Director, Referral Management
for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule). So we need to map content to these headings.
We have:
- Job Summary: description of role. That could be "About the role".
- Education & Experience Required: list of requirements. That could be "Requirements" or "Qualifications". There's also "Preferred" items.
- Key Responsibilities: list of duties. That's "Responsibilities".
- Competencies: list of competencies/skills. That's "Skills".
- Working Conditions: maybe part of "About the role" or separate? Not in list; but we could include under "About the role" or maybe not create a separate heading because not in list. The instruction: Prefer a few substantive sections over many thin ones. So we could incorporate Working Conditions into About the role or Responsibilities? Probably About the role.
- Benefits: we have benefits list. That's "Benefits".
- Pay: we have salary range info. That's "Pay".
- Schedule: not explicitly given; maybe not include.
We must not create sections with placeholder text. So we include only those with real content.
We must not repeat job title as heading.
We must not include Job ID etc.
We must remove boilerplate: cookie/navigation/legal/EEO/equal-opportunity/scam-warning boilerplate, duplicated lines, application instructions. So we need to strip the EEO paragraph at end, also the "Company Overview" maybe considered boilerplate? It's substantive? It's about mission; maybe keep as part of About the role? The instruction: preserve ALL substantive information; do NOT invent or summarize away detail. The company overview is substantive? It's about mission; could be considered part of About the role. But we might keep it as part of About the role.
We need to ensure we don't include the EEO paragraph.
Also need to remove "TriWest job postings typically include a salary range..." that's part of Pay info; we keep that.
We need to format lists with - .
We need to use
for prose.
Let's extract content.
Profile: "We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, WA, WI & WY only). Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position. Veterans, Reservists, Guardsmen and military family members are encouraged to apply!"
That's substantive; could be part of About the role or Requirements. Since it's about eligibility and location, maybe put under Requirements? But we have a separate Requirements section for education/experience. Could combine location and citizenship under Requirements. However the instruction: Use headings from list; we can decide.
Better: About the role includes job summary and maybe location/eligibility. Requirements includes education/experience etc. Qualifications maybe for preferred? But we can just have Requirements and Qualifications separate? The list includes both Requirements and Qualifications as possible headings. We could put required education/experience under Requirements, and preferred qualifications under Qualifications. That seems logical.
Thus:
- About the role: Job Summary + maybe location/remote work and DoD contract statement? Actually location/remote work is more about eligibility; but could be in About the role as context.
- Requirements: Bachelor's Degree ... U.S. Citizenship ... Must be able to receive a favorable Interim and adjudicated final DoD background investigation ... Five years of progressively responsible referral management and leadership experience ... Knowledge of Military Health System and/or TRICARE program ... Knowledge of medical management, including referral management and utilization management
- Qualifications (Preferred): Master's Degree in Business or related field; Military affiliated to include Veterans and/or military spouses
- Responsibilities: list of key responsibilities (bullet points)
- Skills: Competencies list (Coaching/Training/Mentoring, Computer Literacy, Empathy/Customer Service, Independent Thinking/Self-Initiative, Information Management, Leadership, Organizational Skills, Problem Solving/Analysis, Team-Building/Team Player, Technical Skills)
- Benefits: list of benefits (Medical, Dental and Vision Coverage, Paid time off, 401(k) Retirement Savings Plan (with matching), Short-term and long-term disability, basic life, and accidental death and dismemberment insurance, Tuition reimbursement, Paid volunteer time)
- Pay: salary range info: "TriWest job postings typically include a salary range, which can vary based on the specific role and location, but generally this position ranges from around $166,000 to $185,000 per year."
- Schedule: not provided, so omit.
We also have Working Conditions: "Works non-regular hours, as required Works within an office environment, travel required Extensive computer work with prolonged sitting Department of Defense security clearance required". This could be incorporated into About the role or Responsibilities? Probably About the role as part of role description. We'll add to About the role as a paragraph.
We also have Company Overview: "Taking Care of Our Nation’s Heroes. It’s Who We Are. It’s What We Do. Do you have a passion for serving those who served? Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve®! Our job is to make sure that America’s heroes get connected to health care in the community. At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996." This is substantive; could be part of About the role as well.
We need to ensure we don't include EEO paragraph at end.
Now produce HTML.
Structure:
About the role
Job Summary ... plus location/remote work, DoD contract, veterans encouragement, working conditions, company overview.
But we need to keep all details; we can combine into multiple paragraphs if needed. Use for prose; we can have multiple
under same heading.
Better to separate into paragraphs for readability but still under same heading.
