Utilization Management Coordinator (IDD)

Job Description

Job Description

We are seeking a Utilization Management Coordinator (IDD) to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations.

About the Role :

The Utilization Management Coordinator (IDD) plays a critical role in ensuring that individuals with intellectual and developmental disabilities receive appropriate, timely, and cost-effective health care services. This position involves coordinating and reviewing service authorizations, monitoring care plans, and collaborating with healthcare providers, families, and care teams to optimize service delivery. The coordinator will analyze clinical data and utilization trends to support decision-making and compliance with regulatory requirements. By managing utilization processes effectively, this role helps to balance quality care with resource stewardship, ultimately improving health outcomes for the IDD population. The coordinator also serves as a liaison between various stakeholders to facilitate communication and resolve any issues related to service utilization and care coordination.

Minimum Qualifications :

• Associate's degree in nursing, social work, health administration, or a related field.
• At least two years of experience in utilization management, care coordination, or case management within a healthcare or IDD service setting.
• Strong knowledge of intellectual and developmental disabilities and related healthcare services.
• Familiarity with healthcare regulations, utilization review processes, and managed care principles.
• Proficiency in electronic health records (EHR) systems and data management tools.
• Relevant experience may substitute for the educational requirement on a year-for-year basis.

Preferred Qualifications :

Responsibilities :