NewInsurance Sales Representative (Remote/Hybrid | Local Territory) The Compass Business GroupInsurance Sales Representative (Remote/Hybrid | Local Territory)Chapin, South CarolinaRemoteOur mission-driven team thrives on service, integrity, and results empowering you to make a meaningful impact while building a successful career. At Compass Business Group , we help protect families, teams, and small businesses through supplemental insurance solutions.
(Remote or Hybrid) Outpatient Psychiatrist (Adult) | Leadership Growth Opportunity Rivia Mind - Mental Healthcare(Remote or Hybrid) Outpatient Psychiatrist (Adult) | Leadership Growth OpportunityColumbia, SCRemote$220,000–$260,000 / yearLocation Eligibility: At this time, we are only able to consider applicants whose primary residence is in one of the following states within the United States of America: Connecticut, Florida, Massachusetts, New Jersey, New York, North Carolina, Pennsylvania, South Carolina, Texas. Compensation Determination: The pay range listed reflects the minimum and maximum base salary for this role, determined through an internal compensation assessment that considers similar labor markets to our practice across the United States.
Registered Nurse - Managed Care Coordinator - (13234) InGenesisRegistered Nurse - Managed Care Coordinator - (13234)Columbia, SCRemoteAs the industry landscape shifts with new challenges in patient care, quality and compliance requirements, workforce retention, and operational efficiencies, we deliver strategic, data-driven solutions that include redefining workforce management and clinical service delivery. With decades of experience, InGenesis has grown into one of North America’s most trusted Healthcare Services Firms, which includes comprehensive health and workforce solutions.
Registered Nurse, Non-Institutional (Nurse Investigator) / 60018429, 61096625 State of South CarolinaRegistered Nurse, Non-Institutional (Nurse Investigator) / 60018429, 61096625Richland County, SCRemote$70,455–$73,000 / yearDevelop case reviews to include as determined 1) conduct unannounced onsite visit and obtain medical records, 2) Request medical records 3) send provider/recipient survey letters 4) send provider self-audit letter, 5) request additional information or documentation or 6) make telephone calls to recipients to verify services 7) Coordinate and correspond case actions with Managed Care Organizations (referring providers timely), 8) Coordinate and correspond cases and complaints with the Investigator 9) Coordinate, correspond and assist in Agency's special projects (TPL, HYDE, etc.) and contractor reviews such as UPIC, RAC, etc. Evaluate paid claims history data and determine the following: 1) patterns of practice and adherence to Medicaid program policy and procedures; 2) research information and make decisions utilizing nursing knowledge and expertise in evaluating health delivery patterns of individual providers and specialties; 3) use appropriate methodology to conduct comparison studies, focus reviews, and random sampling, review universe of claims, self-audit, line by line sample or random sampling.
NewCompliance UM Nurse (Wed - Sun) Humana IncCompliance UM Nurse (Wed - Sun)SCRemote$71,100–$97,800 / yearWork at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it.
Field Care Manager Behavioral Health Humana IncField Care Manager Behavioral HealthSCRemote$65,000–$88,600 / yearWork at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Individuals must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher.
PRN Home Infusion / IVIG RN AIS HealthcarePRN Home Infusion / IVIG RNColumbia, South CarolinaRemoteInfusion, Home Infusion, RN, Registered Nurse, IV Therapy, Home Health, Hospice, ER, Trauma, ICU, Pediatrics, PRN, Vascular Access, IV Team, Oncology, PICC, Central Line, Infusion clinic, Ambulatory infusion, Cath lab, Transplant, Case Manager. As a national leader in the home infusion / IVIG field, we seek those special RNs who not only possess strong clinical expertise with creative ideas but who also have the kind of deep compassion and sensitivity it takes to treat people in their homes.
NewAssociate Director, Health Services Nursing Humana IncAssociate Director, Health Services NursingSCRemote$104,000–$143,000 / yearWork at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. The Associate Director, Health Services Nursing is responsible for driving excellence in care management (CM) and utilization management inpatient (UM) clinical operations through process improvement initiatives, process development, market enablement, targeted process audits, and training facilitation.
RN Health Care Facility Surveyor Impact Recruiting SolutionsRN Health Care Facility SurveyorColumbia, South CarolinaRemote$75,000–$90,000The Surveyor will serve as a team member or team leader on various types of surveys (i.e. re-certification, comparative, complaint investigation, and revisits) for long-term care and non-long-term care surveys, which can include; ambulatory surgical centers (ASC), Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID), end-stage renal disease (ESRD), Psychiatric Residential Treatment Facility (PRTF), hospital, critical access hospital, and hospice facilities. Impact Recruiting Solutions is currently seeking a RN Health Care Facility Surveyor to fill an opening with a Quality Improvement Consulting Company and will work in a technically exciting environment supporting internal and external customers nationwide .
NewOn-Site Care Coordinator (RN) - Lexington, SC Community Health Solutions of America, Inc.On-Site Care Coordinator (RN) - Lexington, SCLexington, South CarolinaRemoteWhile performing the essential functions of this position, the employee will regularly use a computer, telephone, and other office equipment; communicate with patients, caregivers, providers, and team members through various electronic platforms; and enter, retrieve, and maintain information in multiple electronic health record (EHR) and Medicaid documentation systems. Demonstrated computer proficiency with Microsoft Office, electronic health record (EHR/EMR) systems, Medicaid documentation and care management platforms, and the ability to efficiently navigate multiple electronic systems while maintaining accurate, timely, and compliant clinical documentation in accordance with state and regulatory requirements.
(RN) Remote Care Manager - SC based Molina Healthcare Inc(RN) Remote Care Manager - SC basedColumbia, SCRemoteCompletes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals.
Remote Registered Nurse (RN) Case Manager ValerisRemote Registered Nurse (RN) Case ManagerColumbia, South CarolinaRemoteBacked by proven industry expertise, a deep commitment to patient care, the latest technology, and exceptionally talented team members, Valeris provides the data and strategic insights, patient support services and healthcare provider engagement tools to help life sciences companies successfully commercialize new products. calling and working with the patient’s insurance payer to determine coverage benefits, anticipated out-of-pocket costs associated with their therapy and resources for financial assistance, where applicable based upon needs communicated by the patient.