- Humana (Columbia, SC)
- …documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are ... a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to support the… more
- Lincoln Financial Group (Columbia, SC)
- …Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management ... Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible for… more
- Humana (Columbia, SC)
- …and ad hoc reports in Access and/or SQL + Graduate degree + Utilization Management Review Experience + Registered Nurse (RN) Credentials + Home Health, ... Durable Medical Equipment, and/or Skilled Nursing Facility Experience **Additional Information** **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week)… more
- Humana (Columbia, SC)
- …**Preferred Qualifications** + Registered Nurse + Experience in Medicare Utilization Management + Project Management Professional (PMP) certification ... are addressed. They will work closely with established functions inside utilization management (Medical Director, clinician decision making teams, quality… more
- PruittHealth (Columbia, SC)
- **JOB PURPOSE:** Senior Nurse Consultant serves as a member of the clinical and region team, to assist centers in achieving clinical excellence. She/he is ... operations and quality improvement practices for designated centers. The senior nurse consultant provides education, mentoring and validation of required systems and… more
- Fresenius Medical Center (Lexington, SC)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
- Fresenius Medical Center (Columbia, SC)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- ManpowerGroup (Columbia, SC)
- …Education:** Bachelor's degree- Nursing. Preferred Work Experience: 7 years-healthcare program management , utilization review , or clinical experience in ... our Fortune 500 clients. **Note:-** + Must Have Behavioral Health Experience + Previous Utilization Management (UM) or Case Management (CM) experience +… more
- Cardinal Health (Columbia, SC)
- …for physician leaders and physician board regarding all areas of practice management and operations. This leader has primary responsibility to manage and drive ... will be needed in the following areas: practice operations, revenue cycle management , patient growth and practice marketing, value-based care, payor relations, EHR,… more