Senior Manager, Clinical Care Coordination & Utilization

Job Category : Clinical Care Coordination HH Requisition Number : MANAG002549 Posted : September 1, 2026 Closed : September 4, 2026 Full-Time On-site Locations Showing 1 location Miramar, FL 33025, USA Description Who we are: Integrated Home Care Services (IHCS) provides a comprehensive Integrated Delivery System in the home setting, offering Durable Medical Equipment (DME), Respiratory, Home Health, and Home Infusion services. Through our select network of Medicare and Medicaid Certified and Accredited providers, we are available 24/7 to meet the needs of our patients with compassion, expertise, and excellence. For more than 30 years, we have been dedicated to improving lives by delivering the highest quality in-home care services. As a trusted market leader in value-based Home Health, Durable Medical Equipment, and Home Infusion Services, we proudly serve more than 2 million lives across the United States and the Commonwealth of Puerto Rico. Our integrated care model is trusted by leading Managed Care Organizations (MCOs), physicians, and healthcare partners because of our commitment to exceptional patient outcomes and coordinated care. At IHCS, our patients are at the heart of everything we do. We believe in creating a culture built on compassion, integrity, collaboration, and innovation. Every team member plays a vital role in fulfilling our mission of enhancing the quality of life for those we serve through Exceptional Customer Service, Proven Outcomes, and Seamless Care. If you are passionate about making a meaningful impact, thrive in a collaborative environment, and are committed to excellence, we invite you to join our growing team. Together, we can continue transforming home healthcare while making a difference in the lives of our patients and the communities we serve. Join IHCS where our patients are #1, and our people make the difference. Apply today! Offering a competitive compensation package, including but not limited to; 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 What you will be doing: The Manager of Clinical Care Coordination is responsible for overseeing the referral management and approval of home health care services, DME or infusion services to ensure efficient resource utilization, medically necessary services, regulatory compliance, and exceptional patient care. This role involves reviewing clinical documentation, streamlining workflows, collaborating with interdisciplinary teams, and implementing utilization management strategies to enhance operational efficiency and cost-effectiveness Qualifications: 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. Candidates will be considered for the schedule that best aligns with their availability and current staffing needs. Join our team as we strive for excellence through teamwork, where our patients are #1! IHCS is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. Qualifications Behaviors Preferred Team Player Team Player : Works well as a member of a group Enthusiastic : Shows intense and eager enjoyment and interest Detail Oriented Detail Oriented : Capable of carrying out a given task with all details necessary to get the task done well Dedicated Dedicated : Devoted to a task or purpose with loyalty or integrity Motivations Preferred Ability to Make an Impact Ability to Make an Impact : Inspired to perform well by the ability to contribute to the success of a project or the organization Growth Opportunities : Inspired to perform well by the chance to take on more responsibility Self-Starter : Inspired to perform without outside help Education Preferred Bachelors or better in Nursing or related field. Licenses & Certifications Preferred RN-LICENSE Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor. #J-18808-Ljbffr