Referral & Care Coordination Specialist

• Location: Remote
• Company: eddii, Inc. / eddii-Care
• Engagement: Part-Time Contractor
• Travel: 0%

eddii-Care is a virtual endocrinology specialty clinic providing innovative, compassionate care for people living with diabetes and other endocrine conditions.

We are seeking a proactive Referral & Care Coordination Specialist to manage patient referrals from order placement through scheduling and completion.

Position Overview

The Referral & Care Coordination Specialist will help patients successfully connect with outside providers and services, including ophthalmology, podiatry, imaging, laboratories, and other specialists.

This is not a role focused only on sending referral paperwork. The specialist will identify appropriate in-network providers, confirm availability, coordinate with facilities and patients, address barriers to care, and follow referrals until there is a clear outcome. We are looking for someone who is persistent, organized, resourceful, and comfortable communicating with patients, healthcare facilities, insurance plans, and care-management teams.

Key Responsibilities

• Process referrals placed by eddii providers.
• Identify appropriate specialists and facilities based on clinical need, geography, insurance network, and patient preferences.
• Confirm that providers and facilities participate with the patient's insurance plan.
• Contact payer networks or facilities directly when network information is unclear.
• Contact specialist offices and facilities to confirm services offered and appointment availability.
• Send referral orders, clinical documentation, and other required information.
• Contact patients to help coordinate and schedule referred services.
• Follow up with patients who have not scheduled or completed referrals.
• Identify barriers preventing patients from accessing care, including transportation, cost, scheduling, mobility, language, or other social needs.
• Work with the broader eddii team and payer care coordinators to help address those barriers.
• Track referral status from initiation through scheduling and completion.
• Obtain referral results or documentation when needed.
• Escalate unresolved referrals and maintain a clear next action for every open case.

Special Focus on Diabetes Care Gaps

The specialist will play an important role in helping patients complete services related to diabetes care and quality measures, including diabetic eye exams and other recommended screenings.

For eye-care referrals, this may include:

• Identifying in-network ophthalmology or optometry locations.
• Confirming that the facility can perform the required diabetic eye exam.
• Checking appointment availability.
• Helping the patient select and schedule a location.
• Following up to ensure the appointment is completed.
• Obtaining documentation needed to confirm completion of the care gap.

Qualifications

• 2+ years of experience in medical referrals, care coordination, patient navigation, specialty scheduling, or a similar healthcare operations role.
• Experience communicating directly with specialist offices, healthcare facilities, and patients.
• Experience working with insurance networks or confirming in-network providers.
• Strong organizational skills and attention to detail.
• Excellent phone communication and patient-service skills.
• Comfortable making frequent outbound calls and following unresolved cases persistently.
• Ability to manage multiple referrals and priorities simultaneously.
• Ability to work independently in a remote environment.

Preferred Qualifications

• Experience with Medicare Advantage, Medicaid, or dual-eligible populations.
• Experience in value-based care, care-gap closure, HEDIS, or Stars programs.
• Experience with endocrinology, diabetes care, primary care, or specialty practices.
• Experience identifying and addressing social determinants of health.
• Familiarity with payer provider directories, EHRs, and referral-management systems.
• Experience with telehealth or virtual care.

What Success Looks Like

Success means referrals do not stop when an order is sent.

The right person will help ensure

• Appropriate in-network providers are identified.
• Patients receive realistic appointment options.
• Referrals are scheduled quickly.
• Barriers to care are identified and addressed.
• Open referrals always have a clear next action.
• Completed referrals are documented appropriately.
• Fewer patients are lost between referral placement and actual care.

Key measures may include

• Referral-to-scheduling conversion rate.
• Referral completion rate.
• Time from referral placement to scheduled appointment.
• Percentage of referrals with confirmed in-network providers.
• Percentage of unresolved referrals with a documented barrier and action plan.
• Completion of relevant care gaps.
• Zero referrals becoming stale without a clear next action.



Why Join eddii

• Flexible remote contractor role.
• Competitive compensation.
• Opportunity to directly improve patient access to care.
• Work with a mission-driven team improving outcomes for people living with diabetes and other chronic conditions.