You'll use your clinical nursing experience to coordinate specialty care referrals that help military beneficiaries access timely, appropriate healthcare services. Working within a Referral Management Center (RMC), you'll review referrals, educate patients, collaborate with providers, and help ensure referrals move efficiently from initiation through completion while supporting continuity of care.Schedule: Full-Time | Monday-Friday | Days (7:30 AM-4:30 PM) | Federal Holidays & Scheduled Down Days OffKey ResponsibilitiesReview, coordinate, and manage specialty care referrals from initiation through completion while ensuring compliance with TRICARE requirements, referral management business rules, and established timeliness standards.Assess referral completeness, verify patient eligibility and demographic information, coordinate with referring providers when additional clinical information is needed, and schedule specialty appointments within established access-to-care guidelines.Educate patients regarding referral processes, specialty appointments, required testing, procedures, and pre-appointment instructions while serving as a clinical resource for referral-related questions.Collaborate with providers, case managers, utilization management staff, specialty clinics, and network partners to facilitate appropriate referrals, resolve referral issues, and support continuity of care.Monitor referral activity, obtain and process specialty care documentation, maintain accurate referral records, generate referral-related reports, and help ensure referral documentation is returned to the patient's medical record within established timelines.Perform first-level clinical reviews of specialty referrals, identify patients who may benefit from additional care coordination, participate in quality improvement activities, and contribute to ongoing Referral Management Center operations.
