Senior Director, Healthcare Risk Management & Advisory | Forensic And Litigation Consulting FTI Consulting, Inc.Senior Director, Healthcare Risk Management & Advisory | Forensic And Litigation ConsultingColumbia, SCOur multi-disciplinary team is comprised of consultants with expertise in data analytics, finance, accounting, economics, information technology and healthcare operations and regulations, and includes former healthcare executives and medical practitioners all of whom are focused on delivering meaningful results in order to manage change, mitigate risk, ensure compliance, resolve disputes, execute significant business transactions and improve performance. The healthcare industry is one of the largest, most dynamic, and complex sectors of the world economy and the HRMA team delivers strategic, analytical, financial, data mining and operational expertise through teams who understand the unique industry and regulatory environment in which our clients operate.
Medicaid Risk Adjustment Market Manager CVS Health CorpMedicaid Risk Adjustment Market ManagerSC$54,300–$145,860 / yearPartner with segment product, sales, network, clinical teams to implement processes aimed at strengthening member and provider engagement of Revenue Integrity programs resulting in improved outcomes. This is a high-visibility role responsible for driving market level engagement, delivering insights, and demonstrating the value of Medicaid risk adjustment performance to senior leaders and market partners.
NewQuality and Risk Performance Officer, Medicare Advantage BlueCross BlueShield of South CarolinaQuality and Risk Performance Officer, Medicare AdvantageColumbia, South Carolina10 years of experience in insurance, healthcare, or similarly complex industry; Concurrent experience includes: 5 years of health plan experience; 3 years of management experience OR 3 years of equivalent military experience in grade E4 or above; 3 years of Medicare Advantage Stars Rating program experience. We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.
Medicare Risk Adjustment Manager (Southeast) CVS Health CorpMedicare Risk Adjustment Manager (Southeast)SC$54,300–$119,340 / yearThe role drives, in collaboration with the national and local risk adjustment teams, risk coding improvement activities within the region, medical record collection, provider collaboration and data sharing, general coding education and related activities, as well as other activities as assigned. 7+ years of experience in risk adjustment, clinical quality, or healthcare quality improvement required; experience supporting provider‑based or value‑based initiatives preferred.
Risk Advisor - Employee Benefits Relation InsuranceRisk Advisor - Employee BenefitsColumbia, South CarolinaThe individual in this position conducts research in the market and develops a base of business to educate, promote and sell insurance services, keeps current on business community activities to obtain leads for business development activities, and maintains and services a profitable book of insurance business for existing clients. The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs.
Financial Crimes & Risk Data Analyst RainFinancial Crimes & Risk Data AnalystDc, South CarolinaAnalyze alert and case data to evaluate rule performance (e.g., false positive rates, alert-to-case conversion, escalation outcomes) and recommend data-driven optimizations. Assist in continuously improving transaction monitoring rules across card, ACH, wire, and digital asset activity to increase detection quality and reduce false positives.
Accessibility Compliance and Risk Analyst (Project Manager - Advanced) InterSources Inc.Accessibility Compliance and Risk Analyst (Project Manager - Advanced)Columbia, SCInterSources Inc , is a Small, Woman, and Minority-Owned Business Enterprise, ISO/IEC 27001, SOC 2 Type 2 certified company with massive 18+ years of diversified experience in providing IT Consulting Services, Artificial Intelligence, Data Analysis, Application Development, Cloud Services, Cybersecurity, Digital Marketing, ERP Management, Custom Software Development, Web Development, UI/ UX Design, System Integration, QA Support etc. Preferred Skills Certifications or formal training in WCAG / Section 508 / Digital Accessibility .
Risk Advisor - Employee Benefits Relation Insurance Services, IncRisk Advisor - Employee BenefitsColumbia, SC$100,000–$250,000 / yearThe individual in this position conducts research in the market and develops a base of business to educate, promote and sell insurance services, keeps current on business community activities to obtain leads for business development activities, and maintains and services a profitable book of insurance business for existing clients. The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs.
