- Highmark Health (Columbia, SC)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... required depending on where clinical care is being provided. **Preferred** + Certification in utilization management or a related field + Certification in Case … more
- Sharecare, Inc. (Columbia, SC)
- …appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The RN is also responsible for ... with the participants and their Primary Care Provider according to the disease management program intervention guidelines. An RN is supervised by an Operations… more
- US Tech Solutions (Columbia, SC)
- …Less Than 6 Hours Per Weekend Assigned. + Performs medical or behavioral review/authorization process. Ensures coverage for appropriate services within benefit and ... education with members and providers regarding health care delivery system, utilization on networks and benefit plans. + May identify, initiate, and… more
- US Tech Solutions (Columbia, SC)
- …different programs and work remotely. Detail Oriented, Good Communication Skills, Time Management , Organization, Team Oriented, but able to work independently. + A ... our team culture. **Responsibilities:** + Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical… more
- Highmark Health (Columbia, SC)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... depending on where clinical care is being provided. **Preferred** + Certification in utilization management or a related field **SKILLS** + Working knowledge of… more
- Intermountain Health (Columbia, SC)
- …team meetings. + Reviews data summary on regular basis. **Minimum Qualifications** + Current RN license for state in which the nurse practices. + BLS ... **Job Description:** The Nurse Care Manager works collaboratively with physicians and...institution. Degree will be verified. + Experience in case management , utilization review, or discharge planning. **Physical… more