South Carolina RN Managed Care Coordinator

Job Summary

A company is looking for a RN Managed Care Coordinator I - UM.

Key Responsibilities

• Perform medical or behavioral review/authorization processes to ensure coverage for appropriate services
• Utilize resources for review determinations and ensure compliance with regulatory guidelines
• Provide patient education and serve as a member advocate through continued communication

Required Qualifications, Training, and Education

• Associates degree in a job-related field or equivalent experience
• 2 years of clinical experience
• Active, unrestricted RN licensure or equivalent in the state of hire
• Working knowledge of word processing software
• Ability to work independently and prioritize effectively