Referrals Manager

Position Summary

The Manager, Referral Operations provides system-wide leadership and oversight of referral coordination across all health centers. This role is accountable for ensuring timely, compliant and high-quality processing of outgoing referrals generated by clinical providers. The manager leads referral workflow optimization, referral policy governance, EPIC referral builds enhancements, performance monitoring, and cross-functional collaboration to reduce leakage, improve patient access, and strengthen care continuity. This position supervises Referral Coordinators and drives measurable improvements in referral accuracy, authorization turnaround time, compliance adherence, and patient access outcomes. The Manager serves as the subject matter expert for referral operations across the organization.

Core Job Responsibilities

• Oversee the end-to-end referral lifecycle to ensure timely, accurate, and compliant processing of all outgoing referrals across health centers.
• Monitor and analyze referral performance metrics (volume, aging, authorization turnaround, leakage, denials) and implement corrective action plans as needed.
• Serve as the subject matter expert on referral policy, payer requirements, and managed care authorization processes.
• Identify workflow inefficiencies and lead process improvement initiatives to optimize referral operations and patient access.
• Collaborate with IS/EPIC teams to enhance referral builds, reporting tools, dashboards, and system workflows.
• Audit referral documentation and processes to ensure regulatory compliance and adherence to organizational standards.
• Partner with health center leadership, providers, revenue cycle, and quality teams to resolve referral-related operational barriers.
• Lead and develop Referral Coordinators through performance management, coaching, training, and competency development
• Leads cross-functional initiatives focused on internal referral optimization, specialty access optimization, and system-wide referral workflow alignment in collaboration with clinical, operational, and administrative stakeholders.
• Other duties as assigned.

Requirements/Preferences

• Associate degree in healthcare or related field, plus a minimum of two (2) years supervisory/team lead experience in healthcare OR a high school diploma/GED plus a total of five (5) or more years of supervisory/team lead experience in a healthcare setting required.
• A minimum of (3) years of experience in a clinical office, health plan or health care environment required.
• Minimum two (2) years of experience processing referrals required.
• Intermediate knowledge of third-party payers and managed referrals required.
• Minimum one (1) year HER Systems experience required; EPIC preferred.
• Knowledge of coding (ICD10, CPT), preferred.
• Intermediate proficiency in Microsoft Office: especially Excel required.

Working Conditions/Equipment

• Normal office environment regularly
• Health Center environment occasionally
• Local travel between health centers and community events is required; mode of transportation required
• If personal vehicle is employed, a current driver’s license and proof of insurance is required