E-Referral Vendor Optimization Lead

Become a part of our caring community. As the E-Referral & Vendor Optimization Lead, you will be a strategic individual contributor and team leader responsible for managing electronic referral workflows and overseeing relationships with 90+ referral vendors. You will drive process simplification, vendor optimization, and technology integration to ensure timely, accurate, and compliant patient intake. This position requires advanced expertise, independent judgment, and leadership in developing methods, techniques, and analytical approaches that influence functional strategies and impact organizational results. We designed this role for a high-impact leader who combines operational execution with strategic vision.

Responsibilities

• Subject Matter Expertise & Leadership
  • Be the subject matter expert determining methods, approaches, and priorities for complex tasks.
  • Lead associates in developing techniques and analytical approaches for referral and vendor management.
  • Exercise independent judgment on complex issues and provide direction on priorities for work groups.
• E-Referral Workflow Management
  • Oversee electronic referral systems ensuring timely processing and compliance.
  • Monitor referral queues, resolve bottlenecks, and maintain high conversion rates.
• Vendor Management & Optimization
  • Manage relationships with 90+ referral vendors, serving as the primary contact.
  • Develop and implement a standardized vendor engagement framework to reduce complexity and improve efficiency.
  • Negotiate Service Level Agreements (SLA) and ensure vendor compliance with operational and regulatory standards.
• Strategic Process Improvement
  • Proactively address problems and recommend improvements to processes, tools, and services impacting multiple projects and functions.
  • Collaborate with management to support change implementation and drive operational excellence.
  • Apply knowledge and creative solutions to complex assignments requiring initiative and judgment.
• Stakeholder Communication
  • Provide regular reporting on referral metrics, vendor performance, and optimization progress.
  • Partner with internal teams and external vendors to resolve issues and implement best practices.
• Compliance & Quality
  • Ensure adherence to CMS, Medicare, and state regulations governing home health referrals.
  • Maintain audit-ready documentation for all referral and vendor activities.

Requirements

• Bachelor's degree or equivalent experience required.
• 4 or more years of experience managing multiple vendor relationships and contracts for a large organization.
• 4 or more years of experience optimizing complex workflows for a large organization.
• Experience with referral platforms (e.g., Aidin, CarePort, Ensocare, Epic, WellSky) and vendor management tools.
• Excellent negotiation, communication, and relationship-building abilities.
• Ability to work independently and lead initiatives with minimal instruction.
• Strong analytical and problem-solving skills; ability to influence functional strategies.
• Experience with Medicare guidelines and payer authorization processes.

Work at Home Requirements

• Self-provided internet service must meet the following criteria: at minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps; wireless, wired cable, or DSL connection is suggested.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI/HIPAA information.
• Occasional travel to Humana's offices for training or meetings may be required.

Pay

The compensation range below reflects a good faith estimate of starting base pay for full-time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location, and individual pay will vary based on demonstrated job-related skills, knowledge, experience, education, and certifications.

$104,000 - $143,000 per year

Benefits

Humana offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work.

• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Time off (including paid time off, company and personal holidays, paid parental and caregiver leave).
• Short-term and long-term disability.
• Life insurance and many other opportunities.

About Us

About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery, or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers – all working together to help patients rehabilitate, recover, and regain their independence so they can live healthier and happier lives.

About CenterWell, a Humana company: CenterWell is a leading healthcare services business focused on creating integrated and differentiated experiences that put our patients at the center of everything we do. The result is high-quality healthcare that is accessible, comprehensive, and personalized. As the largest provider of senior-focused primary care, a leading provider of home healthcare, and a leading integrated home delivery, specialty, hospice, and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional, and social wellness of our patients. CenterWell is part of Humana Inc. (NYSE: HUM). Learn more about what we offer at CenterWell.com.