• Medicaid Provider Hospital…

    Humana (Columbia, SC)
    …our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... the Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support… more
    Humana (12/02/25)
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  • Director, Provider Contracting

    Humana (Columbia, SC)
    …of our caring community and help us put health first** The Director, Provider Contracting initiates, negotiates, and executes physician, hospital , and/or other ... Provider Contracting communicates contract terms, payment structures, and reimbursement rates to providers. Analyzes financial impact of contracts and terms.… more
    Humana (12/11/25)
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  • Provider Contracting Executive

    Humana (Columbia, SC)
    …The Provider Contracting Executive initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements. The Provider ... diverse scope and complexity ranging from moderate to substantial. The Provider Contracting Executive communicates contract terms, payment structures, and … more
    Humana (12/07/25)
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  • Director, Field Health Economics…

    Edwards Lifesciences (Columbia, SC)
    …They will work directly with hospital leaders and physicians to deliver hospital economic analyses customized to each provider . This individual will also ... of reimbursement plans (coding, coverage, payment) unique to each provider . + Articulate a thorough understanding of the structural heart landscape, trends,… more
    Edwards Lifesciences (11/22/25)
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  • Director, Specialty Sales - Remote

    Option Care Health (Columbia, SC)
    **Extraordinary Careers. Endless Possibilities.** **With the nation's largest home infusion provider , there is no limit to the growth of your career.** Option Care ... the largest independent home and alternate site infusion services provider in the United States. With over 8,000 team...and more impactful. Our organization requires extraordinary people to provide extraordinary care, so we are investing in a… more
    Option Care Health (12/11/25)
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  • Dental Network Field Contractor

    Humana (Columbia, SC)
    …- 5 years of experience in negotiating managed care contracts with physician, hospital and/or other provider contracts. + Proficiency in analyzing, understanding ... part of our caring community and help us put health first** The Provider Contracting Professional 2 initiates, negotiates, and executes dental provider contracts… more
    Humana (12/09/25)
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  • Hospice Nurse Practitioner

    Gentiva (Columbia, SC)
    …hospice agency promptly if unable to complete F2F visits as scheduled. + May provide F2F coverage for multiple provider numbers with approval. **About You** ... physicians, interdisciplinary group (IDG) members, patients, caregivers, and families. + Provide clinical recommendations to the IDG based on F2F assessment… more
    Gentiva (11/24/25)
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  • Senior Claim Denial Prevention & Appeals…

    Oracle (Columbia, SC)
    …focus more on patient care by reducing administrative burden of clinical and reimbursement tasks such as charting, documentation, and coding by applying power of ... opportunities to prevent future denials, and ensure maximum appropriate reimbursement . This role is critical for financial recovery and...on experience preparing appeals for claim denials in the hospital and ambulatory setting + 3+ years hands on… more
    Oracle (12/11/25)
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  • Clinical Nurse Liaison - MUSC

    PruittHealth (Columbia, SC)
    …levels of care. 2. Must be knowledgeable of private insurance, Medicare and Medicaid coverage criteria, rules and regulations and reimbursement methodologies. 3. ... continuum and facilitating admissions into the Pruitt Health network. 5. Must provide excellent customer service to all referral sources and network of providers.… more
    PruittHealth (12/11/25)
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  • Nurse Auditor 2

    Humana (Columbia, SC)
    …for services rendered is complete, compliant and accurate to support optimal reimbursement . The Nurse Auditor 2 work assignments are varied and frequently require ... in the state they reside. + Minimum of 2 consecutive years acute inpatient hospital care experience in critical, intensive care setting within the last 5 years (Not… more
    Humana (12/11/25)
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