South Carolina Licensed UM Coordinator
Job Summary
A company is looking for a UM Coordinator II to perform medical and pharmacy reviews and utilization management.
Key Responsibilities
- Conduct medical/pharmacy reviews and utilization management based on established criteria
- Provide education and support regarding medical reviews and claims processing
- Assist with discharge planning and collaborate with Managed Care Coordinators
Required Qualifications, Training, and Education
- Bachelor's degree in a job-related field
- Graduate of an accredited School of Licensed Practical Nursing or Licensed Vocational Nursing
- 2 years of experience as LPN or LBSW and 1 year in utilization management or medical/pharmacy reviews
- Active, unrestricted LPN/LVN licensure or active LBSW in the state of hire
- Working knowledge of Microsoft Office
COMPLETE JOB DESCRIPTION
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