- Humana (Columbia, SC)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied… more
- CenterWell (Columbia, SC)
- …caring community and help us put health first** The Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence ... prevent and detect fraud, waste, and abuse. The Compliance Nurse 2 work assignments are varied and...experience a plus + Previous experience in chronic disease management , utilization management , case … more
- CVS Health (Columbia, SC)
- …Must have active current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include ... required in med surg or specialty area. + Managed Care experience preferred, especially Utilization Management . + Preference for those residing in EST or CST… more
- InGenesis (Columbia, SC)
- …or behavior eligibilities regarding benefits and clinical criteria. * Perform utilization management of professional facility benefits/services. * Document ... InGenesis is currently seeking a Licensed Practical Nurse / LPN to work remotely with our...will provide support and review of medical claims and utilization practices. This is a REMOTE opportunity for a… more
- Evolent (Columbia, SC)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... Be Doing:** + Practices and maintains the principles of utilization management and appeals management ...business need of nurses providing coverage until 7:00pm CST. 2 days/week 8am - 5pm EST/CST - **Required** +… more
- ManpowerGroup (Columbia, SC)
- ** Utilization Management Nurse /...Worker (Contract Position)** **Location:** Remote (Must Train Onsite for 1- 2 Weeks) - Must Reside Within 3 Hours of ... Format:** Microsoft Teams **Job Overview** We are seeking a ** Utilization Management Nurse or Licensed...(LPN) or Licensed Vocational Nursing (LVN). **Experience:** + Minimum ** 2 years of clinical experience** in a healthcare setting.… more
- US Tech Solutions (Columbia, SC)
- …mental health/chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review/case management /clinical/or combination; 2 of ... 8:30 am to 5:00 pm REMOTE AFTER FIRST WEEK ONSITE. + Experience: Registered Nurse with > 5 years nursing experience. Background in med/surg, previous case … more
- US Tech Solutions (Columbia, SC)
- …mental health/chemical dependency, orthopedic, general medicine/surgery. Or, 4 years utilization review/case management /clinical/or combination; 2 of ... **Job Title:** **Registered Nurse UM II** **Location: Columbia SC 29229** **Duration: 3+ month's Contract** **Job Description:** + Reviews and evaluates medical or… more