- CVS Health (Columbia, SC)
- …Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in EST/CST zones… more
- CenterWell (Columbia, SC)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… 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
- CVS Health (Columbia, SC)
- …experience working within the mental health system. + Previous experience with utilization management . + Ability to collaborate with various internal ... clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult… more
- Sharecare (Columbia, SC)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
- CenterWell (Anderson, 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)
- …nursing education, orientation, competencies and providing quality improvement and outcomes utilization . This nurse works closely with active-duty service ... Summary The Polytrauma Rehabilitation Liaison Registered Nurse (RN) executes position responsibilities that demonstrate leadership, experience, and creative… 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
- InGenesis (Columbia, SC)
- InGenesis is currently seeking a Licensed Practical Nurse / LPN to work remotely with our client located in Columbia, SC. In this role, you will perform Medical ... will provide support and review of medical claims and utilization practices. This is a REMOTE opportunity for a...operations of assigned area. * Interfaces with the medical management on a regular basis to work more complex… more