Care Management Coordinator in United States at Jobgether

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Care Management Coordinator in United States.

This role plays a key part in ensuring efficient care coordination and smooth patient transitions within a high-performing healthcare environment. You will support care management operations by monitoring compliance, coordinating clinical documentation, and working closely with patient financial services to ensure accurate and timely processes. The position is central to maintaining regulatory standards while helping facilitate safe and efficient discharges to post-acute care settings. You will work with clinical teams to review utilization, manage authorization workflows, and ensure proper documentation for reimbursement and compliance. This is a detail-oriented, process-driven role that combines clinical oversight, administrative coordination, and data tracking. The environment is collaborative, structured, and focused on delivering high-quality, patient-centered care.

• Facilitate efficient care management operations by coordinating daily workflows, clinical reviews, and discharge processes.
• Monitor compliance with assigned responsibilities and ensure completion of daily and weekly operational tasks.
• Conduct InterQual initial and continued stay reviews, including clinical authorization and length-of-stay justifications.
• Coordinate with patient financial services to ensure accurate documentation of authorizations and reimbursement-related data.
• Analyze daily and weekly operational reports, including discharge trends, observation status reviews, and documentation completion rates.
• Distribute performance and compliance reports to care management staff and ensure follow-up on identified issues.
• Support staffing coordination, on-call coverage, and workload distribution to meet departmental service needs.
• Maintain departmental records, ensure regulatory compliance, and support CMS/Medicare requirements.
• Provide training and support for clinical and operational systems such as ECIN, InterQual, Epic, and related platforms.

Requirements:

• 2+ years of experience in hospital care management or a related clinical operations role.
• Knowledge of utilization review processes and healthcare authorization workflows is required.
• Familiarity with tools such as InterQual, ECIN, Kepro, or similar clinical/utilization review systems.
• Strong understanding of CMS/Medicare regulations and healthcare compliance requirements.
• Excellent organizational skills with strong attention to detail and accuracy in documentation.
• Ability to manage multiple priorities in a fast-paced clinical environment.
• Strong communication and coordination skills with the ability to work across multidisciplinary teams.
• Comfort working with clinical data, reports, and healthcare information systems.

Benefits:

• Competitive compensation aligned with healthcare industry standards.
• Opportunity to work within a leading healthcare environment focused on patient-centered care.
• Exposure to advanced care management systems and utilization review processes.
• Career development opportunities, including potential progression into supervisory roles.
• Comprehensive healthcare benefits and employee wellness support.
• Structured training and professional development in clinical operations and healthcare compliance.
• Stable PRN schedule with defined daytime working hours and occasional weekend requirements.