Senior Manager, Referrals

We’re unique. You should be, too.

We’re changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy?

We’re different than most primary care providers. We’re rapidly expanding and we need great people to join our team.

The Senior Manager, Referrals Operations is a subject matter expert on the referral process and is responsible for the day-to-day referral operations, in the areas of data, analytics, compliance, quality, process improvement, and project management. They are an operational and strategic leader who ensures the delivery of quality coordination of care and patient experience. They collaborate to develop tactical and strategic plans that drive performance to meet key performance indicators, leading to VIP patient care.

ESSENTIAL JOB DUTIES/RESPONSIBILITIES:

• Develops, implements, and manages all referral policies, procedures, and protocols to streamline the referral process and improve patient access.
• Oversees the development and implementation of referral management systems and technology solutions to support data-driven decision making and enhance patient outcomes.
• Collaborates with cross-functional teams to identify and address referral-related challenges.
• Leads process improvement within referrals. 
• Develops training and resources to support referral processes.
• Analyzes data and prepares detailed reports and presentations.
• Works with other teams to standardize protocols and training programs for Care Coordinators.
• Monitors key performance indicators (KPIs) to track the effectiveness of the referral process and identify areas for improvement.
• Establishes and maintains relationships with external stakeholders, including specialists, hospitals, vendors, and other healthcare professionals.
• Ensures compliance with all regulatory requirements related to referrals and patient care.
• Leads continuous improvement efforts to enhance the patient experience and accessibility across the enterprise.
• Deliver and manage internal and external vendor software, technology, and compliance updates.
• Leads and supports special projects and initiatives as assigned.
• Performs other duties as assigned and modified at manager’s discretion.

KNOWLEDGE, SKILLS AND ABILITIES:

• Extensive experience processing value-based Medicare Advantage referrals and diagnostics. In-depth knowledge of referral processes.
• Extensive experience coaching/training the processing of value-based Medicare Advantage referrals and diagnostics. 
• Advanced experience in the design and delivery [in-person and online] of training and training materials; use of online training delivery tools.
• Strong problem solving, time management, organizational and analytical skills.
• Ability to conduct and present data and analysis to a variety of stakeholders. Strong written and verbal skills.
• Ability to use tools to digest and present large data sets. Strong data analysis skills. Ability to draw conclusions and make recommendations from data analysis.
• Ability to create process maps and conduct process improvements. 
• Proficient in Microsoft Office Suite products including Word, Excel, PowerPoint and Outlook, database, and presentation software.
• Ability to build strong relationships with cross teams and be agile.
• High level of integrity, dependability, and reliability to manage change and align with our mission to provide VIP and quality service to your patients.
• Ability to exercise independent judgment.
• Spoken and written fluency in English; bilingual preferred. 
• This job requires use and exercise of independent judgment.

EDUCATION AND EXPERIENCE CRITERIA:

• BA/BS degree in Business, Healthcare Administration, or related filed required; MA/MS degree in Business, Healthcare Administration or related field preferred.
• A minimum of 7 years of referral experience in a healthcare setting required; a minimum of 5 years’ experience in healthcare operations, with a focus on referral management.
• Process improvement certification/experience preferred.
• Experience with web-based referral sites and obtaining referrals/authorizations for multiple payors required. 
• Healthcare experience within the Medicare Advantage population preferred. 
• Experience working with large data sets and analyzing data to make decisions and improve performance.