Referral Case Manager

CLASSIFICATION: Hourly, Non-Exempty LOCATION: The Referral Manager is responsible for the overall leadership, operations, and performance of the referral department. This position oversees the Referral Coordinators while ensuring timely, accurate, and efficient coordination of patient referrals, authorizations, and transitions of care.

The Referral Manager collaborates with clinical teams, external providers, and health systems to support patients—particularly those with complex medical, chronic, or psychosocial conditions—while ensuring compliance, quality standards, and continuity of care.

ACCOUNTABLE TO : Managed Care Manager

JOB DUTIES: Responsible for training and procedural guidance of the referral department, which facilitates access to appropriate health services by assisting team members with the coordination of referrals, admissions, discharge and/or transfer of patients to specialty care, including the following:

Provide direct supervision of Referral Coordinators, including hiring, training, coaching, and performance management

Oversee daily operations of the referral department to ensure timely processing, tracking, and completion of referrals

Develop and implement workflows, policies, and procedures to improve department efficiency and effectiveness

Serve as escalation point for complex referral issues, denied authorizations, and patient concerns

Ensure coordination of referrals, admissions, discharges, and transitions to specialty care, hospitals, rehabilitation, and other facilities

Monitor referral lifecycle including eligibility, authorizations, scheduling, and follow-up

Ensure patients with complex medical or psychosocial needs receive appropriate case management services

Maintain effective communication between patients, providers, and external partners across the continuum of care

Ensure department compliance with HIPAA and all regulatory requirements in handling protected health information

Monitor referral tracking systems and ensure accurate data entry, reporting, and documentation

Develop and analyze referral metrics (e.g., turnaround times, completion rates, denial rates) to improve performance

Conduct audits to ensure quality, accuracy, and completeness of referral activities

Partner with providers, behavioral health staff, case managers, and external facilities to coordinate patient care

Maintain ongoing communication with hospitals, discharge planners, and community providers

Act as liaison between clinical teams and referral staff to ensure seamless care coordination

Promote culturally sensitive, patient-centered care for underserved populations

Strong knowledge of healthcare systems including Medi-Cal, Medicare, managed care plans, and IPAs.

Leadership and team management skills with the ability to motivate and develop staff.

Ability to manage multiple priorities in a fast-paced environment.

Knowledge of medical terminology and referral processes.

Proficiency with EMR systems and Microsoft Office applications.

High School diploma or GED required.

Bachelor’s degree in healthcare administration, nursing, or related field preferred.

Minimum of 3–5 years of referral coordination or case management experience.

Bilingual in English/Spanish preferred.

Fast-paced clinical/office environment with frequent interaction with patients and healthcare professionals.

Prolonged sitting and computer use.

Central City Community Health Center offer a dynamic work environment with competitive salaries and benefits. Central City Community Health Center provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Central City complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities.