Part time
BlueCross BlueShield of South Carolina
Simpsonville, SC, USA
Summary We are currently hiring for a part-time RN Managed Care Coordinator to join BlueCross BlueShield of South Carolina. In this role as a part-time RN Managed Care Coordinator I, you will review and evaluate medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical expertise, administrative policies, and established clinical criteria to service requests. Utilizes clinical proficiency and claims knowledge/analysis to assess, plan, implement, coordinate, monitor, and evaluate medical necessity and/or care plan compliance, options, and services required to support members in managing their health, chronic illness, or acute illness. Utilizes available resources to promote quality, cost effective outcomes. Description Location: This position is part-time (30 hours/week) Monday-Friday from 8:30am-5:00pm EST and will be fully remote. The candidate will be required to report on-site for trainings, meetings, or other business...


