Senior Manager, Clinical Care Coordination & Utilization

Integrated Home Brand; Town of Florida (NY); On-site; USD 110,000 - 140,000; Full time

Benefits offered by this job

Medical, Vision, Dental

Holidays pay

PTO

Employer paid life insurance

401K with employer contribution

Wellness program

Employee recognition

Job summary

Integrated Home Care Services (IHCS) is seeking a Manager of Clinical Care Coordination to oversee referral management and approval of home health, DME, and infusion services, ensuring medical necessity and regulatory compliance.

You will lead a team, review clinical documentation, streamline workflows, and implement utilization strategies to enhance efficiency and patient outcomes across our home health network.

Qualifications

• Bachelor's degree in Nursing (BSN, Healthcare Administration, or a related field.
• 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 (CMS, NCQA, URAC).
• Proficient in Microsoft products (Word, Excel, 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, DME, and infusion services to ensure medical necessity and regulatory compliance.
• Review clinical documentation, streamline workflows, and lead utilization management strategies with interdisciplinary teams.
• Monitor cost-effectiveness and optimize resource utilization while delivering exceptional patient care.

Skills

Leadership

Communication

Interpersonal Skills

Problem-solving

Detail oriented

Education

BSN or related field

Tools

Microsoft Word

Microsoft Excel

PowerPoint

Job description

Integrated Home Care Services (IHCS) is seeking a Manager of Clinical Care Coordination to oversee referral management and approval of home health, DME, and infusion services, ensuring medical necessity and regulatory compliance.

You will lead a team, review clinical documentation, streamline workflows, and implement utilization strategies to enhance efficiency and patient outcomes across our home health network.