Project Engineer - Order Management Schneider Electric USA, IncProject Engineer - Order ManagementColumbia, SCFull timeWe ensure you feel secure with benefits that help you and your family thrive: medical (with member reward points), dental, vision, and basic life insurance, Benefit Bucks, flexible work arrangements, paid family leaves, well-being programs, 12 holidays per year, and 15 days of paid time off per year. • Previous experience working with ETO (engineer to order) products and familiarity with different types of applications and complexity features related to ETO products, including determining and communicating barriers & risks.
NewLead Director, Risk Adjustment Performance Reporting and Insights CVS Health CorpLead Director, Risk Adjustment Performance Reporting and InsightsSC$100,000–$231,540 / yearMaster's degree in Business, Informatics, Analytics, Finance, Statistics, Computer Science, Public Health, Healthcare analytics, Actuarial, Mathematics, Economics, or equivalent combination of advanced education, professional certification, or demonstrated subject matter expertise preferred. Partner with provider, clinical, and operational leaders to support performance improvement initiatives through data-driven insights and targeted intervention strategies.
R&I Cybersecurity & AI Risk Senior Manager PricewaterhouseCoopers LLPR&I Cybersecurity & AI Risk Senior ManagerColumbia, SC$91,000–$321,500 / yearExamples of the skills, knowledge, and experiences you need to lead and deliver value at this level include but are not limited to: Craft and convey clear, impactful and engaging messages that tell a holistic story. PwC does not intend to hire experienced or entry level job seekers who will need, now or in the future, PwC sponsorship through the H-1B lottery, except as set forth within the following policy: https://pwc.to/H-1B-Lottery-Policy .
Principal Risk Analyst-ServiceMac First AmericanPrincipal Risk Analyst-ServiceMacUsa, South CarolinaEstablishes a network of subject matter experts that provide the detail and context for existing processes, and/or stakeholders that may influence others to help support or drive improvements and to mitigate risks. Reviews, analyzes, and reports on risk, quality, service, and controls to improve operational efficiency and effectiveness, mitigate risk and remediate operational and regulatory vulnerabilities.
Risk & Independence Contract Specialist Senior Manager - Managed Services PricewaterhouseCoopers LLPRisk & Independence Contract Specialist Senior Manager - Managed ServicesColumbia, SC$91,000–$321,500 / yearLeading the substantive negotiation of complex commercial contracts; Reviewing and redlining detailed risk, legal, and commercial contract terms; Understanding of managed services offerings and related contract terms and conditions, performance metrics, and experience with (1) finance managed services - payroll, accounting, reporting, treasury and broader finance and accounting operations, (2) technology managed services - IT infrastructure, cloud, data analytics, application delivery maintenance application managed services, (3) cyber managed services, or (4) risk & regulatory managed services - regulatory compliance and enterprise risk programs; Exercising an entrepreneurial, problem-solving mentality and autonomy in managing contract negotiations; Explaining contract terms and positions in a collaborative manner to both internal stakeholders and external contract parties; Driving process improvement by analyzing current contracting approaches and processes and improving contracting efficiency and overall experience. Contract Specialists collaborate with R&I risk management and PwC business teams to (1) evaluate contract and related performance risks, (2) educate stakeholders and clients on contract provisions, (3) redline/negotiate contracts with clients' procurement, legal and outside counsel, and (4) develop internal controls to establish and reinforce contract compliance.
