- Humana (Columbia, SC)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
- Humana (Columbia, SC)
- … management or utilization management . **Additional Information** Reports to a Lead Medical Director . The Medical Director conducts Utilization ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests… more
- Humana (Columbia, SC)
- …us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate ... Medical Director works on problems of diverse scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with… more
- Sedgwick (Columbia, SC)
- …rounding ability + Strong understanding of workers compensation, liability and disability claims management + In-depth knowledge of client servicing + Ability ... Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Client Services Director - Casualty | CST & EST Time Zones...EST Time Zones **PRIMARY PURPOSE** : To determine account management strategies related to client service plans; to be… more
- Takeda Pharmaceuticals (Columbia, SC)
- …to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director , Global Labeling Lead where you will be responsible for the development ... guidance. **How you will contribute:** With guidance from leadership: Management of Labeling Cross-Functional Teams + Independently leads Labeling cross-functional… more
- Sedgwick (Columbia, SC)
- …Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Director Marketing Campaign Strategy and Execution **PRIMARY PURPOSE OF THE ROLE:** ... The Director , Marketing Campaign Strategy and Execution is responsible for...improve client satisfaction. **QUALIFICATIONS** + 8+ years B2B Campaign Management leadership experience. + Solid experience with campaign technologies… more
- Evolent Health (Columbia, SC)
- …Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for processing ... medical treatment requests in accordance with departmental policies, regulatory...contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager, Intake Utilization … 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 ... established clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency, claims knowledge/analysis,… 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 ... established clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency, claims knowledge/analysis,… more
- ManpowerGroup (Columbia, SC)
- …determinations. + Identify and refer cases to appropriate internal departments (eg, Medical Director , Case Manager, Quality of Care Referrals). + Participate ... members receive quality, cost-effective care. The Clinical Review Specialist will review medical necessity, support care management plans, and guide members… more
- ManpowerGroup (Columbia, SC)
- …review determinations. + Identify and make referrals to appropriate staff (eg, Medical Director , Case Manager, Preventive Services, etc.). + Participate in ... criteria to service requests. The individual will also provide health management program interventions, utilizing clinical proficiency, claims knowledge, and… more
- Prime Therapeutics (Columbia, SC)
- …with data consolidation and modeling + Prior PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + ... with business partners across client facing divisions, product/ project management , analytics, operations, and IT to enable data-driven strategic decisions.… more
- Prime Therapeutics (Columbia, SC)
- …and program impact measurement using eligibility, medical , and pharmacy administrative claims and external data, (eg, care management , disease management ... advanced scientific model design, including advanced predictive modeling, with health claims data, applying statistical theories and methods to solve complex… more
- Intermountain Health (Columbia, SC)
- …Director of Physician Compensation, Manager of Physician Compensation, Medical Group, region/market, service line, Provider Recruiting, Professional Staff ... of compensation programs and performs other duties as assigned by the Director - Physician Compensation and/or Physician Compensation Manager. **Skills** + Attention… more
- Intermountain Health (Columbia, SC)
- …a liaison in order to facilitate the prompt resolution of complex benefit, claims or enrollment issues for external, internal and team contacts. Handles service ... the task resolution process in Salesforce by utilizing task management with other departments and complaint tasks to seek...Assists in the design of marketing literature for unique medical and dental plans. SALES SYSTEMS: Is committed to… more
- Fujifilm (Columbia, SC)
- …limited management oversight. The position will report to the Director of Corporate Compliance. **Duties and responsibilities** + Develop and implement elements ... needs of healthcare across prevention, diagnosis, and treatment. Fujifilm's medical imaging portfolio includes solutions for digital radiography, mammography,… more