• Utilization Review Case

    Sedgwick Government Solutions (Charleston, SC)
    Job Details Utilization Review Case Manager RN (Remote) 2025-1434 Charleston, SC, USA Medical Services Full Time Description ** Utilization Review ... review experience, and licenses necessary to help support members _?_ The Utilization Review Case Manager RN will provide timely, evidence-based … more
    Sedgwick Government Solutions (06/06/25)
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  • Utilization Review Nurse

    US Tech Solutions (Columbia, SC)
    …mental health/chemical dependency, orthopedic, general medicine/surgery. OR, 4 years utilization review / case management/clinical/or combination; 2 of ... determinations. Identifies and makes referrals to appropriate staff (Medical Director, Case Manager , Preventive Services, Subrogation, Quality of care Referrals,… more
    US Tech Solutions (05/17/25)
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  • RN Case Manager

    HCA Healthcare (Charleston, SC)
    …years of experience in Case Management is highly preferred. + Certification in Case Management or Utilization Review is preferred. + InterQual experience ... satisfaction and personal growth, we encourage you to apply for our RN Case Manager opening. We promptly review all applications. Highly qualified candidates… more
    HCA Healthcare (05/22/25)
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  • RN Case Manager PRN

    HCA Healthcare (Myrtle Beach, SC)
    …in Case Management or Critical Care is preferred. + Certification in Case Management or Utilization Review is preferred. + InterQual experience ... satisfaction and personal growth, we encourage you to apply for our RN Case Manager PRN opening. We review all applications. Qualified candidates will be… more
    HCA Healthcare (03/17/25)
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  • RN Case Manager

    HCA Healthcare (Myrtle Beach, SC)
    …in Case Management or Critical Care is preferred. + Certification in Case Management or Utilization Review is preferred. + InterQual experience ... to join an organization that invests in you as a **Registered Nurse (RN) Case Manager ** ? At **Grand Strand Medical Center** , you come first. HCA Healthcare has… more
    HCA Healthcare (05/15/25)
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  • Senior Case Manager

    Cardinal Health (Columbia, SC)
    …get life-changing therapies to patients who need them-faster.** **_Responsibilities_** The Senior Case Manager supports patient access to therapy through patient ... develop and execute effective solutions. + Provide guidance and training to junior case managers on best practices in case management, patient interaction, and… more
    Cardinal Health (04/29/25)
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  • RN Clinical Manager , Home Health

    CenterWell (North Charleston, SC)
    …action through the utilization of Performance Improvement principles. + Responsible for review of the appropriate number of Case Managers and clinical staff ... community and help us put health first** The Clinical Manager , Home Health Nursing enables patients to stay in...clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the… more
    CenterWell (04/26/25)
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  • Care Manager RN - Remote

    Highmark Health (Columbia, SC)
    …Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... care services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/ case more
    Highmark Health (05/21/25)
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  • Care Manager

    AmeriHealth Caritas (Charleston, SC)
    …Discover more about us at www.amerihealthcaritas.com. **Responsibilities:** The Care Manager II is responsible for managing and coordinating care, services, ... gaps in care and barriers to care. The Care Manager II develops a plan of care through shared...and evaluation of the effectiveness of the plan.; 2. Review medication list and educate Members with pharmacy needs,… more
    AmeriHealth Caritas (06/05/25)
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  • Registered Nurse

    US Tech Solutions (Columbia, SC)
    …mental health/chemical dependency, orthopedic, general medicine/surgery. Or, 4 years utilization review / case management/clinical/or combination; 2 of ... determinations. Identifies and makes referrals to appropriate staff (Medical Director, Case Manager , Preventive Services, Subrogation, Quality of care Referrals,… more
    US Tech Solutions (06/03/25)
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