South Carolina Licensed Managed Care Coordinator

To support healthcare services, the full-time South Carolina Licensed Managed Care Coordinator will review and evaluate medical or behavioral eligibility for benefits, utilizing clinical expertise and administrative policies in a fully remote environment. Key responsibilities Perform medical or behavioral review/authorization processes to ensure coverage for services within established guidelines Utilize resources to support review determinations and ensure compliance with regulatory bodies Provide patient education and serve as a member advocate through ongoing communication regarding healthcare delivery systems Required qualifications Associates degree in a job-related field or equivalent experience Active, unrestricted RN licensure or LMSW licensure in the state of hire Two years of clinical experience Working knowledge of Microsoft Office Ability to handle confidential information with discretion