Business Development Referral Management Lead na ELKO COMMUNITY HEALTH CENTER LLC

Description

Convergence Health is seeking a full-time Business Development and Referral Management Lead to join our team in Elko, Nevada. We are looking for a dynamic and energetic individual who will make a significant impact on patient care and access to multi-specialty services. 

About Us:

At Convergence Health, we are proud to operate a State-Of-The-Art surgical facility equipped with the latest in medical technology. Our 30,000 square foot 3 OR, 2 Procedure room facility is co-located on a health campus with medical offices, an infusion center, imaging, among other services. Our commitment to excellence in patient care is matched only by our dedication to fostering physician satisfaction and building great healthcare teams. Here, you’ll have the opportunity to shape clinical practices and influence the future of surgical care in our Community.

Position Overview:
Convergence Health is seeking a dynamic and motivated individual to serve as our Business Development and Referral Management Lead. This unique role combines patient-focused referral management with strategic business development, ensuring timely and efficient care transitions while expanding Convergence Health’s presence in the community. The ideal candidate will cultivate strong relationships with providers, community partners, and patients, while driving organizational growth through partnerships, outreach, and stakeholder engagement.

Key Responsibilities:

Business Development

· Develop and maintain relationships with community members, healthcare providers, payers, local employers, and government entities.

· Design and implement strategic business development plans aligned with Convergence Health’s goals.

· Conduct market research and stay informed on industry trends and competitor activities.

· Promote new providers, services, and product lines to the community.

· Prepare and deliver presentations to potential partners and clients.

· Lead contract negotiations and stakeholder engagement initiatives.

· Collaborate with internal teams, including marketing, to develop campaigns and outreach materials.

· Monitor, report, and analyze business development activities and outcomes.

· Represent Convergence Health at industry conferences, events, and community meetings.

Referral Management:

· Set up the referral department to ensure efficient referral management and tracking

· Oversee the daily operations of the referral center, maintaining provider relations, troubleshooting issues related to specialty/diagnostic providers. 

· Monitor productivity, generate reports, coordinate schedules, and conduct follow-up on customer service calls.

· Create, setup and maintain accurate referral logs and documentation to ensure timely response to referral partners as well as patient access

· Work with front office staff to review and process patient referrals in the clinic’s EHR system, ensuring completeness, accuracy, and compliance with insurance requirements.

· Develop prior authorizations and pre-certifications process that meets Payors’ criteria

· Track referral status and follow up with patients, providers, and specialists to ensure timely scheduling and care transitions.

· Create appropriate communication process which contains referral details, appointment instructions, and insurance information to patients.

· Key point of contact for patients and providers regarding referral and drive to resolution any inquiries or issues.

· Support clinic staff and providers to ensure continuity of care and closed-loop communication.

· Create workflows and processes that ensure compliance with HIPAA and organizational privacy standards.

· Collaborate with billing staff to minimize claim denials related to referrals and authorizations.

Requirements

· Education: High school diploma required; bachelor’s degree in business, Healthcare Administration, or related field preferred.

· Experience:

o 1–2 years in referral management and coordination, medical office operations, or healthcare administration.

o 3–5 years in business development, relationship management, or sales (healthcare experience preferred).

· Skills:

o Strong organizational, time management, and multi-tasking abilities.

o Excellent verbal and written communication skills.

o Knowledge of medical terminology, referral processes, insurance guidelines, and healthcare market trends.

o Experience with EHR/EMR systems, CRM software, and Microsoft Office Suite.

o Strong presentation, negotiation, and analytical skills.

o Ability to work independently and collaboratively in a fast-paced environment.

· Other:

o Ability to travel locally as needed.

o Highly motivated, results-oriented, and adaptable.

o Knowledge of HIPAA regulations and industry compliance requirements.

Working Conditions:

· Ability to travel as needed to Provider offices and Community events 

· Ability to walk or stand for long periods while working in the field 

· Standard medical office environment with frequent patient, provider, and external stakeholder interaction.

· Extended periods of sitting, computer use, and phone communication.