• RN or LMSW Manager Case Management

    HCA Healthcare (Myrtle Beach, SC)
    …experience preferred + InterQual experience preferred + Currently licensed as a Registered Nurse in the state(s) of practice according to law ... is recognized. Submit your application for the opportunity below: ** RN or LMSW Manager Case Management ** Grand...for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services… more
    HCA Healthcare (10/30/25)
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  • Care Manager RN

    AmeriHealth Caritas (Lugoff, 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 (11/18/25)
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  • Director Case Management

    HCA Healthcare (Myrtle Beach, SC)
    …degree in Nursing, Health Administration, or Business Administration, preferred + Either Registered Nurse ( RN ) licensure, Licensed Clinical Social Worker ... organization that invests in you as a Director Case Management ? At Grand Strand Medical Center, you come first....interdisciplinary teams and external stakeholders. The Director is a registered nurse with responsibility for all operational… more
    HCA Healthcare (10/23/25)
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  • Disease Management Nurse - Remote

    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
    Sharecare (10/22/25)
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  • Case Manager

    AnMed Health (Anderson, SC)
    …databases and documentation systems as required. Qualifications + BSN and Current South Carolina Registered Nurse License; BSN required, but if no BSN at the ... health specialists, and nurses to achieve timely, appropriate patient management . + Utilizes the RN process as...as a collaborative team member. + Licensed as a Registered Nurse in South Carolina. + Minimum… more
    AnMed Health (09/17/25)
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  • Primary Care Physician Lead

    CenterWell (Seneca, 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 (10/17/25)
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  • Payment Integrity Clinician

    Highmark Health (Columbia, SC)
    …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... data to assure appropriate level of payment and resource utilization . It is also used to identify issues which...experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder… more
    Highmark Health (11/14/25)
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  • Transplant Care Nurse (Remote)

    Highmark Health (Columbia, SC)
    …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... be obtained within the first 6 months of employment. **Preferred** + Certification in utilization management or a related field + Certification in Case … more
    Highmark Health (11/06/25)
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  • Managed Care Coordinator

    US Tech Solutions (Columbia, SC)
    …A typical day would like in this role: Employee will be providing telephonic case management and utilization management for our members. The expectation is ... Contract (Possible Extension)** **Job Description:** + Must be an RN in SC and have an active and unrestricted...+ Strong communication skills required to provide telephonic case management to patients and to coordinate with team, providers,… more
    US Tech Solutions (10/11/25)
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