We'll produce:
About the role
Under the direction of the Vice President, Referral Management, this position is responsible for the system-wide development, oversight, direction, evaluation and implementation of the Referral Management Program and staff in support of the T-5 TRICARE West Region contract. The Referral Management department processes Referrals and Authorizations (R/A) according to contract standards. In collaboration with our Military & Veteran Services (MVS) leadership team and the Clinical Operations Utilization Management team, the Director develops strategies for achieving annual Referral Management goals and objectives, including input on system configuration and process development. This position directs referral management, optimization and clinical documentation return processes to meet or exceed contract requirements and corporate objectives. This includes overseeing referral/authorization inventory, staff workload, and directs the Managers of Referral Processing to optimize operational performance of staff including consultation on performance management, productivity, quality and timeliness of R/As, attendance, quality training and education. This Director also collaborates with other stakeholder teams to achieve TriWest performance standards and other contractual requirements.
We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, WA, WI & WY only). Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position. Veterans, Reservists, Guardsmen and military family members are encouraged to apply!
Working Conditions: Works non-regular hours, as required; works within an office environment, travel required; extensive computer work with prolonged sitting; Department of Defense security clearance required.
Taking Care of Our Nation’s Heroes. It’s Who We Are. It’s What We Do. Do you have a passion for serving those who served? Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve®! Our job is to make sure that America’s heroes get connected to health care in the community. At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996.
Then Requirements:
Requirements
- Bachelor's Degree in Business Administration, Health Care Administration or related field or equivalent experience
- U.S. Citizenship
- Must be able to receive a favorable Interim and adjudicated final Department of Defense (DoD) background investigation
- Five years of progressively responsible referral management and leadership experience that includes program design and development to meet performance metrics and goals
- Knowledge of Military Health System and/or TRICARE program
- Knowledge of medical management, including referral management and utilization management
Qualifications (Preferred):
Qualifications
- Master's Degree in Business or related field
- Military affiliated to include Veterans and/or military spouses
Responsibilities:
Responsibilities
- Direct the overall operational leadership of Referral Management (RM) functions and staff to ensure compliance with contract requirements and adherence to contract deliverables.
- Develops strategies for achieving TriWest's referral management objectives.
- Oversee development, implementation, and timely updates to Referral Management department policies, procedures, and guidelines.
- Coordinate with clinical operations to educate and communicate expectations with providers.
- Creates annual referral management strategies, develops performance management metrics, and oversees the management of reporting.
- Work with executive leadership to ensure targets are met for the annual operating plan/financial management.
- Collaborates with Utilization Management Director, MVS Directors, network providers, Military Treatment Facilities and TRICARE Regional Office West regarding TriWest’s RM program initiatives including submission, review, optimization and return of clinical documentation processes.
- Participates in cross-functional teams to enhance business strategy, process improvement, and use of industry best practices related to referral management.
- Develops and implements training programs for Referral Management department staff and monitors effectiveness of staff training initiatives.
- Ensures an effective performance evaluation system is implemented, including appropriate feedback to staff, motivation, and opportunities for growth and development.
- Contributes to assessment and enhancements of the referral management/medical management systems
- Performs other duties as assigned.
Skills:
Skills
- Coaching / Training / Mentoring: Actively foster actions required for desired business outcomes through ongoing constructive feedback.
- Computer Literacy: Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications.
- Empathy / Customer Service: Customer-focused behavior; Helping approach, including listening skills, patience, respect, and empathy for another's position.
- Independent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources.
for prose. Let's extract content. Profile: "We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, WA, WI & WY only). Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position. Veterans, Reservists, Guardsmen and military family members are encouraged to apply!" That's substantive; could be part of About the role or Requirements. Since it's about eligibility and location, maybe put under Requirements? But we have a separate Requirements section for education/experience. Could combine location and citizenship under Requirements. However the instruction: Use headings from list; we can decide. Better: About the role includes job summary and maybe location/eligibility. Requirements includes education/experience etc. Qualifications maybe for preferred? But we can just have Requirements and Qualifications separate? The list includes both Requirements and Qualifications as possible headings. We could put required education/experience under Requirements, and preferred qualifications under Qualifications. That seems logical. Thus: - About the role: Job Summary + maybe location/remote work and DoD contract statement? Actually location/remote work is more about eligibility; but could be in About the role as context. - Requirements: Bachelor's Degree ... U.S. Citizenship ... Must be able to receive a favorable Interim and adjudicated final DoD background investigation ... Five years of progressively responsible referral management and leadership experience ... Knowledge of Military Health System and/or TRICARE program ... Knowledge of medical management, including referral management and utilization management - Qualifications (Preferred): Master's Degree in Business or related field; Military affiliated to include Veterans and/or military spouses - Responsibilities: list of key responsibilities (bullet points) - Skills: Competencies list (Coaching/Training/Mentoring, Computer Literacy, Empathy/Customer Service, Independent Thinking/Self-Initiative, Information Management, Leadership, Organizational Skills, Problem Solving/Analysis, Team-Building/Team Player, Technical Skills) - Benefits: list of benefits (Medical, Dental and Vision Coverage, Paid time off, 401(k) Retirement Savings Plan (with matching), Short-term and long-term disability, basic life, and accidental death and dismemberment insurance, Tuition reimbursement, Paid volunteer time) - Pay: salary range info: "TriWest job postings typically include a salary range, which can vary based on the specific role and location, but generally this position ranges from around $166,000 to $185,000 per year." - Schedule: not provided, so omit. We also have Working Conditions: "Works non-regular hours, as required Works within an office environment, travel required Extensive computer work with prolonged sitting Department of Defense security clearance required". This could be incorporated into About the role or Responsibilities? Probably About the role as part of role description. We'll add to About the role as a paragraph. We also have Company Overview: "Taking Care of Our Nation’s Heroes. It’s Who We Are. It’s What We Do. Do you have a passion for serving those who served? Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve®! Our job is to make sure that America’s heroes get connected to health care in the community. At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996." This is substantive; could be part of About the role as well. We need to ensure we don't include EEO paragraph at end. Now produce HTML. Structure:
About the role
Job Summary ... plus location/remote work, DoD contract, veterans encouragement, working conditions, company overview.
