Referral and Patient Care Manager

Job overview

The Referral and Patient Care Manager role is described as primarily office-based or remote, depending on organizational policy; the listing identifies West Palm Beach, FL. Compensation is $55,000–$70,000 per year. The role supports Clinical Operations and Utilization Management. The manager leads referral processing, case management, and utilization review operations to support timely, clinically appropriate, and compliant decisions. The role also oversees staff, care coordination, quality, and regulatory practices to support appropriate healthcare resource use and patient outcomes.

What you'll do

• Supervise, train, and mentor referral coordinators, case managers, and utilization review staff
• manage workflow, staffing, and productivity
• maintain department policies and procedures
• oversee evidence-based review criteria for referrals, authorizations, and case management decisions
• support complex cases, peer reviews, and appeals
• oversee transitions of care and discharge planning
• monitor compliance, audits, quality reviews, and metrics
• coordinate with medical directors, providers, quality, and claims teams.

What we're looking for

Skills & competencies

referral management

patient care management

utilization review

case management

clinical operations

team leadership

prior authorization

care coordination

west palm beach fl

pcc medical holdings

clinical license required

rn preferred

Work arrangement

• Weekend coverage required

Why this role

An active, unrestricted clinical license is required; Registered Nurse (RN) is strongly preferred. The posting notes occasional availability for urgent clinical reviews outside standard hours may be required.

About the employer

PCC MEDICAL HOLDINGS LLC is hiring for this role. Industry: Direct Health and Medical Insurance Carriers. Sector: 52.