Job Description

The Registered Nurse (RN) on the Referral Coordination Team (RCT) is responsible for coordinating and clinically reviewing consults and referrals to ensure the delivery of appropriate, timely, and high-quality care. The RN functions as a clinical liaison between patients, internal and external providers, and administrative staff, ensuring the consult and referral process is comprehensive, effective, and aligned with clinical guidelines.

Key Responsibilities:

• Conduct clinical review of consults and referral requests for completeness, appropriateness, and utilization in accordance with established standards and guidelines.
• Determine disposition of care, including whether services should be rendered internally or through community providers, based on utilization criteria.
• Review and document incoming medical records, maintaining communication with ordering providers and primary care teams.
• Coordinate care across multiple entities, including patients, external providers, internal clinicians, and administrative staff to ensure accurate and timely processing of referrals and authorizations.
• Triage specialty consults to assess clinical appropriateness and completeness according to national coordination standards.
• Engage patients via telephone to discuss healthcare options, enabling informed decisions on where and how to receive specialty care when community care eligibility criteria are met.
• Serve as a clinical resource to multidisciplinary teams, including physicians, licensed independent practitioners, social workers, and support staff across multiple regions.
• Assist in the development and revision of consult templates in collaboration with clinical application coordinators.
• Act as a liaison throughout the consult process, supporting both internal clinical staff and community care partners.
• Build and maintain collaborative relationships with specialty care providers and utilize established triage tools to support informed decision-making and care coordination.

Requirements

• Active, unrestricted RN license.
• Clinical experience in care coordination, case management, or referral management preferred.
• Strong knowledge of clinical triage, utilization review, and community care guidelines.
• Excellent communication and interpersonal skills to work collaboratively with diverse healthcare teams and patient populations.
• Proficiency in reviewing and interpreting medical records and consult documentation.

Benefits

Work Type: Contract

Work Duration: 52 weeks

Shift: 07:30 - 17:30 (Monday to Friday)

Rate: $49/hr

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