- Highmark Health (Columbia, SC)
- …**JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most ... URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member of the multidisciplinary team… more
- Highmark Health (Columbia, SC)
- …agreements. Monitor financial performance of contracts by tracking utilization and competitive environment, including group specific performance guarantees. ... designs, competitive position, product development, network options, strategic partnerships, utilization review, local/national client demographics and dentist distribution. Interpret… more
- Bon Secours Mercy Health (Greenville, SC)
- At Bon Secours Mercy Health , we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and ... directs patient teaching activities and coordinates the care provided by health team members. **Essential Job Functions** In collaboration with the interdisciplinary… more
- Highmark Health (Columbia, SC)
- **Company :** Highmark Health **Job Description :** Entirely Remote Work From Anywhere Role! We are seeking an experienced Software Engineering Manager to lead our ... have budgetary responsibility and authority. + Understand budget and resource utilization across the product teams. Escalate any issues regarding product delivery… more
- Highmark Health (Columbia, SC)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This role is responsible for designing, developing, implementing, supporting, and optimizing ... solutions, networks, and infrastructure. Ensure optimal technology selection, resource utilization , and seamless integration. + Utilize modeling tools to develop… more
- Highmark Health (Columbia, SC)
- …of AI-powered products, including a core administrative platform, modular utilization and care management solutions, patient-focused digital products, and clinical ... Enrollment, Billing, Benefits, Products and Services. Knowlege of Provider Health Systems like EMRs and RCM processes is a...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Highmark Health (Columbia, SC)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job will manage small scale projects and enhancement packages with mentorship and leadership ... full and timely communication of project activities. Manage resource utilization on the project through matrixed delivery across the...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Highmark Health (Columbia, SC)
- …as: Financial Services, Utilities, Property and Casualty Insurance + CRM utilization **Preferred** + Transactional print and mail and digital delivery experience ... position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of...with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as… more
- 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 ... health /chemical dependency, orthopedic, general medicine/surgery. Or, 4 years utilization review/case management/clinical/or combination; 2 of the 4 years must… 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 ... **Benefits** HCA Healthcare offers a total rewards package that supports the health , life, career and retirement of our colleagues. The available plans and… more