RN/Managed Care Coordinator - Remote
Back RN/Managed Care Coordinator - Remote Healthcare Columbia , South Carolina Contract Hybrid Oct 9, 2026 RN/Managed Care Coordinator - Remote Job at a Glance Title:RN/Managed Care Coordinator Location: Columbia, SC (on-site training during the first week; remote thereafter. Must reside within 2 hours of Columbia, SC.) Contract: W2 only Pay: $ 30/hour + optional medical, dental, vision, 401(k) match Must have an active unrestricted RN license in the state of South Carolina and 4+ years recent clinical experience.
Overview
We are seeking a Managed Care Coordinator to provide telephonic case management and clinical review support for members with chronic, acute, and at-risk conditions. This role applies clinical expertise and established criteria to assess needs, coordinate services, and promote quality, cost-effective outcomes. The ideal candidate brings recent clinical experience, strong communication skills, and the ability to deliver member-centered coaching and education.
Key Responsibilities
Provide telephonic case management, including assessment, care planning, and ongoing monitoring of member goals and outcomes. Evaluate eligibility, benefits, level of care, length of stay, and medical necessity to support appropriate services and benefit exceptions. Document clinical information accurately to support medical necessity determinations and benefits coverage. Perform review and authorization activities in alignment with clinical guidelines and applicable policies. Coordinate referrals to appropriate internal clinical and support resources when needed. Educate and coach members using motivational interviewing, reflective listening, and readiness-to-change techniques to improve engagement. Communicate with members, providers, and interdisciplinary teams to ensure coordinated care and appropriate resource utilization. Required Skills Experience providing telephonic case management and coordinating care plans for members with chronic and/or high-risk conditions. Strong clinical assessment skills and ability to apply clinical criteria to determine medical necessity and appropriate services. Excellent verbal and written communication skills for member/provider interactions and documentation. Demonstrated ability to work effectively within regulated healthcare environments and comply with applicable standards and guidelines. Adaptability to evolving case management processes and workflows. Recent adult care experience. For Registered Nurses: at least 4 years of recent clinical experience. Education Associate Degree in Nursing, graduate of an accredited school of nursing, or other qualifying graduate degree path (e.g., Master's in Social Work; Master's in Psychology or Counseling, as applicable to the role requirements). Preferred Skills Bachelor's degree in Nursing. Utilization review and/or case management experience (including blended clinical and review experience). Case management certification and/or clinical certification in a defined specialty area. Healthcare program management experience. Reliable high-speed internet with direct (wired) connection capability; ability to maintain a dedicated, private home workspace suitable for confidential phone-based work. Why Should I Apply? This role offers the opportunity to support members through impactful, outcomes-focused care coordination while working in a structured environment with remote flexibility after initial training. About CEI: As a trusted technology partner, CEI delivers solutions that help our customers transform their business and achieve meaningful results. From strategy and custom application development through application management - our technology and digital experience services are tailored to meet each unique need of our customers. Our staffing solutions bring specialized skills to complement our customers' workforce and project requirements. #ZR #INDGEN