Manager of Clinical Care Coordination
Integrated Home Care Services, Inc.•Miramar, FL
About The Position
The Manager of Clinical Care Coordination oversees referral management and approvals for home health care, durable medical equipment (DME), and infusion services. The role ensures efficient resource utilization, medical necessity, 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.
- Minimum of 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, medically necessary services, regulatory compliance, and exceptional patient care.
- Review clinical documentation and streamline workflows.
- Collaborate with interdisciplinary teams.
- Implement utilization management strategies to enhance operational efficiency and cost-effectiveness.
- Uphold compliance principles in accordance with the Code of Conduct and related policies.
- Support and participate in annual or otherwise required Corporate Compliance Program training.
Benefits
- Medical, vision, and dental insurance
- Short- and long-term insurance
- 6+ days of holiday pay
- 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
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What This Job Offers
Job Type
Full-time
Career Level
Manager
