Case Manager/Prior Authorization RN (Columbia, SC)

DESCRIPTION: 
One of America's premiere managed medicaid companies has created a ground-floor career opportunity. This is a chance to join a major corporation, yet still impact the daily care of the neediest people. You'll get to learn managed care operations, practice your clinical skills, and become an expert patients turn to without working in direct patient care. Based in Columbia, SC, you'll enjoy office hours in a comfortable, modern office setting, a comprehensive corporate benefits plan, a competitive salary with bonus, and the knowledge that you are impacting the quality of care for thousands of people daily.

As a Case Manager/Prior Authorization RN your responsibilities will include, but not be limited to, the following:

• Review requests for prior authorization for radiology services (MRI’s, CAT Scans, etc.)

• Act as clinical resources to referral staff and make appropriate referrals.

• Provide patient and provider education.

• Enters authorizations into the system

REQUIREMENTS: 

• MUST be an RN

• Bachelor's Degree in Nursing or other clinical degree

• At least two years clinical nursing experience

• Utilization Management (UM) certification preferred

• Experience in health care operations

• Understanding of medical mgmt is very helpful

***** Our client will consider a candidate with no managed care IF they have strong discharge planning and/or chart review and EXCELLENT track record overall.************* 

THE COMPANY: 
Our client is a leading multi-line health care enterprise that provides programs and related services to individuals receiving benefits under Medicaid, including Supplemental Security Income (SSI) and the State Children’s Health Insurance Program (SCHIP). The Company operates health plans in several states.

Responses should be emailed to SC-CT-0640@healthcareerprofessionals.com 
Phone: 866.371.0687 x.210

By applying to this position you are agreeing to receive additional information from our firm and our periodic email newsletter about new opportunities and career information. Your personal information is NEVER released to any third parties. 

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