Associate Director – Referral Services

This is a fully remote position, open to applicants in Nevada.

📋 Description

• Oversee and manage the front-end referral process, which includes benefit verification and prior authorization procedures.

• Assist in the daily operations of the referral management department across neurology, immunology, transplant, and specialty infusion domains.

• Establish metrics and objectives for team members in referral management, focusing on referral pull-through, documentation, benefit verification, and prior authorization processing.

• Cultivate and promote the department's workplace culture.

• Create onboarding training protocols and assess performance against established metrics and goals.

• Identify corrective actions or training strategies for performance enhancement.

• Develop communication methods to collect any missing or incorrect information from both internal and external stakeholders.

• Collaborate with Intake Coordination, Nursing Services, Pharmacy Services, referral operations, and pharmacy operations leadership.

• Assist with accreditation-related processes and data gathering.

• Evaluate departmental alignment with service-level agreements, detect trends, and implement corrective actions.

• Facilitate staffing and resource adjustments in response to referral volumes and organizational growth.

• Relay leadership updates that impact personnel, processes, and technology.

• Act as an escalation point for managing and resolving issues.

• Prioritize tasks and allocate responsibilities to staff members.

• Oversee productivity evaluations, job descriptions, performance assessments, disciplinary actions, corrective measures, and personnel documentation.

• Occasionally travel overnight by car or plane.

⛳️ Requirements

• 5-7 years of experience in managing patient referral and prescription processes in infusion or specialty therapies.

• 3-5 years of experience in general infusion or specialty therapy reimbursement or payer relations.

• 3-5 years of experience in supporting communications related to referrals or prescription services for prescribers, healthcare settings, patients, and field teams.

• 1-3 years of successful management or leadership experience with departmental staff.

• High School Diploma or equivalent qualification.

• Proficient computer skills, including expertise in Microsoft Office.

• Understanding of financial information and reporting.

• Willingness to travel up to 5% for business purposes.

• Preferred experience in overseeing pharmacy intake or referral process activities.

• Preferred knowledge of infusion therapies and patient qualification processes.

• Preferred familiarity with payer contracts for infused therapies.

• Strong understanding of specialty prescription and referral documentation workflows.

• Working knowledge of medical and pharmacy terminology.

• Knowledge of intake requirements for Medicare, Medicaid, Medicare D, commercial, and pharmacy plans.

• Ability to maintain precise records and produce reports and correspondence.

• Ability to organize and coordinate the work of others.

• Ability to prioritize tasks and delegate responsibilities.

• Knowledge of process improvement methodologies.

• Computer proficiency, including Excel, Word, Access Database, and other Microsoft business applications.

• Understanding of CPR+ systems.

• Ability to engage in required annual legal and ethical compliance training.

• Commitment to adhering to LUX Infusion's legal, ethical, and compliance standards.

🏝️ Benefits

• Purpose-driven leadership role that has a real impact on patients.

• A patient-first, clinician-led organizational culture.

• Supportive and collaborative team environment.

• Opportunity for growth within an organization dedicated to building something meaningful.

• Reasonable accommodations during the application or interview process.

• Overtime eligibility or exemption specified for scheduling purposes.