• Utilization Management

    CVS Health (Columbia, SC)
    …No weekends or holidays. + 1+ years of utilization review/ utilization management required. + 3+ years of behavioral health clinical experience in a ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable… more
    CVS Health (06/25/25)
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  • RN Care Review Clinician , Inpatient Review

    Molina Healthcare (Columbia, SC)
    Behavioral health services. Strongly prefer candidates with a background on utilization management or appeals. Excellent computer multi-tasking skills and ... Medical, or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina… more
    Molina Healthcare (06/22/25)
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  • VP, Centerwell PCO, IPA CMO

    CenterWell (Columbia, SC)
    …care that affect patient care and population management , such as quality management , utilization management , network management , and payment ... patients at national scale. S/he will be a proven clinician , leader, and strategist capable of driving the highest...quality/STARS, efficiency of care, and improved clinical outcomes and utilization . + Identify and act on opportunities to better… more
    CenterWell (05/28/25)
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