Utilization Management Nurse- Behavioral Health (Remote) FT

Job Description Summary

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Job Description

Conducts utilization reviews to determine if patients are receiving care appropriate to severity of illness or condition and intensity of services required. Monitors patient charts and records to evaluate care concurrent with the patients treatment. Reviews treatment plans and status of approvals from insurers. Collects and complies data as required and according to applicable policies and regulations. Consults with providers and other stakeholders as needed.

Minimum Training and Education:  Bachelor's degree in Nursing from an accredited school of nursing and five years of nursing work experience to include two years utilization / case management experience in a hospital setting required. Prior leadership experience preferred. Evidence of committee involvement within a healthcare setting needed (either departmental or hospital-wide). Must possess excellent verbal and written communication skills. Familiarity with InterQual and/or MCG screening criteria desired.

Required Licensure, Certifications, Registrations: ?Licensure as a registered nurse by the state of South Carolina or compact state required.

Additional Job Description

This position is remote support for the MUSC Leatherman Health Pavilion in Florence SC.

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Leatherman Behavioral Health Pavilion will serve as a regional behavioral health center and include a combination of triage, crisis stabilization, telehealth, outpatient, and inpatient services that will expand much-needed behavioral health resources in the Pee Dee region. Once built, the center will occupy the site of an MUSC-owned property currently known as the Cedar Tower campus on E. Cedar Street in Florence. The project was coordinated through an advisory committee convened by South Carolina Department of Health and Human Services (SCDHHS) Director Robby Kerr. (Opening October 2025)

The MUSC Health Leatherman Pavilion features will include:

• A rapid access center to provide walk-in triage and assessment and offer transition to care.
• Telepsychiatry services to strengthen access to psychiatric services throughout the region.
• Sixteen adult and four adolescent beds for crisis services to rapidly stabilize patients.
• Outpatient adult and pediatric behavioral health clinics.
• A 63-bed inpatient psychiatric unit to treat patients needing more acute care, including the transfer of the 23 psychiatric hospital beds at the McLeod Behavioral Health Center in Darlington to the new facility.

The behavioral health center develops individualized treatment plans. Services and treatments include:

Services

• Mental Health Services
• Addiction Services
• Therapy

About Florence, SC: “Florence, South Carolina, is a city that blends a fascinating history with a vibrant present. From its humble beginnings as a railroad town to its thriving arts scene and diverse economy, Florence has become a destination that offers something for everyone. Whether you're interested in history, culture, or outdoor activities, Florence is sure to captivate your heart and leave you wanting to explore more.” (quote from hollymelody.com). For more information, please visit About Florence – Greater Florence Chamber of Commerce (flochamber.com)

Benefits
MUSC is a state facility, therefore our full-time positions come with the option of the State of South Carolina health and retirement benefits.

If you like working with energetic enthusiastic individuals, you will enjoy your career with us!

The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.

Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: http://www.uscis.gov/e-verify/employees