Implementation Specialist - Referral Management

About Us: Carefeed helps senior living and long-term care organizations simplify operations, improve communication, and give staff more time to focus on care. We partner with clients to turn complex processes into practical, connected workflows that support their teams and the people they serve. About the Opportunity: Carefeed is seeking a Clinical Implementation Specialist – Referral Management with extensive experience in skilled nursing or short-term rehabilitation, particularly in central intake, prior authorization, and concurrent review. This client-facing role bridges real-world clinical and operational expertise with technology implementation. You will help clients evaluate their existing processes, implement Carefeed’s Referral Management module, train their teams, and establish consistent workflows that support successful adoption. The ideal candidate has personally managed referrals and payer coordination, understands the relationship between admissions, clinical documentation, MDS, and reimbursement, and can confidently teach others. You are comfortable leading conversations with both frontline staff and organizational leaders—and translating complex requirements into clear, actionable steps. This position focuses on technology implementation, client education, and workflow improvement rather than direct patient care or payer coverage decisions. Key Responsibilities: Lead client discovery and workflow planning. Assess how clients manage central intake, referral review, insurance verification, prior authorization, admission coordination, and concurrent or continued-stay reviews. Identify gaps, clarify ownership, and establish an implementation plan aligned with their operational needs. Translate operational needs into effective module use. Guide configuration and workflow development within Carefeed’s supported capabilities. Clearly define which activities occur in Carefeed, which remain in an electronic health record or payer portal, and how teams coordinate the handoffs. Deliver practical, role-based training. Lead engaging sessions for central intake, admissions, nursing, MDS, therapy, business office, and corporate teams. Explain not only how to use the module, but how it fits into each team’s responsibilities and daily work. Manage implementation through go-live and transition. Coordinate milestones, track outstanding decisions and action items, address barriers, and confirm client readiness. Support early adoption and provide a structured handoff to ongoing Client Experience and Support teams. Serve as an internal subject matter expert. Help colleagues understand skilled nursing referral, authorization, clinical documentation, and managed care workflows. Share practical guidance that strengthens the team’s ability to support clients. Build repeatable implementation resources. Develop training materials, workflow guides, readiness checklists, and standard operating procedures that support consistent delivery across single-community and multi-community organizations. Partner across teams to improve the client experience. Collaborate with Product, Client Experience, and Support to troubleshoot workflow challenges, communicate client feedback, and identify opportunities for improvement. Set clear expectations about current functionality and elevate needs appropriately. Required Qualifications: Five or more years of experience in skilled nursing, short-term rehabilitation, or closely related post-acute care operations, with substantial hands‑on responsibility for central intake, prior authorization, and concurrent or continued‑stay review. Demonstrated experience coordinating referrals, reviewing documentation for completeness, verifying insurance and benefits, communicating with payers, tracking authorization requirements, and managing time-sensitive follow-up. Strong working knowledge of clinical documentation, medical necessity, managed care processes, and the relationship between MDS assessments, the Patient‑Driven Payment Model (PDPM), and clinical reimbursement. Experience collaborating with hospital discharge planners, payer case managers, admissions staff, nursing, therapy, MDS, and business office teams. Strong communication, facilitation, and organizational skills, including the ability to train others, document workflows, manage competing priorities, and guide teams through process changes. Comfort learning new technology and helping others use it effectively, with sound judgment when handling confidential resident and client information. Preferred Qualifications: Registered Nurse (RN) background and/or RAC‑CT certification. Multi‑community, regional, or centralized intake experience within a skilled nursing organization. Experience with PointClickCare, MatrixCare, referral management platforms, and payer portals. Experience leading staff education, process improvement, system implementation, or software adoption. Relevant Backgrounds May Include: Central Intake Manager or Nurse, SNF Managed Care Coordinator, SNF Case Manager, Utilization Review Nurse, Clinical Reimbursement Specialist, or MDS Coordinator with direct intake and payer‑review experience. MDS experience is valuable but does not replace the need for hands‑on authorization and concurrent‑review expertise. What Success Looks Like: Clients launch with clearly defined workflows, trained staff, and confidence in how to use Carefeed. Implementation milestones are met, barriers are surfaced early, and handoffs are well coordinated. Your expertise contributes to stronger module adoption, a more consistent client experience, and practical feedback that helps shape future improvements. What You’ll Love: Join a fast‑growing startup making a real impact in the lives of senior care providers and their communities Comprehensive medical, dental, and vision insurance to support your health and well-being 401(k) plan to help you plan for the future Paid vacation, sick time, and company‑paid holidays to support work‑life balance A culture that values growth and development, with opportunities to grow your career as we scale Work Location: Full Remote based in the USA Carefeed provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. #J-18808-Ljbffr Cintrifuse