Job Description

Managed Care Coordinator (RN / Licensed Clinician)

Pay: Up to $30/hr
Schedule: Monday–Friday, 8:30 AM–5:00 PM

Training: 1 week onsite
After Training : Remote (must live within 2 hours of Columbia, SC)
Equipment Provided

 

Position Summary
Responsible for reviewing and authorizing medical and/or behavioral health service requests to ensure services meet benefit coverage and medical necessity guidelines. Applies clinical expertise, contract knowledge, and utilization management principles to support quality, cost-effective member outcomes.

Ideal Candidate: A licensed clinician who is detail-oriented, tech-savvy, and comfortable working independently in a remote environment. Strong clinical judgment, time management, and communication skills are essential, along with the ability to prioritize workload and collaborate within a team-centered culture.

Key Responsibilities

• Perform medical/behavioral utilization reviews and authorizations
• Prioritize and review cases based on 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

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

TRC Talent Solutions is proud to be an Equal Opportunity Employer (EOE). All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

Job Tags

Similar Jobs