- Lincoln Financial Group (Columbia, SC)
- …Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management ... Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible for… more
- US Tech Solutions (Columbia, SC)
- …Knowledge of National Committee for Quality Assurance (NCAG). Knowledge of Utilization Review Accreditation Commission (URAC). Knowledge of South Carolina ... of Nursing. Required Work Experience: 2 years clinical experience plus 1 year utilization /medical review , quality assurance, or home health, OR, 3 years… more
- PruittHealth (Columbia, SC)
- **JOB PURPOSE:** Senior Nurse Consultant serves as a member of the clinical and region team, to assist centers in achieving clinical excellence. She/he is ... operations and quality improvement practices for designated centers. The senior nurse consultant provides education, mentoring and validation of required systems and… more
- Bon Secours Mercy Health (Columbia, SC)
- …of Primary Function/General Purpose of Position** In the capacity of a Registered Nurse , provide and facilitate coordination of services during the acute care stay ... patients. Work directly with the patient, family/support members, inpatient case management team, and interdisciplinary care team members during admission for… more
- US Tech Solutions (Columbia, SC)
- …established clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency, claims knowledge/analysis, and ... to promote quality, cost effective outcomes. + Provides active case management , assesses service needs, develops, and coordinates action plans in cooperation… more
- Fresenius Medical Center (Sumter, SC)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- Marriott (Columbia, SC)
- …with Claims department regarding case management . + Collaborate with UNM on utilization review issues. + Refer catastrophic cases in coordination with claims ... claims most likely to benefit from case management to meet jurisdictional needs. ** Utilization Review ** + Provide initial clinical review in order to… more
- Universal Health Services (West Columbia, SC)
- …absence, and the administrator-on-call. Additionally, this position will include knowledge of Utilization Review rules and regulations as they assist physicians ... You are never alone, as you are part of a large network of peer nurse leaders that routinely exchange ideas and review current topics within the industry.… more
- Universal Health Services (West Columbia, SC)
- Responsibilities Per Diem Utilization Review Coordinator Opportunity Three Rivers Behavioral Health is a 129-bed treatment facility that specializes in quality ... verification of benefits for incoming patients. + Coordinates the utilization management functions of a patient caseload...years psychiatric experience in chart analysis and in the utilization review field. Excellent oral and written… more
- Bon Secours Mercy Health (Columbia, SC)
- …Job Description **Summary of Primary Function** In the capacity of a Registered Nurse , the Ambulatory Care Manager will provide clinical care management services ... Interviewing techniques as a patient-centered approach to activate patients in self- management of their chronic conditions with the goal of improved symptom… more
- Fresenius Medical Center (Columbia, SC)
- …dialysis clinic. You will collaborate with the Medical Director and the Charge Nurse regarding the provision of quality patient care in the dialysis clinic. ... data collections and auditing activities. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review… more