• Care Manager II

    AmeriHealth Caritas (Rock Hill, SC)
    …record/documentation systems is essential **Licensure** + Must hold a current and unrestricted Registered Nurse ( RN ) license in good standing in South ... complete, and accurate documentation of Member interactions in ACFC electronic care management platforms where applicable + Monitor appropriate utilization and… more
    AmeriHealth Caritas (07/27/25)
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  • Inpatient Rehab Case Manager

    HCA Healthcare (Charleston, SC)
    …and expertise! **Job Summary and Qualifications** We are seeking a Case Manager Registered Nurse for our department who will provide clinical expertise to ... in Social Work . Must be licensed as a Registered Nurse in the state which you...in case management . Certification in case management or utilization review preferred . InterQual… more
    HCA Healthcare (09/04/25)
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  • Primary Care Physician Lead

    CenterWell (Anderson, SC)
    …to the strategic intent Overseeing other clinicians which includes Physicians, Advanced Registered Nurse Practitioners (ARNP), and Physicians Assistants (PA) in: ... clinicians with schedule templates, coverage, daily issues + Managing behavioral concerns of supervised staff + Assisting with PTO...+ Identifying trends and areas of opportunity in pharmacy utilization (pharmacy management ) to impact Part D… more
    CenterWell (09/25/25)
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  • Clinical UM Nurse 2

    CenterWell (Columbia, SC)
    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... skills to make an impact** **Required Qualifications** + Licensed Registered Compact Nurse license ( RN )...volume and fast paced environment + Previous experience in utilization management + Education: BSN or Bachelor's… more
    CenterWell (09/26/25)
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  • Pharmacy Benefit Consultant

    Highmark Health (Columbia, SC)
    …**Preferred** + 5 years of experience with communications + 3 years of experience in Utilization Review + 3 years of experience in Account Support + 1 year of ... + In-depth knowledge of the pharmacy industry, including benefit design, formulary management , and pharmacy best practices. + Proven ability to interpret and analyze… more
    Highmark Health (08/26/25)
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