Referrals & Surgical Scheduling Manager - Ambulatory Medicine

Salary Range: $41.93 - $63.19 / hour

The pay range above represents the lowest possible rate for the position and the highest possible rate. Factors that may be used to determine where newly hired employees will be placed in the pay range include the employee specific skills and qualifications, relevant years of experience and comparison to other employees already in this role. Most often, a newly hired employee will be placed below the midpoint of the range. If you are viewing this posting on a job site, please visit our company page and search for the opportunity to view the pay range: https://careers-mycmh.icims.com/jobs

Pay for PRN positions is calculated differently than Full-Time, Regular Part-Time, and Part-Time positions. PRN Rates depend on the position and other factors, including years of experience, or shift commitment according to the department policy. PRN differential is added in certain positions.

Overview:

The Referrals & Surgical Scheduling Manager is responsible for overseeing all functions related to centralized referrals management and surgery scheduling within the Ambulatory Medicine division. This role ensures the efficient and timely processing of referrals, coordination with health plans, patient communication, and surgical scheduling workflows while maintaining compliance with regulatory and payer requirements.

With Community Memorial Healthcare (CMH) transitioning to Epic as its new EHR, this position requires significant experience in Epic's referral and surgical scheduling tools, including EpicCare Link, Cadence, OR Manager (OpTime), and Care Everywhere. The Manager will lead efforts to implement and optimize Epic workflows for both referrals and surgical scheduling, ensuring staff are fully trained and aligned with best practices.

This reports to the Senior Director of Ambulatory Medicine Operations and the position is responsible for directly overseeing the Referrals Team and Surgical Scheduling Team, managing daily workflows, ensuring proper coordination between ambulatory clinics and the hospital's surgical department, and enhancing Epic's scheduling capabilities to improve operational efficiency.

Required:

High School Diploma or Equivalent (GED) High School Diploma or equivalent GED
• One (1) year of experience with Epic's referral management and surgical scheduling tools, including EpicCare Link, Cadence, OR Manager (OpTime), and Care Everywhere
• Three (3) or more years of experience in referrals, prior authorizations, insurance verification, and surgical scheduling
• Two (2) years of supervisory experience in a healthcare-related field
• Two (2) year of experience with medical insurance plans (HMO, PPO, Medicare, Medicaid, and private payers), particularly prior authorizations and pre-certifications
• Two (2) year of experience with CPT, ICD-10 coding, and billing for surgical procedures
• One (1) year of experience navigating health plan portals for authorization approvals and benefit eligibility verification

Preferred:

• Bachelor's Degree in Healthcare Administration, Business, or a related field
• Prior experience in implementing or transitioning to Epic within a healthcare setting
• Experience with Epic's OR Manager (OpTime) for surgery scheduling, including integration with hospital surgical services
• Bilingual in Spanish
• Proficiency with scheduling and insurance verification software
• Strong computer skills, including Microsoft Office Suite and Epic functionality
• Strong verbal and written communication skills with a focus on patient advocacy and provider support

When it comes to quality, we're 5 Star!

Community Memorial Health System was established in 2005 when Community Memorial Hospital in Ventura merged with Ojai Valley Community Hospital. It is comprised of these two hospitals along with a network of primary and specialty care health centers serving various communities across west Ventura County. Our health system is a community-owned, not-for-profit organization. As such, we are not backed by a corporate or government entity, nor do we answer to shareholders. We depend on - and answer to - the communities we serve.

Community Memorial Hospital - Ventura has been awarded a prestigious five-star rating by the Centers for Medicare & Medicaid Services (CMS)! This achievement represents thousands of people going the extra mile every day for our patients, and we are the ONLY hospital in Ventura County to earn this distinction!

Community Memorial Healthcare Benefits

To help heal, comfort, and promote health for the communities we serve, Community Memorial Healthcare takes care of our community of employees so our local community can be cared for. That's why we provide competitive benefits, along with great career choices, training, and leadership development. Our total rewards package provides benefits that support you and your family's health and wellness in all aspects of life. From our top tier insurance plans to our employee assistance program, take advantage of what CMH has to offer so you and your loved ones can have peace of mind now and for years to come. CMH is here for you and your family every step of the way.

• Competitive Pay
• Shift Differentials
• In-House Registry Rates
• Fidelity 403(b) Retirement Plan
• Paid Time Off
• Medical (EPO/PPO), Dental, & Vision Insurance Coverage
• Voluntary Worksite Benefits
• Employee Assistance Program Available 24/7 (EAP)
• Tuition Reimbursement
• Public Service Loan Forgiveness (PSLF)
• Recognition programs
• Employee service recognition events
• Home, Retail, Travel & Entertainment Discounts
• National Hospital Week and National Nurses Week celebrations

Community Memorial Healthcare is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding and related medical conditions), and sexual orientation. We strive to promote an environment where exceptional people bring diverse perspectives and find belonging, support and connection to their work in our community.

"We are an AA/EEO/Veterans/Disabled Employer"