Patient Care Coordinator, Referral Management

The Patient Care Coordinator, Referral Management supports members' access to specialty and ancillary care by processing referral authorizations accurately and efficiently within a capitated, HMO-model TRICARE Prime / US Family Health Plan (USFHP) framework. This non-clinical role serves as a key point of contact for members and provider offices, coordinating the administrative components of the referral process, verifying eligibility, benefits, and network status, and ensuring a smooth, timely, and service-oriented experience for veterans and military-connected members. The role also provides administrative support to the Utilization Management, Case and Care Management, Quality, and Clinical Operations teams as assigned.