CCM Specialist (Healthcare)

TL;DR

CCM Specialist (Healthcare): Developing and implementing chronic and transitional care management workflows to ensure CMS compliance and improve patient outcomes with an accent on clinical education and quality improvement. Focus on analyzing utilization data, refining care coordination protocols, and supporting clinical staff across a network of home health and hospice agencies.

Location: Must be based in the USA

Company

hirify.global is a holding company supporting over 250 home health, hospice, and senior living agencies across 19 states through a centralized service model.

What you will do

• Develop and monitor care coordination and CCM workflows in alignment with CMS guidelines.
• Ensure billing compliance and promote accurate documentation for CCM services.
• Educate clinical staff on comprehensive assessments and individualized care plans.
• Oversee TCM program operations to ensure timely post-discharge follow-up.
• Analyze patient outcomes, readmission rates, and utilization data to identify improvement opportunities.
• Train staff on new processes, technologies, and evidence-based care strategies.

Requirements

• Must be based in the USA
• Knowledge of CMS guidelines and value-based care strategies.
• Experience with ACO operations and care coordination workflows.
• Ability to lead clinical training and onboarding for care coordinators.
• Proficiency in data analysis for quality improvement and KPI tracking.

Culture & Benefits

• Full benefits package including medical, dental, and vision insurance.
• 401(k) retirement plan with company match.
• Generous PTO and paid holidays.
• Professional development opportunities.
• Culture rooted in the CAPLICO values of accountability, passion for learning, and ownership.