Care Management (Referrals Specialist)
NTT DATA North America
**Referrals Coordinator**
**Location: Hybrid-** **Phoenix, AZ**
**Pay Rate: $18.30 per hour**
**Start Date: 6/23/2025**
**Shift: M-F 8:00-5:00 pm**
**Employment Type: Long Term Contract /Not a Direct Hire**
**********Remote with possibility of future onsite-Local Candidates to Phoenix only *********
+ Support comprehensive coordination of medical services including member transitions, screening and supporting the implementation of referrals to promote effective utilization of healthcare services.
+ Promotes/supports quality effectiveness of Healthcare Services.
+ Create authorizations in QNXT to support continuity of care for member.
+ Screens incoming forms using targeted intervention business rules and processes to identify needed medical services, make appropriate referrals to medical services staff and coordinate the required services in accordance with the benefit plan.
+ Coordinates and arranges for health care service delivery under the direction of nurse or medical director in the most appropriate setting at the most appropriate expense by identifying opportunities for the patient to utilize participating providers and services.
Experience:
+ Call center experience/strong customer service skills
+ Referrals, Prior Authorizations experience
+ Strong problem-solving and analytical skills
+ Possess strong computer navigation skills
+ Works well in a team environment
+ Must have basic medical terminology experience
Education:
High school diploma or GED required
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