Sr. Clinical Review Manager, Registered Nurse RN

IHCS provides an Integrated Delivery System in the home setting, which includes, DME, Respiratory, Home Health and Home Infusion services. IHCS has a select network of Medicare and/or Medicaid Certified and Accredited providers to respond to the needs of our patients – 24/7. We operate with the sole intent of providing the highest quality in-home care services that improve and enhance the daily living for our patients, where our patients are #1 With over 30 years of experience, we are the trusted market leader in Home Health, Durable Medical Equipment, and Home Infusion Services. If you are passionate about inspiring, motivating, and leading teams this opportunity could be for you and we want to hear from you! Join our team as we strive for excellence through teamwork. We are committed to delivering high quality care to our patients through Exceptional Customer Service, Proven Outcomes, and Seamless Care.

The Senior Clinical Review Manager is responsible for overseeing the clinical review and management of utilization management (UM) program related to home health and durable medical equipment (DME) services. This role ensures compliance with regulatory requirements, payer guidelines, and internal policies while driving process improvements to optimize review efficiency and ensure accuracy of medical necessity decisions. The Senior Clinical Review Manager will lead a team of clinicians, collaborate with internal and external stakeholders, and provide strategic oversight to ensure high-quality and timely review of UM determinations.