Senior Managed Care Case Manager (RN)

TALENT Software Services; Columbia (SC); On-site; USD 60,000 - 80,000; Full time

Job summary

A healthcare management firm located in South Carolina seeks a qualified professional for a role focused on case management and utilization review. The position involves active management of healthcare cases, development of care plans, member assessments, and telephonic support. Candidates must have an Associate Degree in Nursing or equivalent, an active RN license, and strong analytical and communication skills. This role offers opportunities to work with members managing chronic or acute healthcare conditions.

Qualifications

• Associate Degree in Nursing OR equivalent OR 4 years clinical experience OR 4 years UM / Case Management / Clinical (2 years clinical mandatory).
• Active RN license (SC required).

Responsibilities

• Active case management of assigned members.
• Develops and coordinates care plans.
• Monitors services and evaluates outcomes.
• Assesses eligibility and medical necessity.
• Educates members and promotes care management programs.

Skills

Analytical thinking

Independent decision-making

Communication skills

Productivity management

Microsoft Office (Outlook, Teams, Excel)

Multi-system navigation

Education

Associate Degree in Nursing or equivalent

Job description

A healthcare management firm located in South Carolina seeks a qualified professional for a role focused on case management and utilization review. The position involves active management of healthcare cases, development of care plans, member assessments, and telephonic support. Candidates must have an Associate Degree in Nursing or equivalent, an active RN license, and strong analytical and communication skills. This role offers opportunities to work with members managing chronic or acute healthcare conditions.