who share a common goal to achieve success in a value-based delivery system.
About the Job
The BILH system is a creating a referral program to facilitate coordinated in network care. BILH has a broad spectrum of high quality specialty care. Keeping care within the BILH system will contribute to better care coordination and communication for the patient and providers.
Referrals for the BIDMC and LHMC practices are managed through a centralized call center. Referral specialists intake referral information and process referrals as appropriate. Attempts to redirect out of network requests are done within the referral team, but at times, clinical input is needed to help facilitate understanding and or access appropriate appointment availability within the network. This role is expected to support the referral specialists in promoting in network care.
Provide clinical support to the referral coordinators in efforts to redirect clinically appropriate referrals to the BILH network.
Typical turn around of less than 2 hours response to the referral team/patient in a standard work day.
Review relevant clinical information in patient records in facilitating referral recommendations.
Maintain strong collaborative relationships with primary care and specialty providers.
Facilitate access/scheduling of urgent in network speciality care.
Contact with patients and providers to assist with education about updated referral policies.
Documentation of interactions with patients and providers as needed.
Coordinate with the referral team in tracking program metrics as appropriate.
Communicate access challenges or patient concerns to the medical director as appropriate.
Collaborate with leaders in program evaluation and improvement initiatives.
Attend monthly onsite meetings and as needed with the referral team.
Valid and current Mass RN License
Prior experience with referrals. Ability to work collaboratively with providers and patients
Full time, 40 hours per week
Beth Israel Lahey Health is an integrated system providing patients with better care wherever they are. Care informed by world-class research and education. We are doctors and nurses, technicians and social workers, innovators and educators, and so many others. All with a shared vision for what healthcare can and should be. We are committed to attracting, developing and retaining top talent. We strive to create a diverse and inclusive workplace that reflects the communities in which we work and serve. With a team approach to care, we encourage learning and growth at all levels and offer competitive salaries and benefits.
Equal Opportunity Employer/Minorities/Females/Disabled/Veterans.
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