Utilization Review Jobs in South Carolina
1 - 15 of 25
Search Results - Utilization Review Jobs in South Carolina
Hornet Staffing-Columbia
Knowledge of National Committee for Quality Assurance (NCAG). Knowledge of Utilization Review Accreditation Commission (URAC). Knowledge of South Carolina Department of Insurance (SCDOI). Knowledge of US DOL and Health Insurance Portability/Accountability...
resume-library.com -
Pozent-North Charleston
Associates RN degree
Required
Bachelor's degree
Highly desired
Experience in managed care quality assurance or utilization review.
Required
2
Years
RN License (South Carolina or Compact License Only)
Required...
jobvertise.com -
Hornet Staffing-Columbia
Duties
Performs medical reviews using established criteria sets and/or performs utilization management of professional, inpatient or outpatient, facility benefits or services, and appeals. Documents decisions using indicated protocol sets...
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CenterWell Home Health-Greenville (SC)
to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and conducts regular staff education as needed.
• Analyzes situations, identifies problems, identifies and evaluates alternative courses of action through...
US Tech Solutions, Inc.-Columbia
and/or appeals experience. We want to see all candidates with experience with prior insurance, utilization management, case management, surgical or behavioral health experience.
This role conducts reviews of previously denied services to determine if the medical...
resume-library.com -
CenterWell Home Health-Bluffton (SC)
and recommendations by Utilization Review staff. Upon completion of the assessment, creates and conducts regular staff education as needed.
• Analyzes situations, identifies problems, identifies and evaluates alternative courses of action through the utilization...
3 similar jobs: Shelby, Beaufort, Hilton Head Island
National Coalition Of Healthcare Recruiters-Aiken (SC)
BSN) required
Masters Degree in Nursing or a related healthcare field preferred
Certifications|Licensures: Registered Nurse License required
Certified Case Manager (CCM) a plus, not required
Healthcare Quality of Utilization Review (HQUR) a plus...
nchcr.com -
1 similar job: Dallas
CenterWell Home Health-Bluffton (SC)
to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and conducts regular staff education as needed.
• Analyzes situations, identifies problems, identifies and evaluates alternative courses of action through...
US Tech Solutions-Columbia
and/or appeals experience. We want to see all candidates with experience with prior insurance, utilization management, case management, surgical or behavioral health experience.
This role conducts reviews of previously denied services to determine if the medical...
mindmatch.ai -
Paladin Consulting, Inc-Columbia
of one's home. May involve some travel within one's community.
Required
RN LICENSE
CLAIMS
CODING
DATABASE
MICROSOFT OFFICE
Additional
ONCOLOGY
DATA COLLECTION
MENTAL HEALTH
FINANCIAL PROJECT MANAGEMENT
UTILIZATION REVIEW
DISCHARGE PLANNING...
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CenterWell Home Health-North Charleston
of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and conducts regular staff education as needed.
• Analyzes situations, identifies problems, identifies and evaluates...
TEI Construction Services, Inc.-Duncan (SC)
training and support to users on the software tools, ensuring they are proficient in their use. Identify gaps in tool proficiency and recommend actions to leadership team to continuously improve tool utilization.
Review incoming documentation...
resume-library.com -
Fusion Medical Staffing-Myrtle Beach
acuity, ability to effectively communicate
Other Requirements:
Utilization review and discharge planning experience is necessary. Must have a valid RN license in the state where they will be practicing, BLS certification, and Case Management...
MUSC-Charleston (SC)
The Nurse Case Manager I serves as a clinical expert related to discharge planning, resource utilization, and case management.
Entity
Medical University Hospital Authority (MUHA)
Worker Type
Employee
Worker Sub-Type
Regular
Cost Center
CC000314 CHS...
mindmatch.ai -
MUSC-Charleston (SC)
as a Registered Nurse required. Prior leadership experience preferred. One year of case management and/or utilization review work experience preferred. Case Management certification preferred. Staff hired prior to July 1, 2013, will be grandfathered in regards...
mindmatch.ai -
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