- Humana (Columbia, SC)
- …a part of our caring community and help us put health first** The Behavioral Health Care Coach assesses and evaluates member's needs and requirements to ... assignments are often straightforward and of moderate complexity. The Behavioral Health Care Coach employs... field with experience working with members with behavioral health and/or substance use disorder The… more
- AmeriHealth Caritas (Columbia, SC)
- …physical health needs the case worker will consult with a registered nurse care manager.; **The Behavioral Health Case Worker will:** + Support Members ... qualify.** ; Your career starts now. We're looking for the next generation of health care leaders. At AmeriHealth Caritas, we're passionate about helping people… more
- AmeriHealth Caritas (Orangeburg, SC)
- …knowledge to identify issues, gaps in care , and barriers to care . The Field - Based Remote Behavioral Health Case Worker develops a plan of care ... services. Discover more about us at www.amerihealthcaritas.com. **Responsibilities:** The Field - Based Remote Behavioral Health ...coordinating care , services, and social determinants of health for Members with behavioral health… more
- Molina Healthcare (Columbia, SC)
- …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care , for members with high need ... licensed for the state of SOUTH CAROLINA. LPN Member Health Assessor will work in remote and field...Experience** 1-3 years in case management, disease management, managed care or medical or behavioral health… more
- Highmark Health (Columbia, SC)
- …, identify resources, and conduct a number of other activities to help improve the health outcomes of members; care plans include both long and short term goals ... panel. Provides oversight over a specified panel of members that range in health status/severity and clinical needs; and assesses health management needs of… more
- Advanced Correctional Healthcare (Columbia, SC)
- …the stabilization of at-risk detainees. + Coordinate with county behavioral health services for continuity of care and discharge planning/case management via ... Percentage Up to 25% Job Shift Any Job Category Behavioral Health Description SUMMARY: Our associates deliver...SUMMARY: Our associates deliver a higher standard of medical care , mental health care , and… more
- Highmark Health (Columbia, SC)
- …implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure ... identification and resolution of quality issues. Monitors and analyzes the delivery of health care services; educates providers and members on a proactive basis;… more
- Highmark Health (Columbia, SC)
- …analytics and reporting solutions aligned to the Quadruple Aim of Healthcare: lower per capita health care costs, improved outcomes from and quality of care ... Sciences, Informatics, Biostatistics, Statistics, Epidemiology or Pharmacy or related field **Substitutions** + Bachelor's Degree in Public Health , Nursing,… more
- Highmark Health (Columbia, SC)
- …identify actionable opportunities aligned to the Quadruple Aim of Healthcare: lower per capita health care costs, improved outcomes and quality of care ... working with data to answer important questions about clinical care and population health that drive the... Sciences, Informatics, Biostatistics, Statistics, Epidemiology, Pharmacy or related field **OR** 6 years of relevant work experience in… more
- Centene Corporation (Columbia, SC)
- …education for members and their families. **(Must have Case Management and Strong Behavioral Health Management background).** + Evaluates the needs of the ... member, barriers to accessing the appropriate care , social determinants of health needs, focusing...and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be… more
- Defense Health Agency (Columbia, SC)
- …enhance services, agreements exist between Moncrief and various universities and other health care facilities. These affiliations provide for student instruction ... to identify major complaints, symptoms, or reason for seeking health care . Takes all vital signs (blood...weight, measurement of head circumference, and length); performs a behavioral health screening. Documents patients' chief complaints… more
- University of South Carolina (Columbia, SC)
- …planning. The Neuropsychologist will collaborate with Primary Care Physicians and Behavioral Neurologists to ensure that USC Brain Health Network patients ... Neuropsychologist position will be a blend of direct patient care as well as participating as part of a...field of neuropsychology with a focus on brain health and language recovery, utilizing neuroimaging tools and AI… more
- Highmark Health (Columbia, SC)
- …healthcare fraud investigations **Preferred** + 1 year in Financial Analysis in an acute care hospital or health insurance setting + 1 year in professional ... or offsite. The incumbent is also responsible for the field investigative work necessary to complete a review of...have understanding of technical and financial aspects of the health insurance industry + Strong personal computer skills, along… more
- Highmark Health (Columbia, SC)
- … **SKILLS** + Deep Clincal Expertise -extensive knowledge of clinical, quality, care , utilization, high-cost claim, and population health management. Must be ... **Required** + 7 years in a clinical or Managed Care setting **Preferred** + 5 years Client Support +...Bachelor's degree in Nursing, Pharmacist, Physician Assistant or Clinical field **Substitutions** + None **Preferred** + Master's degree in… more
- Highmark Health (Columbia, SC)
- …skills + An understanding of computer applications + Ability to work with members of the health care team + Any of the following: + Registered Health ... Certified Outpatient Coder (COC) Preferred + Associate's Degree in Health Information Management or related field **_Disclaimer:_**...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Highmark Health (Columbia, SC)
- …BigQuery + Experience with Google Healthcare Data Engine + 5 years working in the Health Care industry (payer or provider) + 2+ years experience with modeling ... Management + Agile Program Management + Basic Enterprise Financial Understanding + Health Care Technology + Broad technical experience and understanding of… more
- Highmark Health (Columbia, SC)
- …products, including a core administrative platform, modular utilization and care management solutions, patient-focused digital products, and clinical data exchange ... Enrollment, Billing, Benefits, Products and Services. Knowlege of Provider Health Systems like EMRs and RCM processes is a...by providing high quality services + Provide feedback from field experience to internal teams and sales colleagues with… more
- Highmark Health (Columbia, SC)
- …or provider) and familiarity with key domains like CMS interoperability, Quality management, care & utilization management, and digital health + 3 years' ... from lead to closure) + 3 years' experience in Health Plan Technology + 3 years' experience with solid...+ Bachelor's degree in Business, Technology, Healthcare or related field or relevant experience and/or education as determined by… more
- Centene Corporation (Columbia, SC)
- …in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall health of ... zone. **Position Purpose:** Performs a clinical review and assesses care related to mental health and substance...outlined by the applicable state required. Master's degree for behavioral health clinicians required. Clinical knowledge and… more
- Sevita (Columbia, SC)
- …by physician's orders and personal care services. + Conduct assessments, implement health care services to be included in each Individual Service Plan (ISP), ... a substance use disorder, and/or has an emotional or behavioral disability. + Monitor the health conditions...is a leading provider of home and community-based specialized health care . We believe that everyone deserves… more