- Humana (Columbia, SC)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... action. + Minimum one, (1) year of experience in Behavioral Health Nursing (inpatient outpatient, psych, substance...Nursing experience + Previous experience in utilization management with ASAM knowledge + Health Plan… more
- Evolent (Columbia, SC)
- …the mission. Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for ... and client contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager, … more
- Humana (Columbia, SC)
- …help us put health first** Humana Healthy Horizons is seeking a Utilization Management Nurse who utilizes clinical nursing skills to support the ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse work assignments are varied and frequently… more
- US Tech Solutions (Columbia, SC)
- … health /chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review/case management /clinical/or combination; 2 of 4 years must ... policies, and established clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency, claims… more
- AmeriHealth Caritas (Florence, SC)
- …compliance with treatment plans and promote self- management . The Field- Based Remote Behavioral Health Case Worker is also responsible for the following: 1. ... products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more… more
- Highmark Health (Columbia, SC)
- …of clinical, case/ utilization management and/or disease/condition management experience, or provider operations and/or health insurance experience ... health status/severity and clinical needs; and assesses health management needs of the assigned member...clinical care is being provided. **Preferred** + Certification in utilization management or a related field +… more
- Highmark Health (Columbia, SC)
- …Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health care services, ... utilization , identification of opportunities for referral to a Health Coach/case management , and identification and resolution...position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Highmark Health (Columbia, SC)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... (DO) **Substitutions** + None **Preferred** + Master's Degree in Business Administration/ Management or Public Health **EXPERIENCE** **Required** + 5 years… more
- HCA Healthcare (Myrtle Beach, SC)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed ... like family! Jump-start your career as a **Manager Case Management ** today with Grand Strand Medical Center. **Benefits** Grand...Center, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The… more
- CenterWell (Charleston, SC)
- …Care Integration Team Manager is responsible for managing a team of nurses, community health workers, and behavioral health resources who engage high ... passionate advocate for improving clinician and patient experience through population health management . **Additional Job Description** **Benefits** + Health… more