Referral Coordinator/HIMS - PIPC

Welcome to Humana, a leading healthcare company dedicated to improving the health and well-being of our members. We are currently seeking a Referral Coordinator/HIMS for our Primary Integrated Care Program (PIPC). In this role, you will be responsible for coordinating and managing the referral process for our PIPC program, while also handling Health Information Management Services (HIMS) tasks. We are looking for a detail-oriented and organized individual who is passionate about helping our members receive the best possible care. If you have experience in healthcare coordination and a strong understanding of HIMS processes, we encourage you to apply for this exciting opportunity to make a difference in the lives of our members.

1. Coordinate and manage the referral process for the Primary Integrated Care Program (PIPC), ensuring timely and accurate completion of all referrals.
2. Work closely with healthcare providers, members, and internal teams to facilitate effective communication and ensure seamless coordination of care.
3. Maintain a thorough understanding of the PIPC program and its requirements to accurately assess and prioritize referrals.
4. Conduct thorough reviews of referrals to ensure compliance with program guidelines and regulations.
5. Collaborate with the HIMS team to manage and process health information requests and maintain accurate and up-to-date member records.
6. Provide exceptional customer service to both internal and external stakeholders, addressing inquiries and concerns in a timely and professional manner.
7. Utilize electronic health record systems and other technology to manage and track referrals, maintain records, and generate reports.
8. Monitor and track referral data to identify trends, identify areas for improvement, and make recommendations for process enhancement.
9. Adhere to all company policies, procedures, and regulatory requirements related to referral management and HIMS.
10. Continuously develop and maintain knowledge of industry trends, best practices, and regulatory changes related to referral coordination and HIMS.
11. Participate in team meetings and training sessions to maintain a strong understanding of company initiatives and goals.
12. Maintain confidentiality and adhere to HIPAA regulations when handling sensitive member information.
13. Collaborate with cross-functional teams to ensure a seamless and efficient workflow for referral management and HIMS processes.
14. Perform other duties as assigned by the supervisor to support the overall success of the PIPC program and the company.

According to JobzMall, the average salary range for a Referral Coordinator/HIMS - PIPC in Houston, TX, USA is between $40,000-$55,000 per year. This may vary depending on the specific company, years of experience, and level of education.

Humana Inc. is a for-profit American health insurance company based in Louisville, Kentucky. Its strategy integrates care delivery, the member experience, and clinical and consumer insights to encourage engagement, behavior change, proactive clinical outreach and wellness for the millions of people they serve across the country. The company operates its business through the following segments: Retail, Group, and Healthcare Services.