But we need to keep all details; we can combine into multiple paragraphs if needed. Usefor prose; we can have multiple
under same heading. Better to separate into paragraphs for readability but still under same heading. We'll produce:
About the role
Under the direction of the Vice President, Referral Management, this position is responsible for the system-wide development, oversight, direction, evaluation and implementation of the Referral Management Program and staff in support of the T-5 TRICARE West Region contract. The Referral Management department processes Referrals and Authorizations (R/A) according to contract standards. In collaboration with our Military & Veteran Services (MVS) leadership team and the Clinical Operations Utilization Management team, the Director develops strategies for achieving annual Referral Management goals and objectives, including input on system configuration and process development. This position directs referral management, optimization and clinical documentation return processes to meet or exceed contract requirements and corporate objectives. This includes overseeing referral/authorization inventory, staff workload, and directs the Managers of Referral Processing to optimize operational performance of staff including consultation on performance management, productivity, quality and timeliness of R/As, attendance, quality training and education. This Director also collaborates with other stakeholder teams to achieve TriWest performance standards and other contractual requirements.
We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, WA, WI & WY only). Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position. Veterans, Reservists, Guardsmen and military family members are encouraged to apply!
Working Conditions: Works non-regular hours, as required; works within an office environment, travel required; extensive computer work with prolonged sitting; Department of Defense security clearance required.
Taking Care of Our Nation’s Heroes. It’s Who We Are. It’s What We Do. Do you have a passion for serving those who served? Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve®! Our job is to make sure that America’s heroes get connected to health care in the community. At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996.
Then Requirements:Requirements
- Bachelor's Degree in Business Administration, Health Care Administration or related field or equivalent experience
- U.S. Citizenship
- Must be able to receive a favorable Interim and adjudicated final Department of Defense (DoD) background investigation
- Five years of progressively responsible referral management and leadership experience that includes program design and development to meet performance metrics and goals
- Knowledge of Military Health System and/or TRICARE program
- Knowledge of medical management, including referral management and utilization management
Qualifications
- Master's Degree in Business or related field
- Military affiliated to include Veterans and/or military spouses
Responsibilities
- Direct the overall operational leadership of Referral Management (RM) functions and staff to ensure compliance with contract requirements and adherence to contract deliverables.
- Develops strategies for achieving TriWest's referral management objectives.
- Oversee development, implementation, and timely updates to Referral Management department policies, procedures, and guidelines.
- Coordinate with clinical operations to educate and communicate expectations with providers.
- Creates annual referral management strategies, develops performance management metrics, and oversees the management of reporting.
- Work with executive leadership to ensure targets are met for the annual operating plan/financial management.
- Collaborates with Utilization Management Director, MVS Directors, network providers, Military Treatment Facilities and TRICARE Regional Office West regarding TriWest’s RM program initiatives including submission, review, optimization and return of clinical documentation processes.
- Participates in cross-functional teams to enhance business strategy, process improvement, and use of industry best practices related to referral management.
- Develops and implements training programs for Referral Management department staff and monitors effectiveness of staff training initiatives.
- Ensures an effective performance evaluation system is implemented, including appropriate feedback to staff, motivation, and opportunities for growth and development.
- Contributes to assessment and enhancements of the referral management/medical management systems
- Performs other duties as assigned.
Skills
- Coaching / Training / Mentoring: Actively foster actions required for desired business outcomes through ongoing constructive feedback.
- Computer Literacy: Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications.
- Empathy / Customer Service: Customer-focused behavior; Helping approach, including listening skills, patience, respect, and empathy for another's position.
- Independent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources.