RN Managed Care Coordinator I — Remote Post-Training

Spectraforce Technologies, Inc.; Columbia (SC); Hybrid; USD 60,000 - 80,000; Full time

Job summary

Spectrumforce Technologies, Inc. is hiring a Managed Care Coordinator I in Columbia, SC. This remote-after-training role focuses on reviewing eligibility, coordinating care, and supporting members with health management programs.

Requirements include an RN license, nursing degree, and clinical experience. The position supports discharge planning, care management, and collaboration with providers to ensure appropriate services.

Qualifications

• Active, unrestricted RN licensure in the United States and in the state of hire.
• Associate Degree in Nursing or nursing program graduate.
• 2 years clinical experience.
• Bachelor's degree in Nursing preferred.
• Case Manager Certification or clinical certification preferred.

Responsibilities

• Oversees medical/behavioral reviews to determine coverage within benefits and medical necessity guidelines.
• Coordinates discharge planning and evaluates service needs with providers.
• Communicates with providers and members in writing and by phone.
• Supports care management initiatives and promotes appropriate use of resources.
• Maintains up-to-date knowledge of contracts and network status.

Skills

Clinical review

Discharge planning

Effective communication

Care management knowledge

Data entry / documentation

Education

Associate Degree - Nursing

Bachelor's degree - Nursing (preferred)

Job description

Spectrumforce Technologies, Inc. is hiring a Managed Care Coordinator I in Columbia, SC. This remote-after-training role focuses on reviewing eligibility, coordinating care, and supporting members with health management programs.

Requirements include an RN license, nursing degree, and clinical experience. The position supports discharge planning, care management, and collaboration with providers to ensure appropriate services.