- InGenesis (Columbia, SC)
- Managed Care II / Social Worker Job Details Professional Discipline : Registered Nurse Specialty : Utilization Review Employment Type : Full Time City : ... and services required to support members in managing their health. This is a REMOTE opportunity for candidates living in SC. Apply today and we'll reach out to… more
- US Tech Solutions (Columbia, SC)
- **Duration: 3+ Months Contract (Possible Extension)** **Job Description:** + Must be an RN in SC and have an active and unrestricted SC RN license. + ... - M-F 8:30am - 5pm. + Onsite training for the first week. Remote once training is complete. + Experience: Hospital experience, UM experience. + Description:… more
- CVS Health (Columbia, SC)
- …Qualifications** + Must reside in EST zone + 3+ years of experience as a Registered Nurse + 3+ years of clinical experience required + Must have active ... reside in EST time zone.** This is a full-time remote position. + Utilizes clinical experience and skills in...able to work Monday through Friday, 8:00am to 5:00pm. Utilization management is a 24/7 operation. Work… more
- CVS Health (Columbia, SC)
- …This is a fully remote role open to candidates with an active RN licensure in the state in which they reside. Working schedule is Monday-Friday, 8am-5pm with ... clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and knowledge in… more
- Highmark Health (Columbia, SC)
- …Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... depending on where clinical care is being provided. **Preferred** + Certification in utilization management or a related field **SKILLS** + Working knowledge of… more
- CenterWell (North Charleston, SC)
- …of Science in Nursing (BSN) strongly preferred. **License/Certifications:** + Active and unrestricted Registered Nurse ( RN ) license or Compact State RN ... SC $10,000 associated sign-on bonus **This is not a remote or work-from-home position. This position requires you to...transportation. + Two years as a Registered Nurse with at least one-year of management … more
- Sharecare (Columbia, SC)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the… more
- Prime Therapeutics (Columbia, SC)
- …Patient Programs. **Education & Experience** + Associates - Nursing + Bachelors - Nursing + RN - Registered Nurse , State and/or Compact State Licensure - ... for work visa or residency sponsorship. **Additional Qualifications** + Registered Nurse ( RN ). + 5...experience. + Experience in managed care, specialty drugs, care management and utilization review. + Meets Credentialing… more
- Humana (Columbia, SC)
- …DSNP program **Use your skills to make an impact** **REQUIRED QUALIFICATIONS:** + Registered nurse ( RN ) with unrestricted licensed **OR** independent ... **Key Functions:** **Strategic Planning and Implementation:** + Develop and implement utilization management strategies that align with organizational goals. +… more
- AmeriHealth Caritas (Columbia, SC)
- …record/documentation systems is essential **Licensure** + Must hold a current and unrestricted Registered Nurse ( RN ) license in good standing in South ... improve the Member's health status, compliance with treatment plans and promote self- management .; **Work Arrangement** + Remote ; + Community Visits - Residency… more
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