Utilization Management Nurse- Behavioral Health (Remote) FT

MUSC Health; South Carolina; Remote; USD 70,000 - 90,000; Full time

Job summary

MUSC Health is seeking a full-time Utilization Management Nurse for their new regional behavioral health center in Florence, SC, offering a comprehensive range of services. This remote role requires a Bachelor's degree in Nursing, along with significant nursing and utilization management experience, providing opportunities to influence patient care positively while ensuring compliance with health regulations.

Benefits

Health Insurance

Retirement Options

Qualifications

• Five years of nursing experience, including two years in utilization/case management.
• RN license in South Carolina or compact state required.
• Familiarity with InterQual and/or MCG screening criteria desired.

Responsibilities

• Conduct utilization reviews to determine appropriate care.
• Monitor patient charts for concurrent care evaluation.
• Review treatment plans and insurance approval status.

Skills

Communication

Utilization Management

Patient Care

Education

Bachelor's degree in Nursing

Job description

Join to apply for the Utilization Management Nurse- Behavioral Health (Remote) FT role at MUSC Health.

Job Description Summary

MUSC is seeking a FT Utilization Management Nurse for our new Leatherman Behavioral Health Care Pavilion in Florence, SC (Remote).

Entity: Medical University Hospital Authority (MUHA)

Worker Type: Employee

Worker Sub-Type: Regular

Cost Center: CC005493 LBH - Case Mgmt

Pay Rate Type: Salary

Pay Grade: Health-28

Scheduled Weekly Hours: 40

Work Shift: Day shift

Job Responsibilities

• Conduct utilization reviews to determine appropriate care based on severity and required services.
• Monitor patient charts and records for concurrent care evaluation.
• Review treatment plans and insurance approval status.
• Collect and comply with data according to policies and regulations.
• Consult with providers and stakeholders as needed.

Minimum Qualifications

• Bachelor's degree in Nursing from an accredited school.
• Five years of nursing experience, including two years in utilization/case management in a hospital setting.
• Prior leadership experience preferred.
• Excellent communication skills.
• Familiarity with InterQual and/or MCG screening criteria desired.

Licensure: RN license in South Carolina or a compact state.

Additional Information

This position supports the MUSC Leatherman Health Pavilion in Florence, SC, a regional behavioral health center opening in October 2025, offering triage, crisis stabilization, telehealth, outpatient, and inpatient services.

Benefits include state health and retirement options. MUSC is an Equal Opportunity Employer and participates in E-Verify.