- 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- US Tech Solutions (Columbia, SC)
- …established clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency and claims knowledge/analysis to ... education with members and providers regarding health care delivery system, utilization on networks and benefit plans. Serves as member advocate through… more
- 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CenterWell (Spartanburg, SC)
- …proactive and sustained engagement in improving health outcomes, optimizing resource utilization , and ensuring effective panel management . + **Focus on ... part of our caring community and help us put health first** The Nurse Practitioner, Paneled applies advanced education and clinical competencies to achieve optimal… more
- Veterans Affairs, Veterans Health Administration (Columbia, SC)
- …knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community care ... for the coordination of care focused on patient education, self- management , and customer satisfaction throughout the continuum of care. Responsibilities… more
- CVS Health (Columbia, SC)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
- Veterans Affairs, Veterans Health Administration (Charleston, SC)
- …Former EDRP participants ineligible to apply. Responsibilities The Urology Registered Nurse (RN) is responsible for providing competent, evidence based procedural ... health education and coaching on wellness, disease prevention, and chronic care management . The Urology RN will assist in directing the provision of nursing… more
- Roper St. Francis (Summerville, SC)
- …following established standards and practices in accordance with the South Carolina Nurse Practice Act. Applies professional nursing theory and practice to assess, ... and promotes collegial and collaborative working relationships within and among disciplines. Charge Nurse role has 2 tiers: Primary Charge Nurse I and Primary… more
- Roper St. Francis (Charleston, SC)
- …following established standards and practices in accordance with the South Carolina Nurse Practice Act. Applies professional nursing theory and practice to assess, ... and promotes collegial and collaborative working relationships within and among disciplines. Charge Nurse role has 2 tiers: Primary Charge Nurse I and Primary… more
- Highmark Health (Columbia, SC)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC) or WV or DE or...first 6 months of employment. **Preferred** + Certification in utilization management or a related field +… more