South Carolina Licensed LPN Coordinator

Job Summary

To support utilization management practices, the full-time remote South Carolina Licensed LPN Coordinator will perform medical reviews, document decisions, and educate members and providers on coverage determinations and medical necessity.

Key responsibilities

• Perform authorization processes and ensure benefit coverage for medical and pharmacy services based on established guidelines
• Educate internal and external customers regarding medical reviews, terminology, and UM processes while maintaining current knowledge of contracts and network status
• Complete required licenses and attend mandatory meetings, making referrals to appropriate staff as needed

Required qualifications

• Bachelor's degree in a job-related field
• Graduate of an accredited school of Licensed Practical Nursing or Licensed Vocational Nursing
• Two years of work experience as an LPN or LBSW
• Active, unrestricted LPN/LVN licensure in South Carolina or active compact multistate unrestricted LPN license
• Proficient in Microsoft Office and possess good judgment and organizational skills