Managed Care Coordinator

Job overview

The Managed Care Coordinator role is remote after approximately three to four onsite orientation days, with the listing location in Columbia, SC. Compensation is $31 per hour. The role supports clinical review and care coordination for members and providers. The coordinator evaluates medical or behavioral service requests against benefit and medical-necessity criteria, coordinates care plans, and communicates determinations. The work helps ensure appropriate coverage, quality and cost-effective outcomes, and member support across inpatient and other care settings.

What you'll do

• Review inpatient admissions and continued stays using Milliman, MCG, InterQual, and company policies
• prepare clinical summaries and letters
• coordinate with case management, medical directors, and other teams
• assess medical necessity, benefits, and service needs
• document clinical information
• support member education and coaching
• communicate with members and providers
• close at least 15 cases daily after orientation, considering complexity.

What we're looking for

Skills & competencies

managed care coordinator

remote after orientation

columbia sc

medical necessity review

utilization review

care coordination

member advocacy

rn license

milliman/mcg/interqual

monday–friday

$31/hr

Work arrangement

• Weekend coverage required

Why this role

Remote work begins after approximately three to four onsite days; Monday–Friday, 8:30 a.m.–5:00 p.m.

About the employer

US Tech Solutions, Inc. is hiring for this role. Industry: Direct Health and Medical Insurance Carriers. Sector: 52.