- Careerbuilder-US (Columbia, SC)
- …Location: Columbia, SC Zip Code: 29219, 29203, 29229, 29201 Top 3/5 Skills: . RN / Registered Nurse License . Chronic condition care . Case Management Job ... mental health/chemical dependency, orthopedic, general medicine/surgery. Or, 4 years' utilization review/case management /clinical/or combination; 2 of the 4… more
- Humana (Columbia, SC)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) with compact license with… more
- Humana (Columbia, SC)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Humana (Columbia, SC)
- …hours and hard-wired, high-speed internet service is required for this position --_ The Utilization Management Nurse 2 helps to ensure fully coordinated care ... + Minimum of associate degree in nursing + Licensed Registered Nurse (RN) in a compact state...internet service is required for this position --_** The Utilization Management Nurse 2 helps… more
- CVS Health (Columbia, SC)
- …both verbal and written Required Qualifications - 3+ years of experience as a Registered Nurse - Must have active current and unrestricted RN licensure in ... and external constituents in the coordination and administration of the utilization /benefit management function.- Typical office working environment with… more
- Veterans Affairs, Veterans Health Administration (Columbia, SC)
- …external customers, and accreditation stakeholders. Meet goals through efficient, effective utilization and management of organizational and personal resources. ... on an as-needed basis until positions filled. Responsibilities This RN Quality Management Accreditation Specialist must have an attitude focused on building a… more
- Highmark Health (Columbia, SC)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... on where clinical care is being provided. **Preferred** + Certification in utilization management or a related field + Certification in Case Management … more
- US Tech Solutions (Columbia, SC)
- …education with members and providers regarding health care delivery system, utilization on networks and benefit plans. + May identify, initiate, and ... member advocate through continued communication and education. Promotes enrollment in care management programs and/or health and disease management programs. +… more
- Sharecare, Inc. (Columbia, SC)
- …other members of the health care team to support appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality ... the participants and their Primary Care Provider according to the disease management program intervention guidelines. An RN is supervised by an Operations Manager… 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 ... established clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency and claims knowledge/analysis to… more
- Fresenius Medical Center (Columbia, SC)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... + Preferred but not required: + 3+ years supervisory or project/program management experience. + Med/surg or ICU/CCU experience. **PHYSICAL DEMANDS AND WORKING… more
