- Humana (Columbia, SC)
- …part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse uses behavioral health knowledge and ... licensed in a Compact State** The Utilization Management Behavioral Health Nurse completes...Qualifications** + Minimum of Associate Degree in Nursing + Registered Nurse ( RN ) licensure with… more
- US Tech Solutions (Columbia, SC)
- …providing telephonic case management for our members. + Past job instability. Registered nurses MUST have 4 years or more of RECENT clinical experience. + Strong ... mental health/chemical dependency, orthopedic, general medicine/surgery. Or, 4 years utilization review/case management /clinical/or combination; 2 of the 4… more
- ManpowerGroup (Columbia, SC)
- …500 clients. **Note:-** + Must Have Behavioral Health Experience + Previous Utilization Management (UM) or Case Management (CM) experience + Training ... the state of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse ...Bachelor's degree- Nursing. Preferred Work Experience: 7 years-healthcare program management , utilization review, or clinical experience in… more
- Highmark Health (Columbia, SC)
- …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... data to assure appropriate level of payment and resource utilization . It is also used to identify issues which...experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder… 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 4 years ... have at least 2 years hospital experience, any other utilization review experience is great, different areas of work...the state of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse … more
- ManpowerGroup (Columbia, SC)
- …mental health/chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review/case management /clinical/or combination; 2 of 4 years ... the United States and in the state of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC), OR, active,… 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 ... the United States and in the state of hire OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC) OR, active,… more
- ManpowerGroup (Columbia, SC)
- …+ Educate members and healthcare providers about the healthcare delivery system, network utilization , and benefit plans. + Promote care management , health, and ... Specialist is responsible for reviewing and evaluating medical or behavioral eligibility for benefits and applying clinical expertise, administrative policies,… more