Referral Specialist

Summary

Join Pomelo Care, a company dedicated to improving maternal and infant health, as a Referral Specialist. You will be responsible for enrolling clients referred to Pomelo's doula network, documenting referrals, matching clients with doulas, and coordinating with health plan case managers. You will also educate clients on the benefits of doula care and manage inbound calls from potential clients and external partners. This role requires excellent communication skills, experience with healthcare referral systems, and the ability to work independently and as part of a team. Pomelo offers competitive healthcare benefits, a generous and flexible vacation policy, and the opportunity to work in a fast-paced, mission-driven startup environment.

Requirements

• Fluent in Spanish
• Excellent customer service and communication skills
• Experience working with various healthcare referral systems
• Are internet-connected, able to work remotely
• Familiar with working with people assigned to Medicaid health plans
• Passionate about changing the current landscape of healthcare
• Strong organizational, documentation, and time-management skills
• Ability to work independently and as part of a team

Responsibilities

• Enroll clients referred to Pomelo’s doula network by health plans, providers, and doulas
• Document, enroll, and match referrals for doula care to doulas within the Pomelo Care doula network
• Educate clients on the benefits of doula care
• Conduct outbound calls and digital outreach (SMS, email) to referred clients to drive new client enrollments, meeting quality and productivity requirements
• Document all incoming referrals and interactions in systems of record with timely and accurate updates
• Match clients with existing doulas in the Pomelo Care doula network
• Coordinate with health plan case managers and external healthcare providers to  share updates on referrals and achieve enrollment goals
• Track, monitor, and enroll referrals, ensuring timely processing and communication with all parties
• Manage inbound calls from potential clients and external partners, answering their questions, addressing their concerns, and providing guidance on how Pomelo can support their needs
• Achieve member enrollment goals as driven by company KPIs
• Confirm client’s health plan eligibility details via automatic clearinghouse and online health insurance portals
• Participate in training and development opportunities to stay current on healthcare trends and regulations

Preferred Qualifications

• Experience working in a fast-paced and dynamic startup environment
• Experience in administrative and revenue driving roles
• Ability to scope and tackle ambiguous problems

Benefits

• Competitive healthcare benefits
• Generous and flexible vacation policy