Supervisor, Care Coordination
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Job Description
Clinical Care Coordination Supervisor overseeing utilization management and Referral Coordinators. Supporting compliant, cost-effective patient care coordination for IHCS, a home healthcare services provider.
Responsibilities:
- Oversee daily operations of the utilization management team
- Ensure compliance with regulatory standards, organizational policies, and industry best practices
- Support staff development and monitor performance
- Promote high-quality, cost-effective care coordination
- Lead and support a team of Referral Coordinators for various health plans
- Ensure compliance with utilization management processes
- Evaluate eligibility for benefit coverage
- Collaborate with internal and external stakeholders to optimize patient care
- Work with health plan case managers and claims payers to facilitate appropriate care coordination
- Ensure accurate claims processing
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 outlined in the Code of Conduct and related policies
- Must participate in mandatory Corporate Compliance Program training initiatives annually or as required
- Proficient in Microsoft Word, Excel, and PowerPoint
- Excellent leadership, problem-solving, and decision-making abilities
- Strong communication and interpersonal skills for cross-functional collaboration
- In-depth knowledge of healthcare regulations and UM guidelines
- Strong leadership, team management, and coaching skills
- Prior experience in a supervisory or leadership role within a healthcare setting
- Preferred associate degree or better in Health Administration or a related field
Benefits:
- Medical, Vision, Dental insurance
- Short- and Long-term insurance
- 6+ Days of Holidays Pay
- 13 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
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