South Carolina Licensed Utilization Coordinator

Job Summary

A company is looking for a Utilization Management Coordinator I to perform medical and pharmacy reviews and support utilization management services.

Key Responsibilities

• Conduct authorization processes and review medical/pharmacy requests for eligibility and necessity
• Educate customers on medical reviews and respond to inquiries regarding coverage determinations
• Maintain required licenses and attend mandatory meetings while making appropriate referrals as needed

Required Qualifications

• Bachelor's degree in a job-related field or graduate of an accredited LPN/LVN program
• Two years of work experience as an LPN or LBSW
• Active, unrestricted LPN/LVN licensure or active LBSW in the state of hire
• Working knowledge of Microsoft Office and word processing software
• Ability to handle confidential information with discretion