Managed Care Coordinator
$30 per hourTRC Talent Solutions
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
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
- 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
Vacancy posted 1 day ago
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