• RN Care Manager - Behavioral

    Molina Healthcare (Darlington, SC)
    **JOB DESCRIPTION** Case Manager will work in remote and field setting supporting our Medicaid SMI (Severe Mental Illness) Population in the state of South ... Carolina. Case Manager will be required to communicate...an integrated delivery of care across the continuum, including behavioral health and long term care, for… more
    Molina Healthcare (05/03/25)
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  • Complex Case Manager RN - Oncology…

    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
    Highmark Health (07/15/25)
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  • Care Manager RN - (Remote)

    Highmark Health (Columbia, SC)
    …appropriate resource utilization, identification of opportunities for referral to a Health Coach/ case management, and identification and resolution of quality ... and refer members whose healthcare outcomes might be enhanced by Health Coaching/ case management interventions. + Employ collaborative interventions which… more
    Highmark Health (07/12/25)
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  • Care Manager II

    AmeriHealth Caritas (Columbia, SC)
    …determinants of health for Members with acute, chronic, medically complex and/or behavioral health conditions and other health needs. Serves as the ... **Role Overview;** The Care Manager II is responsible for managing and coordinating...in order to collaborate with identified community, medical, and/or behavioral health teams + Maintain timely, complete,… more
    AmeriHealth Caritas (07/27/25)
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  • Care Manager

    AmeriHealth Caritas (Columbia, SC)
    …social determinants of health and supportive needs + Coordinates physical, behavioral health and social services + Provides medication management, including ... managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover… more
    AmeriHealth Caritas (05/30/25)
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  • Social Worker

    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
    Intermountain Health (07/29/25)
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  • Coding Auditor Educator

    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
    Highmark Health (05/09/25)
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  • Licensed Master Social Worker

    US Tech Solutions (Columbia, SC)
    …determinations. Identifies and makes referrals to appropriate staff (Medical Director, Case Manager , Preventive Services, Subrogation, Quality of care Referrals, ... weeks. + NICE TO HAVE skill sets/qualities: Knowledge of social determinates of health . Experience locating resources outside of their home state. Good foundation of… more
    US Tech Solutions (06/23/25)
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  • Registered Nurse

    US Tech Solutions (Columbia, SC)
    …determinations. Identifies and makes referrals to appropriate staff (Medical Director, Case Manager , Preventive Services, Subrogation, Quality of Care Referrals, ... medical policies. **Responsibilities:** + Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical… more
    US Tech Solutions (07/11/25)
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  • Senior Strategy Advancement Professional

    CenterWell (Columbia, SC)
    …that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... ad hoc reporting. * Develop basic modeling and business case analysis; work closely with Finance and Data teams...primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager more
    CenterWell (06/24/25)
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  • Registered Nurse - Managed Care Coordinator

    InGenesis (Columbia, SC)
    …determinations. * Identify and makes referrals to appropriate staff (Medical Director, Case Manager , Preventive Services, Subrogation, Quality of care Referrals, ... Columbia, SC. In this role you will review and evaluate medical or behavioral eligibility regarding benefits and clinical criteria and assess and monitor medical… more
    InGenesis (05/16/25)
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