South Carolina Licensed Managed Care Coordinator
- Full-time
A company is looking for a Managed Care Coordinator I to review and evaluate medical or behavioral eligibility regarding benefits and clinical criteria.
Key Responsibilities
Perform medical or behavioral review / authorization processes and ensure accurate documentation of clinical information
Utilize resources for review determinations and ensure compliance with applicable legislation and guidelines
Provide patient education and maintain knowledge of contracts and network status of service providers
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
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