Referral Management Reviewers (Bethesda, MD)

Team Ivyhill is currently seeking to hire Referral Management (Non-Nurse) Reviewers to support its contract with the Integrated Referral Management and Appointing Center (IRMAC), the National Capital Regions’ premier coordinating authority for appointing and referral management services for beneficiaries in the Defense Health Network. 

Referral Management (Non-Nurse) Reviewers will be responsible for facilitating centralized product line and specialty referrals for Active-Duty Service Members and Tricare Prime beneficiaries enrolled to a Military Treatment Facility (MTF) in the National Capital Region.

This is an onsite employment opportunity. 

Duties and Responsibilities

1. Perform referral review duties, seeking guidance from the product line nurse(s), and other members of the healthcare team and MTF points of contact as necessary. Reviews all referrals for administrative, clinical completeness and appropriateness, dispositioning the referral within 24 hours from the date referral was written. Collaborates with appointing center, case managers, product line nurses, providers, clinics, manage care support contractor liaison and other members of the healthcare team as needed to ensure proper use of Direct Care system and civilian network resources, as well as to ensure that patients are booked at the right time, with the right provider, at the right place.
2. Review Specialty Referral Guideline (SRG) compliance f