Manager of Clinical Care Coordination

Integrated Home • Miramar, FL

2h

About The Position

The Manager of Clinical Care Coordination oversees referral management and approval of home health care, durable medical equipment (DME), and infusion services. The role ensures efficient resource utilization, medically necessary services, regulatory compliance, and exceptional patient care. Responsibilities include reviewing clinical documentation, streamlining workflows, collaborating with interdisciplinary teams, and implementing utilization management strategies to improve operational efficiency and cost-effectiveness.

Requirements

• Bachelor's degree in Nursing (BSN), Healthcare Administration, or a related field.
• At least 3–5 years of experience in utilization management, case management, or a related healthcare setting.
• At least 2 years of leadership or supervisory experience in a healthcare environment.
• Strong understanding of utilization management, medical necessity criteria, and regulatory compliance, including CMS, NCQA, and URAC.
• Proficiency in Microsoft Word, Excel, and PowerPoint.
• Excellent leadership, problem-solving, and decision-making abilities.
• Strong communication and interpersonal skills for cross-functional collaboration.

Responsibilities

• Oversee referral management and approval of home health care, DME, and infusion services.
• Ensure efficient resource utilization and that services are medically necessary.
• Ensure regulatory compliance.
• Review clinical documentation.
• Streamline workflows.
• Collaborate with interdisciplinary teams.
• Implement utilization management strategies to improve operational efficiency and cost-effectiveness.
• Uphold compliance principles in the Code of Conduct and related policies.
• Support and participate in mandatory Corporate Compliance Program training annually or as required.

Benefits

• Medical, vision, and dental coverage
• Short- and long-term insurance
• More than six days of paid holidays
• 17 days of PTO
• Employer-paid life insurance
• 401(k) with employer contribution
• Wellness program with reward incentives
• Employee recognition and reward programs
• Comprehensive paid training program
• Competitive compensation package

What This Job Offers

• Job Type: Full-time
• Career Level: Manager