001 Blue Cross And Blue Shield Of South Carolina

Coordinator, Managed Care II/UM-1

W@H South Carolinaremotemid

Posted today · via Workday

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About this role

Summary Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical expertise, administrative policies, and established clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency, claims knowledge/analysis, and comprehensive knowledge of healthcare continuum to assess, plan, implement, coordinate, monitor, and evaluate medical necessity, options, and services required to support members in managing their health, chronic illness, or acute illness. Utilizes available resources to promote quality, cost effective outcomes.…

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What we'd score you on

reqspace match rubric

Five dimensions, recruiter-grade. Upload your resume and we'll generate a written explanation of where you fit and where the gaps are.

Skills match

For this role: go, monday

Level fit

This role is mid-level. We check your trajectory against it.

Domain experience

Your work in the role's domain matters more than your years total. We weight recent and direct experience.

Recency

A skill you used last quarter weighs more than one from five years ago. We grade on recency, not lifetime.

Location fit

This role is remote-eligible — we factor in your stated location and time-zone overlap.

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Skills in this role

Pulled from the job description. These are the keywords we'll weight when scoring your fit.

gomonday

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