- Humana (Columbia, SC)
- **Become a part of our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral ... health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the… more
- Humana (Columbia, SC)
- **Become a part of our caring community and help us put health first** The Behavioral Health Medical Director responsible for behavioral ... health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the… more
- Evolent Health (Columbia, SC)
- …from scrubs to jeans. **Collaboration Opportunities:** Evolent Health is looking for a Behavioral Health Medical Director to be a member of ... Stay for the culture. **What You'll Be Doing:** As a Behavioral Health Field Medical Director will be a key member of the utilization management team.… more
- Highmark Health (Columbia, SC)
- **Company :** Endorsed **Job Description :** **GENERAL OVERVIEW** The Medical Director will provide qualified medical direction and consultation for care ... provide clinical leadership and guidance to the regional interdisciplinary team. The medical director collaborates clinically with the APP to insure standards… more
- CVS Health (Columbia, SC)
- … health care and social determinant needs. The Duals Care Management (CM) Medical Director will participate in designing, developing and deploying our Models ... Bring your heart to CVS Health . Every one of us at CVS ...care management staff as they support of members' physical, behavioral and socioeconomic needs. * Partner closely with the… more
- Highmark Health (Columbia, SC)
- …Patient care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed ... current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and… more
- CenterWell (Columbia, SC)
- …Education, and work as a thought partner with Coding and Documentation Improvement Medical Director . The main responsibilities of the role are: + Determine ... strategy with clinical education team and CDI (coding and documentation improvement) medical director embedded in Clinical excellence. + Align clinician coding… more
- Highmark Health (Columbia, SC)
- …conceptualize and design how people interact with finding and accessing virtual/physical medical and behavioral care in tight collaboration with our Experience, ... **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- NASCO (Columbia, SC)
- …Cross Blue Shield Medical , Dental, and Vision Plans + Telehealthcare - for Medical and Behavioral visits + Generous PTO with buy/sell options + 9 Company ... **Overview** As the Director of Cloud Services at NASCO, you'll be...is designed to support the physical, mental, and financial health of our associates. We offer: **Physical and Mental… more
- Humana (Columbia, SC)
- **Become a part of our caring community and help us put health first** Director of Enterprise Information Protection (EIP) Cybersecurity Engineering focused on ... of manual processes using AI and RPA (Robotics Process Automation) ** Behavioral Competencies:** * Exceptional leadership skills, marked by poise, positive influence,… more
- Magellan Health Services (Columbia, SC)
- …personnel at child development centers, and consultation to installation command regarding behavioral health issues affecting children and youth. CYB counselors ... - Required Clinical Work Experience - Preferred Education - Required Master's - Behavioral Health , Master's - Social Work Education - Preferred License and… more
- RWJBarnabas Health (Sumter, SC)
- …EndocrinologyReq #:0000162043 Category:Pediatric Nursing Status:Full-Time Shift:Day Facility:Barnabas Health Medical Group Department:Pediatric Practice-SBPA ... Offset Location: Barnabas Health Medical Group, 375 Mount Pleasant Ave, Suite 105, WEST...Essential Functions: Coordination 20% + Develop standards along with Medical Director , Pediatric Endocrinology (MDPE) for inpatient… more
- US Tech Solutions (Columbia, SC)
- …to determine if the procedure can be approved or denied. Some may need sent to the medical director . They will also need to be flexible to help others in their ... back up review determinations. Identifies and makes referrals to appropriate staff ( Medical Director , Case Manager, Preventive Services, Subrogation, Quality of… more
- ManpowerGroup (Columbia, SC)
- …I** "to join one of our Fortune 500 clients. **Note:-** + Must Have Behavioral Health Experience + Previous Utilization Management (UM) or Case Management (CM) ... up review determinations. + Identifies and makes referrals to appropriate staff ( Medical Director , Case Manager, Preventive Services, Subrogation, Quality of… more
- ManpowerGroup (Columbia, SC)
- …coaching to promote engagement in health programs and behavior change. ** Medical or Behavioral Review/Authorization (20%)** + Perform medical and ... by utilizing allocated resources and making necessary referrals to relevant departments (eg, Medical Director , Case Manager, Quality of Care, etc.). + Maintain… more
- US Tech Solutions (Columbia, SC)
- …back up review determinations. Identifies and makes referrals to appropriate staff ( Medical Director , Case Manager, Preventive Services, Subrogation, Quality of ... consists of approx. 20 Case Managers **Responsibilities:** + Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by… more
- US Tech Solutions (Columbia, SC)
- …back up review determinations. Identifies and makes referrals to appropriate staff ( Medical Director , Case Manager, Preventive Services, Subrogation, Quality of ... our members and support each other. **Responsibilities:** + Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by… more
- ManpowerGroup (Columbia, SC)
- …back up review determinations. Identifies and makes referrals to appropriate staff ( Medical Director , Case Manager, Preventive Services, Subrogation, Quality of ... be onsite & Remote after training **Job Responsibilities:** + Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by… more
- Sharecare, Inc. (Columbia, SC)
- …one or more of the following areas: NICU, Oncology, Transplant, Maternity, and/or Behavioral Health . + Training in motivational interviewing preferred. + Strong ... **Job Description:** Sharecare is the leading digital health company that helps people - no matter...providers or members to the Clinical Advocate Manager or Director when he/she identifies an opportunity for education or… more
- Conviva (Columbia, SC)
- …best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can ... part of our caring community and help us put health first** This role is embedded within the clinical...CenterWell Primary Care Organization. This role reports to Associate Director of coding education and has a dotted line… more