- Evolent Health (Columbia, SC)
- …Through strong organizational practices and attention to detail the Behavioral Health UM Team supports a range of managed care populations including Medicaid, ... Identifies and refers cases not meeting established clinical criteria to the Medical Director Review. + Identifies and escalates quality of care issues to the… more
- Highmark Health (Columbia, SC)
- …in the capacity as a clinical pharmacist the incumbent may also review UM requests; provide consultation into the case and disease management identification process, ... overall efficiencies. + Manage individual projects for timely review with the Director , Clinical Pharmacy. + Participate in Medicare Stars performance measures to… more