MINIMUM QUALIFICATIONS:
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1. Bachelor’s degree in Healthcare Management, Public Health, or other related field.
OR
2. Associate’s degree in Healthcare Management, Public Health or other related field AND two (2) years of experience directly related to the duties and responsibilities specified.
OR
3. High school diploma or equivalent AND four (4) years of experience directly related to the duties and responsibilities specified.
PREFERRED QUALIFICATIONS:
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
Bachelor’s degree in Healthcare Management or Public Health.
EXPERIENCE:
1. Three (3) years’ experience in the healthcare field.
2. One (1) year of experience in referral management or data analysis preferred.
CORE DUTIES AND RESPONSIBILITIES
The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.
1. Reviews all incoming referrals for appropriateness based on established criteria and program guidelines.
2. Assigns referrals to the appropriate Population Health team member for patient engagement and follow-up.
3. Monitors and manage referral queues to ensure timely processing and minimize delays in patient care.
4. Utilizes EMR and payer reports via payer portal and email to passively identify patients who meet program criteria for Population Health services.
5. Maintains accurate documentation of referral status, patient eligibility, and assignment actions within the EMR.
6. Communicates with providers, care teams, and administrative staff to clarify referral details and resolve discrepancies.
7. Tracks referral trends and escalates issues related to referral volume, appropriateness, or workflow bottlenecks.
8. Collaborates with Population Health leadership to refine referral processes and improve efficiency.
9. Educates internal staff on referral procedures and program eligibility criteria as needed.
10. Ensures compliance with organizational policies, payer requirements, and regulatory standards related to referral management.
PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. Ability to sit for extended periods of time.
WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. Standard office/clinical environment.
SKILLS AND ABILITIES:
1. Strong organizational and time management skills with attention to detail.
2. Excellent interpersonal communication skills for interactions with providers, staff, and patients.
3. Ability to analyze data and identify patterns for patient eligibility.
4. Proficient in Microsoft Office and EMR systems.
5. Ability to work independently and collaboratively within a team environment.
Additional Job Description:
Scheduled Weekly Hours:
40Shift:
Exempt/Non-Exempt:
United States of America (Non-Exempt)Company:
SYSTEM West Virginia University Health SystemCost Center:
415 SYSTEM Population Health ManagementCopyright © 2026 Grabjobs Pte.Ltd. All Rights Reserved.