South Carolina Licensed Registered Nurse

Job Summary

To support optimal patient health and resource utilization, the full-time South Carolina Licensed Registered Nurse will manage the medical necessity process, coordinate clinical care, and advocate for patients while working remotely.

Key responsibilities

• Coordinates clinical care and resource utilization by evaluating medical necessity and discharge planning
• Completes admission and concurrent reviews to secure authorizations and improve clinical outcomes
• Advocates for patients with payers to obtain appropriate reimbursement and manage dispute resolution processes

Required qualifications

• Education: Associate's degree in Nursing required
• Experience: At least two years of acute hospital or Behavioral Health patient care experience
• Licensure/Certification: Active Registered Nurse license required
• Preferred Education: Bachelor of Science in Nursing (BSN)
• Preferred Licensure/Certification: Accredited Case Manager (ACM)