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Complex Case Manager Jobs in Miami, FL (NOW HIRING)

Sedgwick

RN Field Case Manager

Miami, FL · On-site

$74K - $94K/yr

Sedgwick Field Case Managers work face to face with their injured workers and medical providers to ... the management of complex medical conditions, treatment planning and recovery from illness or ...

Sedgwick

RN Field Case Manager

Miami, FL · On-site +1

$74K - $94K/yr

Sedgwick Field Case Managers work face to face with their injured workers and medical providers to ... the management of complex medical conditions, treatment planning and recovery from illness or ...

York Risk Services

RN Field Case Manager

Miami, FL · On-site +1

$74K - $94K/yr

Sedgwick Field Case Managers work face to face with their injured workers and medical providers to ... the management of complex medical conditions, treatment planning and recovery from illness or ...

SOLIS Health Plans

Case Management Nurse

Miami, FL · On-site

CASE MANAGEMENT NURSE About us: Solis Health Plans is a new kind of Medicare Advantage Company. We ... Conducts comprehensive assessments of patients with complex medical needs to identify their ...

Solis Health Plans

Case Management Nurse

Miami, FL · On-site

$60K - $70K/yr

CASE MANAGEMENT NURSE About us: Solis Health Plans is a new kind of Medicare Advantage Company. We ... Conducts comprehensive assessments of patients with complex medical needs to identify their ...

VIVA USA INC

Case Management Coordinator

Miami, FL · On-site

Case Management Coordinator will effectively manage a caseload that includes supportive and medically complex members. Develops a proactive course of action to address issues presented to enhance the ...

VIVA USA INC

Case Management Coordinator

Miami, FL · On-site

Case Management Coordinator will effectively manage a caseload that includes supportive and medically complex members. Develops a proactive course of action to address issues presented to enhance the ...

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Complex Case Manager information

See Miami, FL salary details

$13

$23

$40

How much do complex case manager jobs pay per hour?

As of Aug 10, 2026, the average hourly pay for complex case manager in Miami, FL is $23.68, according to ZipRecruiter salary data. Most workers in this role earn between $18.41 and $25.77 per hour, depending on experience, location, and employer.

What other jobs can a complex case manager do?

A complex case manager can transition into roles such as care coordinator, social worker, healthcare administrator, or patient advocate, utilizing skills in case planning, communication, and problem-solving. These positions often require knowledge of healthcare systems, documentation, and sometimes additional certifications or licenses.

What is a complex case manager?

A Complex Case Manager is a healthcare professional who coordinates care for patients with multiple or serious health conditions that require comprehensive management. They assess patient needs, develop care plans, and work closely with patients, families, and healthcare providers to ensure optimal outcomes. Complex Case Managers help navigate healthcare systems, address barriers to care, and connect patients with resources, aiming to improve quality of life and reduce hospitalizations. Their role is crucial in managing cases that involve chronic illnesses, behavioral health issues, or social challenges.

What are some common challenges faced by complex case managers and how can they be addressed?

Complex Case Managers often encounter challenges such as coordinating care across multiple providers, managing high caseloads, and addressing social determinants of health that impact patient outcomes. Effective communication, strong organizational skills, and leveraging interdisciplinary teamwork are key strategies to overcome these challenges. Additionally, staying updated on resources and support services in the community can help ensure clients receive comprehensive care. Regular team meetings and ongoing professional development also support success in this dynamic role.

What are the key skills and qualifications needed to thrive as a complex case manager, and why are they important?

To thrive as a Complex Case Manager, you need a background in healthcare or social work, typically with a relevant degree and licensure such as RN, LCSW, or CCM certification. Familiarity with case management software, electronic health records (EHRs), and care coordination tools is essential. Excellent communication, critical thinking, and problem-solving skills are vital for building trust with clients and collaborating with multidisciplinary teams. These competencies ensure effective management of complex patient needs, improved outcomes, and efficient resource utilization.
What cities near Miami, FL are hiring for Complex Case Manager jobs? Cities near Miami, FL with the most Complex Case Manager job openings:
Complex Case Manager jobs near you
Infographic showing various Complex Case Manager job openings in Miami, FL as of August 2026, with employment types broken down into 1% As Needed, 84% Full Time, 14% Part Time, and 1% Contract. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution, with an average salary of $49,251 per year, or $23.7 per hour.

RN Prior Authorizations

Healthcare Support Staffing

Miami, FL • On-site

Full-time

Re-posted 3 days ago

Job description

Company Description

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Job Description

Core duties and responsibilities include the following. Other duties may be assigned.



Supports and encourages others to support the Mission, Core, Values and Goals of Prestige Health Choice.

Conducts occasional facility on-site and/or telephonic concurrent reviews and discharge planning and coordination of assigned hospitals.

Collaborates with follow up appointment coordination activities, and makes necessary referrals to medical and behavioral complex case managers .

Coordinates and supports all discharge authorization and service coordination activities necessary for discharge including inpatient hospital admissions, inpatient rehabilitation services, skilled nursing admission, home care, home care infusion services, outpatient and /or inpatient elective surgery, and referrals for physician consultation with nonparticipating physician offices.

Collaborates with health partners and behavioral Health partners with care coordination, transitions of care, discharges activities and member service issues

Attends facility and health center clinical and provider meetings.

Participates in daily facility rounds, and respective customer clinical and provider services meetings.

Collaborates with hospitalist's networks, and reviews network performance and access.

Monitors performance metrics and operations reports such as bed day, LOS, daily census, discharge and high risk reports.

Assists in coordination of PCP appointments for members prior to discharge

Collaborates with member services and provider operations for network access, authorization inquires, and care coordination.

Collaborates with contracted customer representatives and clinical staff to coordinate and address service and care issues.

Provides operations, performance and summary reports to Director of Inpatient Services.

Meets with Director of Inpatient Services as needed for census and operational updates.

Meets as needed with customer hospitalist networks.

Performs other related duties and projects, as assigned.

Qualifications

**Interqual experience required**

Prior Authorization or concurrent review and case management experience for a health plan/managed care company (at least 3 years)

Knowledge of Windows and Microsoft Office applications.

Current and unrestricted Florida RN license.

Case management and health education experience preferred.

Community and public health experience preferred.

Additional Information


Healthcare Support logo

About Healthcare Support

Sourced by ZipRecruiter

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.

Industry

Recruiting and staffing services

Company size

201 - 500 Employees

Headquarters location

Maitland, FL, US

Year founded

2003

Social media

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