- 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 ... staff (Medical Director, Case Manager, Preventive Services, Subrogation, Quality of care Referrals, etc.). * Participate in data collection/input into system for… more
- US Tech Solutions (Columbia, SC)
- …and to coordinate with team, providers, and patient representatives regarding patient care . + Skill sets/qualities: Same as required skills listed in job ... staff (Medical Director, Case Manager, Preventive Services, Subrogation, Quality of care Referrals, etc.). + Participates in data collection/input into system for… more
- Humana (Columbia, SC)
- …+ Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization + Proficient utilizing electronic medical record ... caring community and help us put health first** The UM Administration Coordinator contributes to administration of utilization management. The UM Administration … more
- Evolent (Columbia, SC)
- …regulatory and health plan requirements. They have a broad knowledge of health care delivery, managed care regulations, and prior authorization experience. ... Stay for the culture. **What You'll Be Doing:** The ** Coordinator , Appeals and Grievances** at Evolent is responsible for...role or comparable administrative role within a health plan, managed care organization or third-party administrator is… more
- Cardinal Health (Columbia, SC)
- …management preferred. + Familiarity with Medicare, Medicaid, commercial insurance plans, and managed care preferred. + Proficiency in billing software (eg ... building relationships of trust with customers and internal business partners. The Coordinator , Collections is responsible for the timely follow-up and resolution of… more
- Cardinal Health (Columbia, SC)
- …Minimum 2 years of experience in Insurance follow-up preferred + Understanding of managed care contracts and fee schedules, including Medicare and Medicaid ... accurately, efficiently, promptly, recognizing their importance and relationship to patient care + Consults with appeals department for disputed / denied claims.… more
- Highmark Health (Columbia, SC)
- …degree + Pharmacy technician certification certificate + Experience working in a managed care medication formulary management environment + Working knowledge of ... retail pharmacy and/or third party prescription procession + Strong background and understanding of medications and formulary terminology + Pharmacy technicians must be familiar with multiple Medicaid drug benefit design offerings and rules/regulations across… more