South Carolina Licensed LPN Coordinator
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Job Summary
To support utilization review practices, the full-time remote South Carolina Licensed LPN Coordinator will perform medical surgical/pharmacy reviews, manage authorization processes, and document decisions based on established criteria while collaborating with internal and external stakeholders.
Key responsibilities:
- Perform authorization processes and reviews to determine eligibility, medical necessity, and appropriateness of services
- Educate members and providers on medical reviews, coverage determinations, and utilization management processes
- Maintain current knowledge of contracts and network status, and make referrals to appropriate staff as needed
Required qualifications:
- Bachelor's degree in a job-related field or graduate of an accredited school of Licensed Practical Nursing or Licensed Vocational Nursing
- 2 years of working experience as an LPN or LBSW
- Active, unrestricted LPN/LVN licensure or active LBSW in the state of hire
- Proficiency in Microsoft Office software
- Ability to handle confidential information with discretion
Complete Job Description
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