Managed Care Coordinator
$62,400–$62,400 year
Remote · Columbia, South Carolina, United States
Job Summary
Review and authorize medical and behavioral health service requests to ensure benefit coverage and medical necessity guidelines; perform medical/behavioral utilization reviews and authorizations; prioritize cases by due dates and clinical documentation; compare requests against policy and member contracts; refer complex cases to Medical Director when needed; communicate approvals/denials to providers; ensure accurate documentation and regulatory compliance; ideal candidate is a licensed clinician who is detail-oriented, tech-savvy, and able to work independently in a remote environment, with strong clinical judgment, time management, and collaboration within a team-centered culture.
Required Qualifications
- Associate Degree in Nursing OR Master’s in Social Work, Counseling, or Psychology
- Active, unrestricted RN, LMSW, Counselor, or Psychologist license
- Minimum 2 years of clinical experience
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