- CVS Health (Columbia, SC)
- …a permanent weekend position Required Qualifications - 3+ years of experience as a Registered Nurse - Must have active current and unrestricted RN licensure in ... and external constituents in the coordination and administration of the utilization /benefit management function.- Typical office working environment with… more
- Humana (Columbia, SC)
- …put health first** Humana Healthy Horizons in Virginia is seeking a Manager, Utilization Management (Behavioral Health) who will utilize their clinical skills to ... behavioral health services and/or benefit administration determinations. The Manager, Utilization Management (Behavioral Health) applies a Person-Centered… more
- Veterans Affairs, Veterans Health Administration (Columbia, SC)
- …external customers, and accreditation stakeholders. Meet goals through efficient, effective utilization and management of organizational and personal resources. ... on an as-needed basis until positions filled. Responsibilities This RN Quality Management Accreditation Specialist must have an attitude focused on building a… more
- US Tech Solutions (Columbia, SC)
- …established clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency and claims knowledge/analysis to ... education with members and providers regarding health care delivery system, utilization on networks and benefit plans. Serves as member advocate through… more
- Fresenius Medical Center (Columbia, SC)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... + Preferred but not required: + 3+ years supervisory or project/program management experience. + Med/surg or ICU/CCU experience. **PHYSICAL DEMANDS AND WORKING… more
- Bon Secours Mercy Health (Columbia, SC)
- …**Summary of Primary Function/General Purpose of Position** In the capacity of a Registered Nurse , provide and facilitate coordination of services during the ... Education Specialty/Major Nursing (BSN) **Licensing/ Certification** - Licensure/Certification Required Registered Nurse with active License in State of… more
- Molina Healthcare (Columbia, SC)
- …driver's license **PREFERRED EDUCATION:** **PREFERRED EXPERIENCE:** + 3-5-year experience as a Registered Nurse and/or Nurse Practitioner, ideally in a ... **JOB DESCRIPTION** **Job Summary** The Care Connections Nurse Practitioners focus on screening and preventive primary care services delivered in the home,… more
- Lincoln Financial Group (Columbia, SC)
- …and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills ... will provide coaching and guidance to claims regarding medical management **What you'll be doing** * Evaluate medical information...looking for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license… more
- Marriott (Columbia, SC)
- …Information** Nurse CARE Manager (CARE - Coordinated Action and Response) Registered Nurse license required **Job Number** 24069165 **Job Category** Finance ... **Claims Services** + Collaborate with Claims department regarding case management . + Collaborate with UNM on utilization ...informed **Education or Certification** + Must be a licensed registered nurse + Certification as an occupational… more
- Humana (Columbia, SC)
- …implementing Clinical Prior Authorization policies, processes, detailed workflows, and leading the Utilization Management team. + Hiring and directly leading a ... team of Utilization Management nurses, clinicians and support staff...skills to make an impact** **Required Qualifications** + Active Registered Nurse (RN) license, or Licensed Social… more
- Universal Health Services (West Columbia, SC)
- …of our senior leaders. If you would like to learn more about the Registered Nurse (RN) position before applying, please contact Kieanna Robinson, HR ... in nursing. Specialty certification also preferred. Licensure/Certification: Currently licensed as a Registered Nurse in the state of South Carolina. BLS/CPI… more
- Universal Health Services (West Columbia, SC)
- …and verification of benefits for incoming patients. + Coordinates the utilization management functions of a patient caseload through collaboration ... Responsibilities Per Diem Utilization Review Coordinator Opportunity Three Rivers Behavioral Health...Masters' degree in a recognized mental health field or Registered Nurse . + Experience: + Minimum of… more
- Bon Secours Mercy Health (Columbia, SC)
- …excellence. Job Description **Summary of Primary Function** In the capacity of a Registered Nurse , the Ambulatory Care Manager will provide clinical care ... management services to identified eligible patients; coordinating care to...Bachelor's Degree Specialty/Major Nursing (BSN) **Licensing/ Certification** Licensure/Certification **Required** Registered Nurse with active License in State… more
- Teleflex (Columbia, SC)
- …today, from our world-class brands including: + LMA(R) and Rusch(R) airway management devices designed to help reduce the risk of airway-related complications. + ... Arrow pain management products designed to improve patients' post-operative pain experience. + The Arrow(R) EZ-IO(R) System that helps address the time-critical… more