Care Management Leader – Discharge & Coordination

Pscfl; Miami (FL); On-site; USD 95,000 - 130,000; Full time

Job summary

PSCFL seeks an experienced leader to oversee clinical care coordination, utilization management, and discharge planning across inpatient, outpatient, and emergency settings. The role focuses on staff training, regulatory compliance, patient-centered outcomes, and continuous quality improvement.

You will lead a multidisciplinary team, ensure efficient operations, and collaborate with third-party payors to resolve medical necessity determinations, while advancing evidence-based care practices and

Qualifications

• BSN from an accredited program and Florida RN license.
• 3-5 years clinical experience.
• 4-7 years case management or utilization management with some discharge planning experience.
• 4-7 years supervisory or management experience in related setting and program function.
• Master's in Nursing preferred.
• Case management certification preferred.
• Knowledge of managed care, Medicaid, Medicare regulations.

Responsibilities

• Oversee care coordination, utilization management, and discharge planning.
• Ensure compliance with JC/DNV-GL, CMS, and state requirements.
• Lead training, supervision, and performance evaluations of staff.
• Develop efficient care management systems and processes.
• Coordinate with third-party payors and external health care agencies.
• Support quality improvement initiatives and departmental projects.
• Promote excellent patient and family education and service quality.

Skills

Leadership

Regulatory compliance

Quality improvement

Discharge planning

Team collaboration

Analytics

Education

Bachelor's Degree BSN from an accredited RN program

RN Licensure in Florida or eNLC

Master's of Science in Nursing preferred

Case Management Certification preferred

Experience in healthcare regulations and reimbursement

Tools

Cerner Millennium

Meditech

EPIC

Allscripts

Job description

PSCFL seeks an experienced leader to oversee clinical care coordination, utilization management, and discharge planning across inpatient, outpatient, and emergency settings. The role focuses on staff training, regulatory compliance, patient-centered outcomes, and continuous quality improvement.

You will lead a multidisciplinary team, ensure efficient operations, and collaborate with third-party payors to resolve medical necessity determinations, while advancing evidence-based care practices and