- Evolent (Columbia, SC)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior ... policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as... medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all… more
- Fresenius Medical Center (West Columbia, SC)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture...a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in… more
- CenterWell (Columbia, SC)
- …a part of our caring community and help us put health first** The Nurse Practitioner, Paneled applies advanced education and clinical competencies to achieve ... optimal patient panel outcomes. The Nurse Practitioner works on problems of diverse scope and...accordance with standards of care. + Follows level of medical care and quality for patients and monitors care… more
- Fresenius Medical Center (Columbia, SC)
- …regulations at: https://content.intranet.fmcna.com/regulatory-affairs/wp-content/uploads/sites/46/2019/05/Pre-Licensed- Nurse -50-State- Review ... of the hemodialysis health care team as a Registered Nurse Applicant, under the direction or supervision of a...transcribes, and enters physician lab orders accurately into the Medical Information System. + Ensures appropriate preparation of lab… more
- Veterans Affairs, Veterans Health Administration (Columbia, SC)
- …preceptor providing didactic and clinical instruction in anesthesia to student nurse anesthetists, medical and dental residents, and other health care ... relevant clinical information. Participate in the teaching program of medical students and residents who rotate through Anesthesiology. Develop and maintain… more
- Gentiva (Columbia, SC)
- …(LCD) criteria per hospice policy and regulatory requirements. + Communicate clinical findings, review treatment plans, lab results, diagnostics, and ... Partnerships. Transform Hospice Care.** We are seeking a dedicated Hospice Nurse Practitioner to perform Face-to-Face (F2F) encounters essential for hospice… more
- InGenesis (Columbia, SC)
- …located in Columbia, SC. In this role you will review and evaluate medical or behavioral eligibility regarding benefits and clinical criteria and assess and ... monitor medical necessity using your clinical proficiency and claims knowledge. This is a REMOTE...any questions you may have. Job Duties * Perform medical review /authorization process. * Ensure coverage for… more
- PruittHealth (Columbia, SC)
- …reviewing medical records and documentation. **KEY RESPONSIBILITIES:** 1. Coordinates clinical competency assessment and training needs of clinical staff, ... ** CLINICAL COMPETENCY COORDINATOR** **This role is Monday through...conditions and acuity. 7. Meets regularly with DHS to review learning needs, coordinate training and to implement plans… more
- Humana (Columbia, SC)
- …and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis ... independent determination of the appropriate courses of action. The Nurse Auditor 2 validates and interprets medical ...coding experience to conduct a clinical validation review of the inpatient medical record to… more
- CVS Health (Columbia, SC)
- …benefit overall claim management. + Using a holistic approach, consults with clinical colleagues, supervisors, Medical Directors and/or other programs to ... in the US with virtual training.** American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS Health. Founded in 1993,… more
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