E-Referral Vendor Optimization Lead

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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. The 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 position for a high-impact leader who combines operational execution with strategic vision. By simplifying vendor engagement and optimizing referral workflows, you will directly influence functional strategies, organizational efficiency, and patient experience.

• 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.

• Oversee electronic referral systems ensuring timely processing and compliance.

• Monitor referral queues, resolve bottlenecks, and maintain high conversion rates.

• 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.

• 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.

• 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.

• Ensure adherence to CMS, Medicare, and state regulations governing home health referrals.

• Maintain audit-ready documentation for all referral and vendor activities.

• 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 (ex: Aidin, Care Port, Ensocare, Epic, Well Sky) and vendor management tools.

• Excellent negotiation, communication, and relationship-building abilities.

• Can 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:
To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel:
While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

40

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, certifications, etc.

$104,000 - $143,000 per year

Humana, Inc. and its affiliated subsidiaries (collectively,…