Director of Referral Services

Job not on LinkedIn

🔥 3 minutes ago

🇺🇸 United States – Remote

💵 $100k - $110k / year

⏰ Full Time

🔴 Lead

👔 Director

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LUX Infusion

WebsiteLinkedInAll Job Openings

2 - 10 employees

Founded 2022

🏥 Healthcare

💊 Pharmaceuticals

Healthcare • Pharmaceuticals

LUX Infusion is a U. S. -based clinical services company that provides infusion therapy and specialty pharmacy solutions. It operates comfort-focused infusion locations and a nationwide at-home infusion nursing program, delivering therapies for conditions such as immune deficiencies (immunoglobulin), autoimmune/inflammatory diseases (biologics and biosimilars), transplant immunosuppression, and bleeding disorders. The company manages insurance navigation and prior authorizations, offers 340B and HUB services for manufacturers and payors, accepts commercial, Medicare, and Medicaid plans, and holds URAC-accredited locations in multiple states.

📋 Description

• Oversee and manage the front-end referral process, including benefit verification and prior authorization for neurology, immunology, transplant, and specialty infusion areas • Support day-to-day Benefit Verification and Prior Authorization department activities • Set metrics and goals for Referral Management team members covering referral pull-through, documentation management, benefit verification, and prior authorization processing • Establish training protocols and evaluate performance against metrics and goals • Develop corrective action or training plans when needed • Establish communication procedures for gathering missing or inaccurate information from internal and external stakeholders • Collaborate with Intake Coordination, Nursing Services, Pharmacy Services, referral operations, and pharmacy operations leadership • Support accreditation-related processes and data collection • Review department alignment with service-level agreements, identify trends, and take corrective action • Support staffing and resource adjustments for referral volumes and organizational growth • Communicate leadership updates affecting people, processes, and technology • Serve as an escalation point for issue management and resolution • Triage work and assign duties to staff • Perform employee management tasks, including productivity reviews, job description management, performance reviews, disciplinary processes, corrective action, and personnel paperwork

🎯 Requirements

• 5-7 years of experience managing patient referral and prescription activities in infusion or specialty therapies • 3-5 years of general infusion or specialty therapy reimbursement or payer experience • 3-5 years of experience supporting prescriber, healthcare setting, patient, and field-facing communications related to referral or prescription services • 1-3 years of successful management/leadership of department employees • Strong customer service skills • High School Diploma or equivalent • Advanced computer and internet skills, including Microsoft Office • Knowledge of financial information and reporting • Willingness to travel up to 5% for business purposes • 1-3 years of people management experience overseeing pharmacy intake or referral process activities preferred • Strong knowledge of infusion therapies and patient qualification steps preferred • Knowledge of payer contracts for infused therapies preferred • Knowledge of specialty prescription and referral documentation workflows • Working knowledge of medical/pharmacy terminology • Knowledge of intake requirements for Medicare, Medicaid, Medicare D, commercial, and pharmacy plans • Ability to communicate, inspire, and motivate staff • Strategic and proactive thinking • Ability to maintain accurate records and prepare reports and correspondence • Ability to organize and coordinate others' work • Ability to set priorities and assign work • Ability to identify process improvements and enact change • Excellent verbal, written, and communication skills • Excellent group presentation skills • Computer skills • CPR+ knowledge • Microsoft Excel, Word, and Access Database • Ability to work overtime and travel overnight occasionally by car and plane

🏖️ Benefits

• Purpose-driven leadership work with real patient impact • Patient-first, clinician-led culture • Collaborative, supportive teammates • Opportunity to grow with an organization building something meaningful • Reasonable accommodations during the application or interview process

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