- 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
- US Tech Solutions (Columbia, SC)
- …staff (Medical Director, Case Manager, Preventive Services, Subrogation, Quality of care Referrals, etc.). + Participates in data collection/input into system for ... in direct intervention/patient education with members and providers regarding health care delivery system, utilization on networks and benefit plans. May identify,… 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
- Cognizant (Columbia, SC)
- …Monday to Friday - Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced level work ... to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined...2-3 years combined clinical and utilization management experience with managed health care plan . 3 years'… more
- Humana (Columbia, SC)
- …Qualifications** + Bachelor's degree in Nurse (BSN). + Valid and unrestricted Registered Nurse (RN) license in the (appropriate state) with no disciplinary ... desired clinical outcomes and to enhance quality of medical care . The **Telephonic Nurse Case Manager** will...delivery system. + Knowledge of MCG or Interqual. + Managed care experience. **Additional Information** **Work Days/Hours**… more
- Evolent (Columbia, SC)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior...year of experience with medical management activities in a managed care environment + Schedule: Monday-Friday, 9:00… more
- CVS Health (Columbia, SC)
- …shift times are not permitted. **Required Qualifications** + Active unrestricted state Registered Nurse licensure in state of residence required. + Minimum ... members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant to join our remote team. **Key Responsibilities**...**Preferred Qualifications** + 1+ year of experience in a managed care organization (MCO). + Experience in… more
- Assured & Associates (Lamar, SC)
- Assured and Associates is looking for a Registered Nurse to join our team. This person is responsible for assisting physicians while providing treatment to ... high-quality care to individuals in our communities whose care can be safely and effectively managed in the home setting, with respect and empathy. At… more
- AmeriHealth Caritas (Columbia, SC)
- …internal candidates, bordering states may be accepted. ; **Education/Experience:** + Registered Nurse required + 3 to 5 years Managed Care experience. ... to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health… more
- AmeriHealth Caritas (Columbia, 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
- CenterWell (Columbia, SC)
- …Science in Nursing (BSN) strongly preferred. **License/Certifications:** + Active and unrestricted Registered Nurse (RN) license or Compact State RN license with ... The **RN Clinical Manager** coordinates and oversees all direct care patient services provided by clinical personnel. This role...A minimum of 2 years of experience as a Registered Nurse (RN). + Home health experience… more