- Highmark Health (Columbia, SC)
- …the effective utilization management strategies including: review of appropriateness of health care services, application of criteria to assure appropriate ... of quality issues. Monitors and analyzes the delivery of health care services; educates providers and members...established industry and corporate standards and are within the care manager 's professional discipline. Effectively function in… more
- Molina Healthcare (Cayce, SC)
- …under productivity and outcome standards * Promotes integration of services for members including behavioral health care and long term services and supports ... plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care , for members with high need… more
- CenterWell (Columbia, SC)
- …across a complex health care organization. + Knowledge of health care regulations and policies related to behavioral health + Computer skills in ... integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up...care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager… more
- Highmark Health (Columbia, SC)
- …implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure ... of quality issues. Monitors and analyzes the delivery of health care services; educates providers and members...established industry and corporate standards and are within the care manager 's professional discipline. + Function in… more
- Centene Corporation (Columbia, SC)
- …facilitates complex care management activities for primarily mental and behavioral health needs members to provide high quality, cost-effective healthcare ... plan/service plan for the best outcome, which may include behavioral health and social determinant needs +...to identify providers, specialists, and community resources needed for care including mental health and substance use… more
- Highmark Health (Columbia, SC)
- …Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company ... times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice… more
- Highmark Health (Columbia, SC)
- …, identify resources, and conduct a number of other activities to help improve the health outcomes of members; care plans include both long and short term goals ... ownership and oversight over a specified panel of members that range in health status/severity and clinical needs. The incumbent assesses health management needs… more
- Highmark Health (Columbia, SC)
- …in a project manager role **Preferred** + Leadership experience + Health Care Insurance industry business and operational knowledge + Experience managing ... **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job...position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Highmark Health (Columbia, SC)
- …relationship management and performance + Experience in Indirect Category Sourcing and/or Health Care Sourcing with demonstrated expertise in influencing the ... **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job...Certified Professional in Supply Management (CPSM) + Certified Purchasing Manager (CPM) **SKILLS** + Experience in strategic management and… more
- CenterWell (Columbia, SC)
- …around maintenance of chronic health conditions, as well as available options for behavioral care and social support + Serve as liaison between the patient ... integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up...care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager… more
- National Youth Advocate Program (Columbia, SC)
- …a sincere desire and ability to advocate for children facing behavioral health , immigration, educational, legal, development, and socio-economic challenges. ... Us? Exciting Benefits and Opportunities at NYAP The Case Manager is responsible for the completion and submission of...members, friends of family to vet sponsor's ability to care for the minor(s); + Act as UC case… more
- J&J Family of Companies (Columbia, SC)
- Johnson & Johnson is recruiting for a field-based Site Activation CAR-T Senior Manager , Cell Therapy Experience Lead to support the United States. This is a field ... close proximity to a major metropolitan airport. At Johnson & Johnson, we believe health is everything. Our strength in healthcare innovation empowers us to build a… more
- Sevita (Columbia, SC)
- …**_Apply Today!_** Sevita is a leading provider of home and community-based specialized health care . We believe that everyone deserves to live a full, ... day. Join us today, and experience a career well lived. **QI Field Services Manager ** Are you looking for meaningful work that uses your background in social… more
- US Tech Solutions (Columbia, SC)
- …10% Participates in direct intervention/patient education with members and providers regarding health care delivery system, utilization on networks and benefit ... Provides appropriate communications (written, telephone) regarding requested services to both health care providers and members. **Experience:** . Required… more
- CenterWell (Columbia, SC)
- …impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... such as CPA, CIA + Previous experience in home health , care delivery, or care ...care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager… more
- Highmark Health (Columbia, SC)
- …in special committee meetings as required. + Cooperates with other health care team members and the Operations Manager pursuant to the Allegheny ... timely manner. + Patients are appropriately referred to other health care support systems or community resources...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Highmark Health (Columbia, SC)
- …3 years of Working knowledge of medical procedures and terminology + 3 years of Health Care claims, Health Insurance and Benefit Administration **SKILLS** ... level of production each month, as determined by the manager to ensure compliance with DLP changes. This role...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Highmark Health (Columbia, SC)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** We are on a mission to deliver remarkable health experiences, freeing people to be their ... requires an advanced 360 person-centered approach to deliver the right message, guidance, care , outcome, and experiences, all at the right time. This Sr Application… more
- Highmark Health (Columbia, SC)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** We are on a mission to deliver remarkable health experiences, freeing people to be their ... requires an advanced 360 person-centered approach to deliver the right message, guidance, care , outcome, and experiences, all at the right time. This Sr level role… more
- US Tech Solutions (Columbia, SC)
- …10% Participates in direct intervention/patient education with members and providers regarding health care delivery system, utilization on networks and benefit ... Provides appropriate communications (written, telephone) regarding requested services to both health care providers and members **Experience:** + 4 years… more