- Molina Healthcare (Edgefield, SC)
- **JOB DESCRIPTION** Behavioral Health Case Manager will work in remote and field setting supporting our Medicaid SMI (Severe Mental Illness) Population ... case managers/supervisors as needed or required + Case managers in Behavioral Health ...Social Worker (LCSW), Advanced Practice Social Worker (APSW), Certified Case Manager (CCM), Certified in Health… more
- CVS Health (Columbia, SC)
- …care for members. - This position consists of working intensely as a telephonic case manager with patients and their care team for fully and/or self-insured ... . Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers...states - 1+ years' current or previous experience in Behavioral Health - 1+ years' experience documenting… more
- Molina Healthcare (Cayce, SC)
- …the state of South Carolina. Member Health Assessor will be partnering with Behavioral Health Case Managers and meeting with Medicaid members to ... following: Licensed Clinical Social Worker (LCSW), Advanced Practice Social Worker (APSW), Certified Case Manager (CCM), Certified in Health Education and… more
- Highmark Health (Columbia, SC)
- …ownership and oversight over a specified panel of members that range in health status/severity and clinical needs. The incumbent assesses health management needs ... interventions and referrals, the incumbent will manage an active case load of members in his/her panel that are...various resources to assist members in achieving their personal health goals. The incumbent monitors, improves and maintains quality… more
- US Tech Solutions (Columbia, SC)
- …telephonically and via digital platforms to meet their healthcare goals. Backgrounds in only behavioral health or maternity would be better suited for one of our ... determinations. Identifies and makes referrals to appropriate staff (Medical Director, Case Manager , Preventive Services, Subrogation, Quality of care Referrals,… more
- Advanced Correctional Healthcare (Columbia, SC)
- Site Mental Health Manager Job Details Job Location Richland County Alvin S. Glenn Detention Center - SC - Columbia, SC Position Type Full Time Education Level ... Percentage Up to 25% Job Shift Any Job Category Behavioral Health Description SUMMARY: Our associates deliver...health services for continuity of care and discharge planning/ case management via sharing of pertinent patient information. +… more
- Highmark Health (Columbia, SC)
- **Company :** Highmark Inc. **Job Description :** **JOB SUMMARY** HNAS ( Health Now Administrative Services) offers flexible, cost-effective solutions for employee ... health benefits. HNAS is part of Highmark Health...or its strategic business partners. When this is the case , there may be less direct reporting relationships and… more
- Highmark Health (Columbia, SC)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** The Customer Navigation and Service Senior Product Manager defines the vision, strategy and ... optimizing channel connectivity, and enhancing agent tools. The Senior Product Manager will define the product's value proposition, develop a compelling business… more
- Highmark Health (Columbia, SC)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** The Billing Product Manager defines and executes the strategy and roadmap for a best-in-class ... define the product's value proposition to develop a compelling business case focused on revenue generation and operational efficiency. Responsibilities include… more
- Highmark Health (Columbia, SC)
- …and existing Risk Adjustment Programs. The incumbent will deliver value to the Health Plan, and its beneficiaries enrolled in Risk Adjusted government programs (MA ... the engagement deliverables, resources, and outcomes. + Develop the engagement business case , scope, staffing and incentive model for RPM engagement with Providers… more
- CenterWell (West Columbia, SC)
- …Team Manager is responsible for managing a team of nurses, community health workers, and behavioral health resources who engage high risk/high ... individualized care and services they need to reach optimal health . The Manager is also responsible for...well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up… more
- AmeriHealth Caritas (Columbia, SC)
- …managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover ... care coordination services in achieving their optimal level of health through self-management. The Care Manager (RN)... health and supportive needs. + Coordinates physical, behavioral health and social services; + Provides… more
- Otsuka America Pharmaceutical Inc. (Columbia, SC)
- …matter in the prediction, prevention, and management of conditions related to women's health , the mental and behavioral spaces, and overall well-being. This is ... Otsuka Precision Health is a health experience company...billion in 2023. **About This Role** An OPH Product Manager brings a unique blend of product management and… more
- Maxim Healthcare Services (Aiken, SC)
- Maxim Healthcare Services is hiring for an Sales and Community Development Manager to focus on growth and development of in-home nursing and caregiving services for ... programs, local insurance payers, physician groups, government entities, and case management groups. Why Join Maxim: + Competitive pay...Join Maxim: + Competitive pay & weekly paychecks + Health , dental, vision, and life insurance + 401(k) savings… more
- Highmark Health (Columbia, SC)
- …industry, corporate, state, and federal law standards and are within the care manager 's professional discipline. + For assigned case load, create care plans ... :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides oversight over… more
- Intermountain Health (Columbia, SC)
- **Job Description:** The Social Work Care Manager works collaboratively with physicians and other members of the health care team to improve the health of ... position educates patients and caregivers to help them manage their health care needs. The incumbent facilitates communication, coordinates services, addresses… more
- Highmark Health (Columbia, SC)
- **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding ... works with external resources to create and monitor inpatient case mix reports and the top 25 assigned DRGs/APCs...of Ethical Coding as set forth by the American Health Information Management Association and Corporate Compliance Coding Guidelines.… more
- US Tech Solutions (Columbia, SC)
- …determinations. Identifies and makes referrals to appropriate staff (Medical Director, Case Manager , Preventive Services, Subrogation, Quality of care Referrals, ... Management Certification must be obtained within 4 years of hire as a Case Manager . Preferred Education: Bachelor's degree- Nursing Preferred Work Experience: 7… more
- US Tech Solutions (Columbia, SC)
- …+ Identifies and makes referrals to appropriate staff (Medical Director, Case Manager , Preventive Services, Subrogation, Quality of Care Referrals, ... great team player. **Responsibilities:** + Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical… more
- CenterWell (Columbia, SC)
- …experience a plus + Previous experience in chronic disease management, utilization management, case management, discharge planning and/or home health or rehab + ... and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral ...primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager… more