South Carolina Licensed Managed Care Coordinator
A company is looking for a Managed Care Coordinator I to evaluate medical or behavioral eligibility regarding benefits and clinical criteria. Key Responsibilities Perform medical or behavioral review/authorization processes to ensure coverage within guidelines Utilize resources to support review determinations and ensure compliance with regulatory bodies Provide patient education and serve as a member advocate regarding healthcare delivery and benefit plans 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 licensure in social work or counseling Working knowledge of word processing software and Microsoft Office Ability to work independently and prioritize effectively
A company is looking for a Managed Care Coordinator I to evaluate medical or behavioral eligibility regarding benefits and clinical criteria.
Key Responsibilities
Perform medical or behavioral review/authorization processes to ensure coverage within guidelines
Utilize resources to support review determinations and ensure compliance with regulatory bodies
Provide patient education and serve as a member advocate regarding healthcare delivery and benefit plans
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 licensure in social work or counseling
Working knowledge of word processing software and Microsoft Office
Ability to work independently and prioritize effectively
