• Registered Nurse - Managed…

    InGenesis (Columbia, SC)
    InGenesis is currently seeking a Registered Nurse / RN - Managed Care Coordinator to work for our client located in Columbia, SC. In this role you will ... proper claims adjudication * Perform other duties as assigned. Minimum Qualifications * Current Registered Nurse / RN license in the State of South Carolina. *… more
    InGenesis (11/14/25)
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  • Clinical Reviewer, Nurse (Medical Oncology)

    Evolent (Columbia, SC)
    …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care...year of experience with medical management activities in a managed care environment + UM/UR experience +… more
    Evolent (12/10/25)
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  • Patient Care Advocate

    Centene Corporation (Columbia, SC)
    … care , social work, quality improvement or health coaching preferably in a managed care environment. 2+ years of experience work experience should be in ... , social work, quality improvement or health coaching preferably in a managed care environment. **License/Certification:** One of the following is preferred.… more
    Centene Corporation (12/11/25)
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  • Denials Prevention Specialist, Clinician PRN

    Datavant (Columbia, SC)
    …with clinical knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade ... by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well...will bring to the table:** + Two (2) years managed care experience in UM/CM/CDI Department preferred… more
    Datavant (11/12/25)
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  • Payment Integrity Clinician

    Highmark Health (Columbia, SC)
    …a clinical setting **Preferred** + 1-3 years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + ... outcomes. Will monitor and analyze the delivery of health care services in accordance with claims submitted, and analyzes...to privacy, sharing only information relevant to the member's care and within the framework of applicable laws. Practice… more
    Highmark Health (11/14/25)
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