- InGenesis (Columbia, SC)
- InGenesis is currently seeking a Registered Nurse / RN - Managed Care Coordinator to work for our client located in Columbia, SC. In this role you will ... proper claims adjudication * Perform other duties as assigned. Minimum Qualifications * Current Registered Nurse / RN license in the State of South Carolina. *… more
- CVS Health (Columbia, SC)
- …compassionate. And we do it all with heart, each and every day. **Job Summary** The Care Manager- Registered Nurse is a key member of our Special Needs Plan ... of care management within Medicare and Medicaid managed care . + Familiarity with community resources...**Required Qualifications** + Candidate must have active and unrestricted Registered Nurse (RN) licensure in the state… more
- CVS Health (Columbia, SC)
- …+ 3+ years of clinical experience in a healthcare setting. + 2+ years as a Registered Nurse (RN) or License Practical Nurse / License Vocational Nurse . ... each and every day. **Position Summary** The Quality Management Nurse (QM Nurse ) supports Aetna Better Health...Experience in Healthcare Quality, CPHQ preferred. + Background in Managed Care . + Familiarity with claims processing… more
- Humana (Columbia, SC)
- …timeframe **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) Compact license, with no disciplinary action + 3 ... us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support the...clinical setting experience + MCG or InterQual experience + Managed care experience working directly with insurance… more
- AmeriHealth Caritas (Columbia, SC)
- …driver's license with car insurance is required. + Must hold a current and unrestricted Registered Nurse (RN) license in good standing in South Carolina or a ... to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health… more
- AmeriHealth Caritas (Lugoff, SC)
- …record/documentation systems is essential **Licensure** + Must hold a current and unrestricted Registered Nurse (RN) license in good standing in South Carolina ... to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health… more
- Datavant (Columbia, SC)
- …with clinical knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade ... by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well...will bring to the table:** + Two (2) years managed care experience in UM/CM/CDI Department preferred… more
- Highmark Health (Columbia, SC)
- …a clinical setting **Preferred** + 1-3 years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + ... outcomes. Will monitor and analyze the delivery of health care services in accordance with claims submitted, and analyzes...to privacy, sharing only information relevant to the member's care and within the framework of applicable laws. Practice… more