Clinical Care Coordination Manager

🔥 2 hours ago

🐊 Florida – Remote

🐊 Florida – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Integrated Home Care Services, Inc.

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2015

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 B2B

Healthcare • Healthcare Insurance • B2B

Integrated Home Care Services, Inc. is an integrated home care benefits manager that coordinates and manages value-based home health services, durable medical equipment, and home infusion for patients and members on behalf of health plans and providers. It provides network development and credentialing, utilization management, claims adjudication, analytics, and a technology-enabled platform for referrals, real-time documentation, and 24/7 access to services, aiming to reduce costs, improve outcomes, and streamline administration for payers, providers, and patients.

📋 Description

• Oversee referral management and approval of home health care, DME, or infusion services • Ensure efficient resource utilization, medically necessary services, regulatory compliance, and exceptional patient care • Review clinical documentation • Streamline workflows • Collaborate with interdisciplinary teams • Implement utilization management strategies to enhance 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 (e.g., CMS, NCQA, URAC) • Required to uphold compliance principles as outlined in the Code of Conduct and related policies • Actively supports and participates in mandatory Corporate Compliance Program training initiatives annually or as required • Proficient in Microsoft products (Word, Excel, PowerPoint) • Excellent leadership, problem-solving, and decision-making abilities • Strong communication and interpersonal skills for cross-functional collaboration • RN-LICENSE listed under Licenses & Certifications

🏖️ Benefits

• Medical, Vision, Dental • Short- and Long-term insurance • 6+ Days of Holidays Pay • 17 days of PTO • Employer paid life insurance • 401K with employer contribution • Wellness program with reward incentives • Employee recognition and reward programs • Comprehensive paid training program