• Social Services Care Manager

    Humana (Columbia, SC)
    **Become a part of our caring community and help us put health first** The Care Manager , Telephonic Behavioral Health 2, in a telephonic environment, ... for the care and wellbeing of members. The Care Manager , Telephonic Behavioral Health 2 is a **Licensed,** **Masters level, social worker** who… more
    Humana (03/20/25)
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  • Behavioral Health Provider Contract…

    CVS Health (Columbia, SC)
    …consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions ... manage dispute resolution and settlement negotiations of contracts with single and group Behavioral Health providers within a defined market. You will manage… more
    CVS Health (03/16/25)
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  • RN Supervisor, Care Management…

    Molina Healthcare (Columbia, SC)
    …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care , for members with high need ... for Molina members. Oversees and/or participates in Interdisciplinary Care Team meetings. + Works with the Manager...or more years in case management, disease management, managed care or medical or behavioral health more
    Molina Healthcare (03/13/25)
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  • LPN Behavioral Health - Member…

    Molina Healthcare (Columbia, SC)
    …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care , for members with high need ... Experience** 1-3 years in case management, disease management, managed care or medical or behavioral health...Worker (LCSW), Advanced Practice Social Worker (APSW), Certified Case Manager (CCM), Certified in Health Education and… more
    Molina Healthcare (03/04/25)
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  • Social Work Care Manager

    Intermountain Health (Columbia, SC)
    …and provides short term treatment planning for mental, emotional and behavioral disorders, conditions and addictions. **Essentials:** + Participates in case reviews ... to evaluate care management and progress toward goals. Consults with healthcare team members to promote, monitor, and evaluate compliance with patient's treatment… more
    Intermountain Health (03/15/25)
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  • Case Manager , RN

    CAI (Columbia, SC)
    …implement and evaluate care for eligible members with chronic and complex health care , social service and custodial needs in a nursing facility or ... address the member's specific needs + Educate members or caregivers regarding health care needs, available benefits, resources and services including available… more
    CAI (02/01/25)
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  • Complex Case Manager RN (Remote)

    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 (03/13/25)
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  • Program Manager

    Highmark Health (Columbia, SC)
    …nationally recognized commitment to promote living health , inclusive of individuals' social health . The Program Manager will be an integral part of Highmark ... **Company :** Highmark Health **Job Description :** **GENERAL OVERVIEW** Highmark ...develop and implement SDOH programs that remove barriers to care and help people thrive, support evaluation frameworks to… more
    Highmark Health (03/15/25)
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  • Category Manager

    Highmark Health (Columbia, SC)
    …management and performance **Preferred** + 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
    Highmark Health (02/18/25)
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  • Manager Strategic Risk Adjustment Programs

    Highmark Health (Columbia, SC)
    …and existing Risk Adjustment Programs. The incumbent will deliver value to the Health Plan, and its beneficiaries enrolled in Risk Adjusted government programs (MA ... Programs. Supports other key objectives designed to build/strengthen patient care delivery and capture of Risk Adjustment documentation/ reporting capabilities,… more
    Highmark Health (03/06/25)
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  • Accreditation Manager

    Humana (Columbia, SC)
    …areas. **Preferred Qualifications** + Experience in managing a team. + Registered Nurse or Behavioral Health professional. + Managed care , Medicaid health ... first** Humana Healthy Horizons is seeking an Accreditation Manager who will oversee and support a team of...millions of people we serve to achieve their best health - delivering the care and service… more
    Humana (03/21/25)
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  • Coordinator, Managed Care II/CM-DM

    ManpowerGroup (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. ManpowerGroup(R) (NYSE: MAN),… more
    ManpowerGroup (03/12/25)
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  • Market VP, Value-Based Care Business…

    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 ... care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager...care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager more
    CenterWell (03/14/25)
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  • Managed Care Coordinator

    US Tech Solutions (Columbia, SC)
    …+ 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
    US Tech Solutions (03/04/25)
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  • Senior Strategy Professional, Specialty…

    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 ... time with patients, providing compassionate, personalized care that brings better health outcomes. We...care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager more
    CenterWell (03/19/25)
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  • Managed Care Coordinator UM II

    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
    US Tech Solutions (03/18/25)
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  • Senior Application Developer (Person360 & MDM)

    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 (01/30/25)
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  • Utilization Management Nurse

    US Tech Solutions (Columbia, SC)
    …sets/qualities: Utilization management experience and /or Appeals experience /strong clinical skills Behavioral Health or infusion therapy experience + A typical ... Provides appropriate communications (written, telephone) regarding requested services to both health care providers and members. Participates in direct… more
    US Tech Solutions (03/19/25)
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  • National leader, Provider Education

    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 ... or operational leadership experience in the areas of Population Health Management, Practice Management, (VBC) Value Based Care...care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager more
    CenterWell (03/06/25)
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  • Senior Clinical Pharmacy Technician

    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 ... time with patients, providing compassionate, personalized care that brings better health outcomes. We...care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager more
    CenterWell (02/20/25)
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