• Utilization Management Nurse

    CVS Health (Columbia, SC)
    …care **Preferred Qualifications** + NICU experience highly preferred + Managed care/ utilization review experience + Ability to multitask, prioritize and ... time, talking on the telephone, and typing on the computer. The UM Nurse Consultant utilizes clinical skills to coordinate, document and communicate all aspects of… more
    CVS Health (07/23/25)
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  • Utilization Management Nurse

    CVS Health (Columbia, SC)
    …and external constituents in the coordination and administration of the utilization /benefit management function. Required Qualifications + Registered Nurse in ... years of Nursing experience. Preferred Qualifications + Prior authorization utilization management/ review experience preferred Outpatient Clinical experience. +… more
    CVS Health (07/26/25)
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  • Nurse - Inpatient Case Manager

    Veterans Affairs, Veterans Health Administration (Charleston, SC)
    …documents, ensuring that the admission and continued stay process follows utilization review guidelines through application of established lnterQual criteria. ... Summary The Registered Nurse (RN) Inpatient Case Manager is responsible for...from admission to discharge. He/she is responsible for conducting utilization management activities reviews on observation, admission and continued… more
    Veterans Affairs, Veterans Health Administration (07/22/25)
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  • Charge Nurse - Labor And Delivery…

    Roper St. Francis (Summerville, SC)
    …critical thinking. Ability to run effective shift safety huddles, report safety concerns, review device utilization , report staffing concerns, and review ... following established standards and practices in accordance with the South Carolina Nurse Practice Act. Applies professional nursing theory and practice to assess,… more
    Roper St. Francis (07/30/25)
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  • Charge Nurse - Nephrology - Roper Hospital

    Roper St. Francis (Charleston, SC)
    …critical thinking. Ability to run effective shift safety huddles, report safety concerns, review device utilization , report staffing concerns, and review ... following established standards and practices in accordance with the South Carolina Nurse Practice Act. Applies professional nursing theory and practice to assess,… more
    Roper St. Francis (07/08/25)
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  • Registered Nurse - Med/Surg

    Veterans Affairs, Veterans Health Administration (Charleston, SC)
    …education, orientation, competencies and providing quality improvement and enhance outcomes utilization . This nurse integrates knowledge, skills, abilities, and ... determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply.… more
    Veterans Affairs, Veterans Health Administration (07/22/25)
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  • Case Manager Registered Nurse - Specialty…

    CVS Health (Columbia, SC)
    …with transferring patients to lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized accreditation preferred. + ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
    CVS Health (07/26/25)
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  • Licensed Practical Nurse / LPN

    InGenesis (Columbia, SC)
    …established criteria or clinical guidelines. In this role, you will provide support and review of medical claims and utilization practices. This is a REMOTE ... InGenesis is currently seeking a Licensed Practical Nurse / LPN to work remotely with our...Review interdepartmental requests and medical information to complete utilization process * Documents process used and decision int… more
    InGenesis (05/16/25)
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  • Disease Management Nurse - Remote

    Sharecare (Columbia, SC)
    utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants for identification ... more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and...and to take the pre and post tests to review competency during orientation. Yearly competency tests are required… more
    Sharecare (07/12/25)
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  • Assistant Nurse Manager

    Roper St. Francis (Summerville, SC)
    …as appropriate. Participates in budget preparation for cost centers. Assures economical utilization of time, materials and resources through review of workflow ... established standards and practices in accordance with the South Carolina Nurse Practice Act (RN) and following hospital standards and professional practice.… more
    Roper St. Francis (07/24/25)
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