South Carolina RN Managed Care CoordinatorVirtualVocations • Fremont, California, United States
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South Carolina RN Managed Care Coordinator
VirtualVocations • Fremont, California, United States
[job_card.variable_days_ago]
[job_preview.job_type]
- [job_card.full_time]
[job_card.job_description]
A company is looking for a part-time RN Managed Care Coordinator I focused on DME, Home Health, and Hospice.
Key Responsibilities
Perform medical or behavioral review / authorization processes to ensure coverage aligns with benefit and medical necessity guidelines
Utilize resources for review determinations and participate in data collection for clinical information flow and claims adjudication
Provide patient education and serve as a member advocate, promoting enrollment in care management programs
Required Qualifications
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
Active, unrestricted RN licensure or equivalent in the state of hire
Working knowledge of Microsoft Office software
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