- Molina Healthcare (Olanta, SC)
- **JOB DESCRIPTION** RN Behavioral Health Case Manager will work in remote and field setting supporting our Medicaid SMI (Severe Mental Illness) ... Population in the state of South Carolina. Case Manager will be required to communicate...an integrated delivery of care across the continuum, including behavioral health and long term care, for… more
- Molina Healthcare (Timmonsville, SC)
- …concerns. + Collaborates with RN case managers/supervisors as needed or required + Case managers in Behavioral Health and Social Science fields may ... an integrated delivery of care across the continuum, including behavioral health and long term care, for...Social Worker (LCSW), Advanced Practice Social Worker (APSW), Certified Case Manager (CCM), Certified in Health… more
- Humana (Columbia, SC)
- …a part of our caring community and help us put health first** The Manager , Utilization Management Behavioral Health utilizes behavioral health ... and communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Behavioral Health works within… more
- Highmark Health (Columbia, SC)
- …management and/or disease/condition management experience, provider operations and / or health insurance experience **Preferred** + **Pediatric Complex Case ... **Company :** Highmark Inc. **Job Description :** **JOB SUMMARY** **Pediatric Complex Case Management** This job owns and conducts oversight over a specified panel… more
- Highmark Health (Columbia, SC)
- …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...regulatory agency requirements and applicable standards of practice for case management. + Other duties as assigned or requested.… more
- US Tech Solutions (Columbia, SC)
- …determinations. Identifies and makes referrals to appropriate staff (Medical Director, Case Manager , Preventive Services, Subrogation, Quality of care Referrals, ... + A typical day would like in this role: Employee will be providing telephonic case management for our members. + Past job instability. Registered nurses MUST have 4… more
- Intermountain Health (Columbia, SC)
- …and provides short term treatment planning for mental, emotional and behavioral disorders, conditions and addictions. **Essentials:** + Participates in case ... psychosocial functioning for the purpose of diagnosing mental, emotional, behavioral , addictive and developmental disorders and disabilities, implementing appropriate… more
- Highmark Health (Columbia, SC)
- …the engagement deliverables, resources, and outcomes. + Develop the engagement business case , scope, staffing and incentive model for RPM engagement with Providers ... executive leadership of the Enterprise (both Highmark and Highmark Health ), including CFO, EVP, Chief Actuary, and Vice President,...position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- AmeriHealth Caritas (Florence, SC)
- …managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover ... **REMOTE | Care Manager II Registered Nurse (BSN) - Foster Care...in order to collaborate with identified community, medical, and/or behavioral health teams. 5. Maintain timely, complete,… more
- US Tech Solutions (Columbia, SC)
- …determinations. Identifies and makes referrals to appropriate staff (Medical Director, Case Manager , Preventive Services, Subrogation, Quality of care Referrals, ... independently, prioritize effectively and have critical thinking skills. Experience in case management or care coordination and telephonic care experience is… more
- ManpowerGroup (Columbia, SC)
- …+ Identify and refer cases to appropriate internal departments (eg, Medical Director, Case Manager , Quality of Care Referrals). + Participate in data collection ... **Job Summary** The Clinical Review Specialist assesses and evaluates medical or behavioral eligibility for health benefits, ensuring services meet clinical and… more
- ManpowerGroup (Columbia, SC)
- …+ Identify and make referrals to appropriate staff (eg, Medical Director, Case Manager , Preventive Services, etc.). + Participate in data collection/input ... criteria to service requests. The individual will also provide health management program interventions, utilizing clinical proficiency, claims knowledge, and… more