A company is looking for a Managed Care Coordinator I.
Key Responsibilities
Perform medical or behavioral review / authorization processes to ensure coverage for appropriate services
Utilize resources to support review determinations and ensure compliance with regulatory guidelines
Provide education to members and providers regarding healthcare delivery and promote care management program enrollment
Required Qualifications
Associates degree in a job-related field or equivalent experience
2 years of clinical experience
Active, unrestricted RN licensure or equivalent licensure in social work or counseling
Working knowledge of word processing software
Ability to work independently and prioritize effectively
Managed Care Coordinator • Portsmouth, Virginia, United States