RN Managed Care Coordinator South Carolina - North Hollywood California

Company: VirtualVocations
Location: North Hollywood, California
Posted On: 11/20/2024

A company is looking for a (RN) Managed Care Coordinator I - UM to review and evaluate medical or behavioral eligibility regarding benefits and clinical criteria.
Key Responsibilities

Perform medical or behavioral review/authorization processes to ensure appropriate service coverage
Evaluate outcomes of plans, eligibility, and medical necessity regarding requested services
Provide patient education and promote enrollment in care management programs

Required Qualifications, Training, and Education

Associates degree in a job-related field or two years of relevant work experience
Two years of clinical experience
Active, unrestricted RN licensure or equivalent from the United States
Working knowledge of word processing software and Microsoft Office
Ability to work independently and prioritize effectively More...

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