South Carolina RN Managed Care Coordinator

Job Summary

To support health management initiatives, the full-time salaried South Carolina RN Managed Care Coordinator will review and evaluate medical or behavioral eligibility, manage service requests, and coordinate care plans while working remotely from South Carolina.

Key responsibilities

• Perform medical or behavioral review and authorization processes to ensure coverage and compliance with medical necessity guidelines
• Utilize resources to support review determinations and identify referrals to appropriate staff for enhanced care coordination
• Provide patient education and advocacy regarding healthcare delivery systems and promote enrollment in care management programs

Required qualifications

• Associate's degree in a job-related field or equivalent experience from an accredited nursing school
• Active, unrestricted RN licensure in the state of hire or compact multistate RN license
• Two years of clinical experience
• Proficiency in Microsoft Office
• Ability to work independently and prioritize effectively