- Highmark Health (Columbia, SC)
- …panel. Provides oversight over a specified panel of members that range in health status/severity and clinical needs; and assesses health management needs of ... various resources to assist members in achieving their personal health goals. Will work with providers to insure quality...in a clinical setting **Preferred** + 5 years in UM /CM/QA/Managed Care + 1 year in advanced training and… more
- US Tech Solutions (Columbia, SC)
- …+ Experience with prior insurance, utilization management, case management, surgical or behavioral health experience. This role conducts reviews of previously ... and procedures, while adhering to confidentiality regulations regarding protected health information. + Performs appeal and retrospective reviews demonstrating… more