Risk & Independence Contract Specialist Senior Manager - Advisory Consulting Services PwCRisk & Independence Contract Specialist Senior Manager - Advisory Consulting ServicesColumbia, SC$91,000–$321,500 / yearLeading the substantive negotiation of complex commercial contracts; Reviewing and redlining detailed risk, legal, and commercial contract terms; Understanding of professional advisory/consulting service offerings, performance details, and related business strategies, including large-scale technology transformations, vendor selection and assessments, small to medium scale system implementations and AI roadmaps, and business integrator/change management projects; Exercising an entrepreneurial, problem-solving mentality and autonomy in managing contract negotiations; Explaining contract terms and positions in a collaborative manner to both internal stakeholders and external contract parties; Driving process improvement by analyzing current contracting approaches and processes and improving contracting efficiency and overall experience. Contract Specialists collaborate with R&I risk management and PwC business teams to (1) evaluate contract and related performance risks, (2) educate stakeholders and clients on contract provisions, (3) redline/negotiate contracts with clients' procurement, legal and outside counsel, and (4) develop internal controls to establish and reinforce contract compliance.
Risk Analyst-ServiceMac First AmericanRisk Analyst-ServiceMacUsa, South CarolinaEstablishes a network of subject matter experts that provide the detail and context for existing processes, and/or stakeholders that may influence others to help support or drive improvements and to mitigate risks. Reviews, analyzes, and reports on risk, quality, service, and controls to improve operational efficiency and effectiveness, mitigate risk and remediate operational and regulatory vulnerabilities.
Director; Program Management Clarity InnovationsDirector; Program ManagementColumbia, South Carolina$146,000–$390,000 / yearClarity Innovations is a trusted national security partner, dedicated to safeguarding our nation’s interests and delivering innovative solutions that empower the Intelligence Community (IC) and Department of Defense (DoD) to transform data into actionable intelligence, ensuring mission success in an evolving world. Staff Planning & HR Coordination : Anticipate complex program-wide staffing models, attrition risks, and resource shifts 6–12 months in advance, coordinating with Talent Acquisition and HR to onboard, transfer, and position personnel for maximum productivity and team satisfaction.
Lead Director, Stop Loss Relationship Management CVS Health CorpLead Director, Stop Loss Relationship ManagementSC$100,000–$231,540 / yearThe role will centralize accountability for stop loss-related funding decisions, risk acceptance, issue resolution, and carrier engagement, ensuring clearer governance, faster resolution of high-cost claim issues, and improved predictability across the stop loss ecosystem. The ideal candidate is a strong enterprise relationship leader with deep experience managing complex, cross-functional programs, executive-level stakeholders, financial risk, operational escalations, and external partner performance.
Project Engineer - Order Management Schneider Electric SEProject Engineer - Order ManagementColumbia, SCBachelor's Degree in Business, Supply Chain, Engineering or related field • Basic understanding of CPP as well as how order progresses thru gates at manufacturing plant: scheduling, approvals, engineering, procurement, manufacturing, testing and pack- out for shipment. We ensure you feel secure with benefits that help you and your family thrive: medical (with member reward points), dental, vision, and basic life insurance, Benefit Bucks, flexible work arrangements, paid family leaves, well-being programs, 12 holidays per year, and 15 days of paid time off per year.
NewSenior Manager, Project Management - Pharmacy Compliance CVS Health CorpSenior Manager, Project Management - Pharmacy ComplianceSC$67,900–$182,549 / yearAs a subject matter expert on legislation, regulatory requirements, and compliance initiatives impacting pharmacy programs and prescription drug products administered through both the pharmacy and medical, this role provides strategic guidance, regulatory interpretation, and leadership across implementation and regulatory readiness activities. The Senior Manager partners with stakeholders to assess impacts, mitigate compliance risks, and support regulatory initiatives, including oversight of prior authorization and utilization management activities for prescription drug products processed through the medical benefit.
NewProject Manager II, Technical Project Management Cencora IncProject Manager II, Technical Project ManagementSCSummary: Coordinates technical project and program management by executing moderately complex project coordination, schedule management, and stakeholder communication tasks under general guidance within pharmaceutical distribution technology programs. Applies developing knowledge of project management methodologies, risk management practices, and agile delivery frameworks to contribute to moderately complex programs of limited to moderate scope.