- Lennar Homes (Columbia, SC)
- …for the Division. Monitor and coordinate potential land acquisition opportunities.Manage initial review of all potential acquisitionsTrack all sites under review ... target regions.Development/Entitlement budgeting.Compile material needed for any hearings and review boards.Work with an attorney in preparation of LOIs, Contracts,… more
- GXO (Orangeburg, SC)
- …compensation and a generous benefits package, including full health insurance ( medical , dental and vision), 401(k), life insurance, disability and more. What ... All employees may be required to perform duties outside of their normal responsibilities from time to time, as needed. Review GXO's candidate privacy statement here. more
- Prime Therapeutics (Columbia, SC)
- …**Job Description Summary** Key member of the utilization management team, and provides timely medical review of service requests that do not initially meet the ... Initial Clinical Reviewers as needed to discuss cases and problems. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the MD… more
- Evolent Health (Columbia, SC)
- …when available, within the regulatory timeframe of the request. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... **What You'll Be Doing:** As a Oncology, Physician Clinical Reviewer you will be a key member of the...Oncology cases, that do not initially meet the applicable medical necessity guidelines, as well as other requests when… more
- Evolent Health (Columbia, SC)
- …and provides clinical rationale for standard and expedited appeals. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... culture. **What You'll Be Doing:** As a Physician Clinical Reviewer you will be a key member of the...Imaging cases, that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests… more
- Evolent Health (Columbia, SC)
- …Opportunities:** + Routinely interacts with leadership and management staff, other Medical Directors, and health plan members and staff whenever a physician`s ... patients as directed by the office of the Chief Medical Officer. **What You Will Be Doing:** + Responsible...with practices and/or payers. + Perform all peer clinical review activities while located in a state or territory… more
- Humana (Columbia, SC)
- …and help us put health first** The Group Medicare Proposal Development/Contract Review Professional 2 reviews solicitations and prepares routine contract review ... (RFPs)/request for renewals (RFRs). The Group Medicare Proposal Development/Contract Review Professional 2 is primarily responsible for reviewing moderate to… more
- Sedgwick (Columbia, SC)
- …Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer SVP Bill Review - Careworks **PRIMARY PURPOSE OF THE ROLE:** To plan, direct, control and ... oversee functions within Bill Review -Careworks; and to maintain relationships with internal and external...benefits package is offered including but not limited to, medical , dental, vision, 401k and matching, PTO, disability and… more
- Intermountain Health (Columbia, SC)
- …year previous cash handling experience, preferably including vocational training/education in medical billing or medical records required. required- Knowledge of ... Excellent computer skills (including Microsoft Office applications), highly preferred- Medical terminology. Familiarity with electronic remittances, highly preferred **Physical… more
- Humana (Columbia, SC)
- …skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management ... your life extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan, time off (including… more
- Highmark Health (Columbia, SC)
- …and improve the care of our members. **ESSENTIAL RESPONSIBILITIES** + Conduct electronic review of escalated cases against medical policy criteria, which may ... current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and… more
- Merck (Columbia, SC)
- …to ensure that they thoroughly comprehend the science behind the medicine and review further unmet medical needs to bolster collaboration and further ... key role in the following activities: scientific literature search & review , development & review of medical education materials, participation in scientific… more
- Humana (Columbia, SC)
- …and will understand how to operationalize this knowledge in their daily work. The Medical Director's work includes computer based review of moderately complex to ... clinical group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed… more
- Humana (Columbia, SC)
- …will understand how to operationalize this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to ... health insurance, other healthcare providers + Utilization management experience in a medical management review organization, such as Medicare Advantage and… more
- Humana (Columbia, SC)
- …will understand how to operationalize this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to ... clinical group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed… more
- Sumitomo Pharma (Columbia, SC)
- …and post-marketing clinical development activities. + Provide detailed and compliant medical review and approval of external resources, communications, and ... follow us on LinkedIn. **Job Overview** The Senior Manager, Medical Strategy (Oncology) will be a key member of...Medical Advisory Boards, and Patient Advisory Boards upon review and approval of Legal and Compliance process. +… more
- CVS Health (Columbia, SC)
- …and individual client requested coverage determinations or appeals when appropriate. - Medical Directors will participate in inter-rater review activities and ... and individual client requested coverage determinations or appeals when appropriate. - Medical Directors will participate in inter-rater review activities and… more
- Cardinal Health (Columbia, SC)
- …regarding Medical Drug Information, including any MSL presentations and Medical /Safety Review Committees **Qualifications:** + 10+ years of experience ... they can focus on their patients. **What a Senior Medical Science Liaison contributes to Cardinal Health** : The...other status protected by federal, state or local law._ _To read and review this privacy notice click_ here… more
- Bausch + Lomb (Columbia, SC)
- …of action, clinical trial data, etc. + Responsible for performing accurate and detailed medical review of materials for therapeutic area within Medical ... the advancement of eye health in the future. **Position** **Summary** The Medical Affairs Director provides support to the Medical Affairs/Clinical Affairs… more
- Humana (Columbia, SC)
- …management, provider relations, quality of care, audit, grievance and appeal and policy review . The Behavioral Health Medical Director will develop and present ... clinical group practice management + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed… more
