Director, Healthcare Services - REMOTE Molina Healthcare IncDirector, Healthcare Services - REMOTECharleston, SCRemoteRegistered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (LMSW). At least 8 years of health care experience, and at least 5 years of managed care experienced in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or equivalent combination of relevant education and experience.
(Remote or Hybrid) Outpatient Psychiatrist (Adult) | Leadership Growth Opportunity Rivia Mind - Mental Healthcare(Remote or Hybrid) Outpatient Psychiatrist (Adult) | Leadership Growth OpportunityCharleston, 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 (RN) Clinical Specialist - Oncology & Bone Marrow Transplant - Roper Hospital Roper St. Francis HealthcareRegistered Nurse (RN) Clinical Specialist - Oncology & Bone Marrow Transplant - Roper HospitalCharleston, SCRemoteLicensure/Certification: Currently licensed as a Registered Nurse in the state of South Carolina or holds a current compact/multi-state license as a Registered Nurse in a recognized NCSBN Compact State and is not a permanent resident of SC. Job Summary: The RN Clinical Specialist exhibits current clinical knowledge and expertise for designated patient populations and is accountable for continued competence in nursing practice and clinical outcomes in accordance with current evidenced - based practice guidelines.
NewVA Clinical Liaison & Business Development Coordinator Medical University of South CarolinaVA Clinical Liaison & Business Development CoordinatorCharleston, SCRemoteThis remote, Columbia-based role is responsible for growing appointment volume and service utilization at the William Jennings Bryan Dorn VA Medical Center (Dorn VAMC) through clinical navigation, provider relationship development, and strategic engagement with VA and MUSC Midlands Division leadership. Current American Heart Association (AHA) Basic Life Support (BLS) certification or American Red Cross BLS for Healthcare Providers certification is required.
(RN) Remote Care Review Clinician - Utilization Review Molina Healthcare Inc(RN) Remote Care Review Clinician - Utilization ReviewSCRemoteResponsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience.
(RN) Remote Care Manager - SC based Molina Healthcare Inc(RN) Remote Care Manager - SC basedCharleston, 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.