Referrals Manager

Access Community Health Network; Chicago, Northern (IL, KY); Hybrid; USD 85,000 - 110,000; Full time

Job summary

Access Community Health Network is seeking a Manager of Referral Operations to provide system-wide leadership for referral coordination, drive performance improvements, and ensure compliant processing of outgoing referrals across health centers. The role supervises Referral Coordinators and partners with clinical, operational, and IT teams.

The candidate will monitor metrics, optimize workflows, and lead policy governance to reduce leakage and improve patient access.

Qualifications

• Requires leadership and supervisory experience in a healthcare setting.
• Experience overseeing referral coordination and ensuring timely, compliant processing.
• Strong analytics for performance metrics and action planning.

Responsibilities

• Oversee end-to-end referral lifecycle across health centers.
• Monitor and analyze referral performance metrics and implement corrective actions.
• Serve as subject matter expert on referral policy, payer requirements, and managed care authorization processes.
• Identify workflow inefficiencies and lead process improvement initiatives.
• Collaborate with IS/EPIC teams to enhance referral builds and dashboards.
• Audit referral documentation to ensure regulatory compliance.
• Partner with health center leadership and teams to resolve operational barriers.
• Lead and develop Referral Coordinators through coaching and training.
• Lead cross-functional initiatives for internal referral optimization and system alignment.
• Other duties as assigned.

Skills

Leadership

Referral Coordination

Process Improvement

Cross-functional Collaboration

Data Analysis

Patient Access

Education

Associate degree in healthcare or related field

High school diploma or GED with 5+ years supervisory experience

Tools

EPIC

Excel

MS Office

Job description

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