UM II Care Manager Nurse - Part-Time Remote

Spectraforce Technologies; Columbia (SC); Hybrid; USD 28,000 - 55,000; Part time

Job summary

Spectraforce Technologies is seeking a part-time Managed Care Coordinator UM II in Columbia, SC. The role involves reviewing medical and behavioral eligibility, applying clinical criteria, and coordinating care to support members with health management needs.

The position requires an RN license, clinical utilization review or case management experience, and strong communication skills. Onsite training is provided, with remote work possible after four weeks of on-site training.

Qualifications

• Active RN license in the United States and state of hire.
• Experience in utilization review and case management.
• Ability to assess medical necessity and coordinate care.

Responsibilities

• Review medical/behavioral eligibility and authorize services per guidelines.
• Coordinate discharge planning with providers and facilities.
• Communicate with members and providers regarding services and plans.
• Provide patient education on care options and health management.
• Maintain knowledge of contracts, networks, and authorization processes.

Skills

RN licensure

Clinical review

Care coordination

Education

Associate Degree - Nursing

Bachelor's degree - Nursing

Job description

Spectraforce Technologies is seeking a part-time Managed Care Coordinator UM II in Columbia, SC. The role involves reviewing medical and behavioral eligibility, applying clinical criteria, and coordinating care to support members with health management needs.

The position requires an RN license, clinical utilization review or case management experience, and strong communication skills. Onsite training is provided, with remote work possible after four weeks of on-site training.