Referral Navigator Representative

To support the Medical Management Department, the part-time Referral Navigator Representative will coordinate care navigation and referral processes, ensuring timely communication and service delivery while working remotely from anywhere within the U.S. Key responsibilities: Serve as a centralized resource for care navigation, supporting referral completion and continuity of care activities Perform initial review and validation of clinical and administrative documentation for authorization and regulatory processing Coordinate with various stakeholders, including physicians and healthcare providers, to facilitate patient care requests Required qualifications: High School diploma or GED from an accredited program 2+ years of experience in managed care, utilization management, or healthcare operations Experience interacting with healthcare providers and managing authorizations or referrals Familiarity with electronic medical records (EMR) and healthcare information systems Knowledge of medical terminology, referral management, and authorization processes