South Carolina RN Managed Care Coordinator

Job Summary

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

Key Responsibilities

• Perform medical or behavioral review/authorization processes to ensure coverage for appropriate services
• Utilize resources to support review determinations and ensure compliance with regulatory guidelines
• Provide education to members and providers about healthcare delivery systems and promote enrollment in care management programs

Required Qualifications, Training, and Education

• Associates degree in a job-related field
• Graduate of an accredited school of nursing or 2 years of job-related work experience
• 2 years of clinical experience required
• Active, unrestricted RN licensure or equivalent in the state of hire
• Working knowledge of word processing software and Microsoft Office