- Evolent Health (Columbia, SC)
- …Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Clinical Reviewer , Nurse , you will be a key member of the utilization ... while providing better health outcomes. **Collaboration Opportunities:** As a Clinical Reviewer , Nurse , you will...**What You Will Be Doing:** + Functions in a clinical review capacity to evaluate all cases,… more
- Fresenius Medical Center (West Columbia, SC)
- …or federal surveys. + Participates in the completion of the FMS Administrative Clinical Review . **PHYSICAL DEMANDS AND WORKING CONDITIONS:** + The physical ... requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory… more
- Fresenius Medical Center (Columbia, SC)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning… more
- Prime Therapeutics (Columbia, SC)
- …Description Summary** This position has managerial and clinical oversight of the Clinical Pharmacist and Registered Nurse Review Team, playing a key ... drives every decision we make. **Job Posting Title** Supervisor Clinical Pharmacist Review - Remote in California...the clinical performance of a team of Clinical Pharmacist and Nurse Reviewers while supporting… more
- ManpowerGroup (Columbia, SC)
- **Job Title: Medical Claims Reviewer ** **Pay Rate:23/Hr (REMOTE opportunity after training)** **Duration:3+ Months on W2** **Location:4101 Percival Road Columbia SC ... OR, active compact multistate unrestricted LPN license as defined by the Nurse Licensure Compact (NLC), OR, active, unrestricted LBSW (Licensed Bachelor of Social… more
- ManpowerGroup (Columbia, SC)
- **Title: Medical Reviewer ** **Location:** **4101 Percival Road Columbia SC 29229 US (Onsite)** **Duration: 03+ Month's Contract** **Shift: Monday to Friday, 8 AM - 5 ... $20.00 to $23.00/hr.** We are looking for a "Medical Reviewer " to join one of our Fortune 500 clients....of our Fortune 500 clients. **Job Summary** The Medical Review and Utilization Management Specialist is responsible for performing… more
- US Tech Solutions (Columbia, SC)
- …health/chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review /case management/ clinical /or combination; 2 of 4 years must ... + Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical expertise, administrative policies, and… 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 ... a pro-active education and support plan, consistent with/based on the comprehensive quarterly clinical systems review and clinical outcomes to ensure center… more
- Prime Therapeutics (Columbia, SC)
- …this program is provided by the Manager, Patient Programs. **Responsibilities** + Registered Nurse (RN). + 5 years of post-degree clinical experience. + ... and drives every decision we make. **Job Posting Title** Infusion Referral Nurse - REMOTE **Job Description Summary** Under supervision, is responsible for performing… more
- Lincoln Financial Group (Columbia, SC)
- …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 ... proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills **Application… more
- Defense Health Agency (Columbia, SC)
- …care facilities. These affiliations provide for student instruction and supervision for clinical learning experiences and an enriched spectrum of clinical ... universities. Links: https://moncrief.tricare.mil/ https://home.army.mil/jackson/index.php **Responsibilities** As an License Practical Nurse /Vocational Nurse you will: Obtains information from… more
- Highmark Health (Columbia, SC)
- …Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** The Registered Nurse assesses human responses and plans, implements and evaluates nursing care ... for individuals or families for whom the nurse is responsible. The Registered Nurse is...in on-going interdisciplinary communication specific to each patient with review of patient status and plan of care. +… more
- US Tech Solutions (Columbia, SC)
- …mental health/chemical dependency, orthopedic, general medicine/surgery. Or, 4 years utilization review /case management/ clinical /or combination; 2 of the 4 years ... instability. Registered nurses MUST have 4 years or more of RECENT clinical experience. + Strong communication skills required to provide telephonic case management… more
- Edwards Lifesciences (Columbia, SC)
- …event narratives for internal review (eg R&D, quality, RA) or external review ( Clinical Endpoints Committee), as well as for regulatory submissions. + ... complaint information. + Collaborate with senior safety management to review and analyze aggregate safety reports to identify early...clinical and relevant industry experience Required Or + Nurse Practitioner (NP) with a Master's of Science in… more
- Fresenius Medical Center (Irmo, SC)
- …direct patient care staff on appropriate programs under the supervision of a nurse . + Provides developmental support to applicable clinical and facility staff. ... for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training...Related** + Participates in the recruitment process for new clinical staff + Assists with clinical orientation… more
- CenterWell (Columbia, SC)
- …provision of services consistent with government laws/regulations, business policies/care guidelines/ clinical standards. Collaborates to develop annual clinical ... related to wound and ostomy care, patient care supplies and guidance with clinical care delivery including patient education. + Works as an integral part of… more
- Highmark Health (Columbia, SC)
- …services to members with behavioral health concerns. The incumbent uses clinical and motivational interviewing skills to assess members' needs and establish ... resources and tools to assist in health-related decision making. Conduct telephonic clinical and psycho-social assessments that address the health and wellness needs… more
- Highmark Health (Columbia, SC)
- …**Job Description :** **JOB SUMMARY** This job will lead a team of Registered Nurse Complex Case Managers that deliver case management services to a specified panel ... of the Organization's members that range in health status/severity and clinical needs. Accountable for daily operation of unit including staffing and scheduling to… more
- Fresenius Medical Center (Columbia, SC)
- …dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training and in compliance ... and/or change in patient condition directly to the registered nurse or supervisor. + Observe patient and conduct machine...activities. + Enters all treatment data into the designated clinical application in an accurate and timely manner. +… more
- CVS Health (Columbia, SC)
- …outcomes as well as opportunities to enhance a member's overall wellness. + Uses clinical tools and information/data review to conduct an evaluation of member's ... in serving dual eligible populations by utilizing best-in-class operating and clinical models. We collaborate with members, providers, and community organizations in… more