Registered Nurse (RN) – Referral Management
Location: RAF Lakenheath, Brandon,
Job Type: Federal
Company: Decypher
Category: Medical Services
Job Description Apply Now
Decypher is seeking a dedicated Registered Nurse (RN) – Referral Management professional to join our team and play a pivotal role in supporting the health and readiness of America's service members, veterans, and their families. As a core partner to the Defense Health Agency, Decypher is committed to delivering high-quality healthcare services, technology, and management solutions that make a significant impact nationwide. Our mission is to ensure access to quality care for those who have served, and we are looking for an experienced Registered Nurse (RN) with specialized expertise in referral management to help us achieve this mission.
In the Registered Nurse (RN) – Referral Management position, you will be responsible for coordinating the end-to-end patient referral process. This includes ensuring referrals are properly scheduled, eligibility is verified, and all activities comply with established Air Force Access to Care standards. The role requires maintaining meticulous documentation, communicating effectively between patients and providers, and collaborating with both internal and external healthcare stakeholders to facilitate seamless care transitions. You will play a vital part in reviewing, authorizing, and tracking medical referrals and services, while delivering compassionate, high-quality customer service to patients and their families.
As a Registered Nurse (RN) – Referral Management professional, your day-to-day responsibilities will involve working closely with multidisciplinary teams, managing referral metrics, ensuring compliance with Defense Health Agency guidelines, and facilitating communication between all parties involved in the referral process. The position requires a detail-oriented approach, the ability to manage multiple priorities, and a dedication to continuous process improvement in order to support optimal patient care outcomes.
Working in this role offers the opportunity to make a direct and meaningful difference in the lives of military personnel and their families. Within the collaborative and mission-driven culture at Decypher, you will be valued for your clinical expertise and your commitment to excellence in healthcare delivery. If you are a Registered Nurse (RN) with a proven background in referral management, utilization management, or case management, we encourage you to apply for this rewarding opportunity by clicking the job application button today.
Registered Nurse (RN) – Referral Management Summary- Coordinate patient referral processes to ensure timely scheduling and care transitions
- Verify eligibility and compliance with healthcare standards and regulations
- Maintain accurate documentation and facilitate communication between providers, patients, and stakeholders
- Support the mission to provide quality care for service members, veterans, and their families
- Schedule referral appointments in line with Air Force Access to Care Standards, tracking and ensuring 90% compliance for all referrals
- Review and validate referrals for clinical appropriateness, authorizing medical services as needed
- Collaborate with TRICARE Regional Office Clinical Liaison Nurses, MTF Liaisons, and other stakeholders to resolve process issues
- Verify beneficiary eligibility using DEERS and process referrals within outlined priority standards (Routine, Emergent, Urgent)
- Track referral reports, ensure timely return of results to the referring provider, and maintain accurate medical records
- Coordinate with specialty clinics to obtain pre-appointment instructions and ensure patients are fully informed
- Participate in multidisciplinary team meetings and provide feedback on utilization review issues
- Train clinical staff on the referral process, best practices, and system updates as required
- Utilize MHS GENESIS and other systems for data entry, referral tracking, and reporting
- Provide high-quality customer service support, addressing patient inquiries and guiding them through the referral process
- Maintain compliance with all training, licensure, and credentialing requirements
- Competitive hourly compensation
- Comprehensive benefits package (details provided during interview process)
- Opportunities for professional growth and advancement
- Graduate of an accredited school of nursing acceptable to the Surgeon General, HQ USAF
- Current, active, unrestricted Registered Nurse (RN) license in accordance with State Board requirements
- Basic Life Support (BLS) certification required
- Three (3) years of direct patient care experience in a clinical setting
- At least two (2) consecutive years of utilization management, utilization review, or case management experience
- U.S. Citizenship is required
- Exceptional interpersonal and communication skills with the ability to work effectively within multidisciplinary teams
- Strong organizational and analytical abilities, with a keen attention to detail
- Proven experience in referral management, utilization review, or case management
- Commitment to delivering compassionate customer service to patients and families
- Adaptable and able to thrive in a dynamic, mission-driven environment
- Work schedule is Monday through Friday, with shifts between 6:00 am and 6:00 pm, not to exceed 40 hours per week
- This is an onsite role with no overtime authorized
- Decypher is an equal opportunity and affirmative action employer committed to a diverse and inclusive workforce (M/F/D/V)
- If you are ready to advance your career and contribute to a meaningful mission, please apply by clicking the job application button