- PruittHealth (Columbia, SC)
- …needs of clinical staff, based on ongoing evaluation, patient needs and acuity. 2 . Provides relevant and creative education for clinical staff on a variety of ... including the right to wage complaints. * Complies with corporate compliance program. * Reports job-related functions/tasks that involve occupational hazards… more
- Wellpath (Columbia, SC)
- …and customer service. You'll oversee the delivery of nursing care, ensuring compliance with established policies and procedures, and work to continuously maintain ... Provide supervisory oversight by monitoring staff performance and conduct, ensuring compliance with policies, procedures, and dress codes during assigned shifts. +… more
- US Tech Solutions (Columbia, SC)
- …system for clinical information flow and proper claims adjudication. Demonstrates compliance with all applicable legislation and guidelines for all regulatory ... orthopedic, general medicine/surgery. OR, 4 years utilization review/case management/clinical/or combination; 2 of 4 years must be clinical. **Skills:** + Working… more
- US Tech Solutions (Columbia, SC)
- …system for clinical information flow and proper claims adjudication. Demonstrates compliance with all applicable legislation and guidelines for all regulatory ... general medicine/surgery. Or, 4 years utilization review/case management/clinical/or combination; 2 of the 4 years must be clinical. Required License/Certificate:… more
- US Tech Solutions (Columbia, SC)
- …after 1 week onsite training. + Skill sets/qualities: Must have at least 2 years hospital experience, any other utilization review experience is great, different ... health coach, coordinate, monitor, and evaluate medical necessity and/or care plan compliance , options, and services required to support members in managing their… more
- Evolent (Columbia, SC)
- …Minimum of 5 years in Utilization Management, health care Appeals, compliance and/or grievances/complaints in a quality improvement environment- **Required** + Able ... break) 3 days/week, to meet the business need of 2 nurses providing coverage until 7:00pm CST. Can negotiate...on days when candidate has appointments/events before 7:00pm CST- 2 days/week 8-5 CST/EST or your time zone -… more
- PruittHealth (Florence, SC)
- **Registered Nurse RN - Home Health Services** **Full time** **Location:** **Darlington** Home is where the heart is! That's why PruittHealth @ Home is committed to ... Conducts field visits to (1) evaluate & initiate start of care and ( 2 ) conduct clinical outcomes monitoring, follow-up and care performance improvement initiatives *… more
- PruittHealth (Ridgeway, SC)
- …with the patient's assessment and care plan, and as directed by the nurse supervisor. Under the direction of the manager, performs daily phlebotomy activities ... the Certified Nursing Assistant (CNA) job code 0101, Department 6300 for HCC. 2 . Handles laboratory data collection systems and equipment to ensure requests for… more
- Prime Therapeutics (Columbia, SC)
- …participating in on-going training programs to ensure quality performance in compliance with applicable standards and regulations. Expert within the organization. + ... their staff, cardholders, and pharmacies. + Escalates medical exception requests to nurse , pharmacist or physician on the utilization review clinical team when… more
- Centene Corporation (Columbia, SC)
- …and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators + Provides ... from an Accredited School of Nursing or a Bachelor's degree in Nursing and 2 - 4 years of related experience. **License/Certification:** + RN - Registered Nurse… more