- US Tech Solutions (Columbia, SC)
- … Utilization management experience and /or Appeals experience /strong clinical skills Behavioral Health or infusion therapy experience + A typical day would ... Participates in direct intervention/patient education with members and providers regarding health care delivery system, utilization on networks and benefit… more
- Humana (Columbia, SC)
- **Become a part of our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health ... care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of… more
- CenterWell (Columbia, SC)
- …best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can ... **Become a part of our caring community and help us put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers… more
- CenterWell (Columbia, SC)
- …best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can ... **Become a part of our caring community and help us put health first** Healthcare isn't just about health anymore. It's about caring for family, friends,… more
- AmeriHealth Caritas (Orangeburg, SC)
- **Role Overview** The Field- Based Remote Behavioral Health Case Worker is responsible for managing and coordinating care, services, and social determinants of ... health for Members with behavioral ...electronic care management platforms where applicable + Monitor appropriate utilization and coordinate services with other payer sources, make… more
- BriteLife Recovery (Hilton Head Island, SC)
- BEHAVIORAL HEALTH TECHNICIAN/DRIVER Do you work for a company that no longer aligns with your core values? Have you dreamt of working in a "true" team ... best, most talented and caring, authentic individuals to create a world-class mission-centered behavioral health organization, focused on doing it the right way… more
- Highmark Health (Columbia, SC)
- …including gathering data from multiple sources related to Benefit/Claim Utilization , Enrollment, Networks ( utilization , disruption, geo-access) and making ... of their data analysis.This includes benefits design analysis based on benefit utilization while factoring in financial analysis to determine cost impact. +… more
- HCA Healthcare (Charleston, SC)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed ... Do you have the career opportunities as a(an) Mental Health Professional you want with your current employer? We...members, payer representatives, and other parties as appropriate regarding behavioral services . Performs utilization review as… more
- HCA Healthcare (Myrtle Beach, SC)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as telemedicine services and free AirMed medical ... you have the PRN career opportunities as a(an) Mental Health Professional Licensed PRN you want with your current...members, payer representatives, and other parties as appropriate regarding behavioral services . Performs utilization review as… more
- Highmark Health (Columbia, SC)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job works collaboratively riskacross Highmark Health clinical areas to support clinical ... Compliance Analyst is responsible for monitoring and analyzing medical and utilization management activities to ensure compliance with internal policies, state, CMS,… more