Top 78 Rn utilization manager Jobs in Columbia, Sc

Telephonic Case Manager I - Columbia, SC
CorVel Corporation —Columbia, SC
- $63,739 - $95,264 a year
- Full-time
- Remote
- Nursing
- RN License
- Computer literacy
- Health savings account
- Disability insurance
Quick Apply
11d
Medical Field Case Manager
Enlyte —Columbia, SC
- $62,800 - $75,000 a year
- Full-time
- Nursing
- Microsoft Outlook
- RN License
- Travel reimbursement
- Health savings account
10d
Dialysis Clinical Manager Registered Nurse - RN
Fresenius Medical Care —West Columbia, SC
- Full-time
- Nursing
- RN License
- Customer service
2d
Registered Nurse (RN) - Utilization Management, PRN, Days
Prisma Health —Columbia, SC
- PRN
- Acute care
- Nursing
- RN License
Registered Nurse (RN)-Hospital Case Manager, Full-Time, Days
Prisma Health —Columbia, SC
- Full-time
- Acute care
- Nursing
- RN License
Care Manager II
Amerihealth Caritas —Columbia, SC
- Full-time
- Hybrid work
- Nursing
- Microsoft Outlook
- RN License
- Paid holidays
- Health insurance
(RN) Senior Medical Reviewer (Remote in SC)
BlueCross BlueShield of South Carolina —Lexington County, SC
- Full-time
- Remote
- Nursing
- RN License
- Word processing
8d
Hospice RN Case Manager
Hospice Services of SC —West Columbia, SC
- $80,000 - $83,000 a year
- Full-time
- Background check
- Nursing
- Anatomy knowledge
- Mileage reimbursement
- Health insurance
Quick Apply
1d
Registered Nurse (RN) - Navigator, Behavioral Care, PRN, Varied Shifts
Prisma Health —Columbia, SC
- PRN
- Nursing
- RN License
- Hospital
14d
Registered Nurse (RN)-Continuum of Care Mgr, Full-Time, Days
Prisma Health —Columbia, SC
- Full-time
- Nursing
- RN License
- Mid-level
9d
Hospice Assistant Nurse Manager (RN)-Registered Nurse, Midlands Inpatient, Full Time
Prisma Health —Columbia, SC
- Full-time
- Nursing
- RN License
- Inpatient
RN Acute Care PRN days Facility Resource Pool Richland Hospital
Prisma Health —Columbia, SC
- Weekends as needed
- Acute care
- Nursing
- Medication administration
9d
Registered Nurse (RN)-Acute Care, Endoscopy, FT, Days
Prisma Health —Columbia, SC
- Weekends as needed
- Acute care
- Nursing
- Medication administration
2d
Assistant Nurse Manager (ANM) - Medical Oncology & Infusion, FT, Days
Prisma Health —Columbia, SC
- Full-time
- Nursing
- RN License
- Hospital
Registered Nurse (RN)-Acute Care, Perioperative Services, Columbia, SC
Prisma Health —Columbia, SC
- Weekends as needed
- Acute care
- Nursing
- Medication administration
- Loan repayment program
- Relocation assistance
Assistant Nurse Manager, Vascular Access and Rapid Response, FT
Prisma Health —Columbia, SC
- Full-time
- Nursing
- RN License
- Inpatient
Registered Nurse (RN)-Acute Care, Facility Resource Pool, PRN, Days
Prisma Health —Columbia, SC
- Weekends as needed
- Acute care
- Nursing
- Medication administration
2d
Registered Nurse (RN) - Acute Care, IICU, FT, Days
Prisma Health —Columbia, SC
- Weekends as needed
- Acute care
- Nursing
- Medication administration
Registered Nurse (RN) - Acute Care, Orthopedic Spine, PT, Nights
Prisma Health —Columbia, SC
- Part-time
- Acute care
- Nursing
- Medication administration
Registered Nurse (RN)-Acute Care, Med Surg - Orthopedics, PT, Nights
Prisma Health —Columbia, SC
- Part-time
- Acute care
- Nursing
- Medication administration

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Telephonic Case Manager I - Columbia, SC

CorVel Corporation -
Columbia, SC

Quick Apply

Job Details

Full-time
$63,739 - $95,264 a year
11 days ago

Benefits

Health savings account
Disability insurance
Health insurance
Dental insurance
401(k)
Flexible spending account
Paid time off
Vision insurance
Opportunities for advancement
Life insurance

Qualifications

Customer communication

Full Job Description

The Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals. The goal is to support quality treatment and, when appropriate, a timely return to work. This role uses clinical expertise to assess the appropriateness of current treatment plans based on the patient’s medical and physical condition. The Case Manager communicates directly with treating physicians to evaluate and recommend alternative care options when needed. They also explain medical conditions and treatment plans to patients, family members, and adjusters, while supporting the objectives of the Case Management department and of CorVel.

This is a remote role.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

Provide medical case management to individuals through coordination with the patient, the physician, other health care providers, the employer, and the referral source
Provide assessment, planning, implementation, and evaluation of patient's progress
Evaluate patient's treatment plan for appropriateness, medical necessity, and cost effectiveness
Utilize medical and nursing knowledge to discuss the current treatment plan/alternate treatment plans with the physician
Make medical recommendations of available treatment plans to the payer
Implement care such as negotiating and coordinating the delivery of durable medical equipment and nursing services
Devise cost-effective strategies for medical care
Required to prepare organized reports within a specified timeframe
Minimum Productivity Standard is 95% per month
Additional duties as assigned

KNOWLEDGE & SKILLS:

Ability to make independent medical decisions and recommendations to all parties

Effective multi-tasking skills in a high-volume, fast-paced, team-oriented environment
Ability to interface with claims staff, attorneys, physicians and their representatives, and advisors/clients and coworkers
Excellent written and verbal communication skills
Ability to meet designated deadlines
Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets
Strong interpersonal, time management, and organizational skills
Ability to work both independently and within a team environment

EDUCATION & EXPERIENCE:

Bachelor’s degree required, BSN preferred
Graduate of accredited school of nursing
Current RN Licensure in state of operation
3 or more years of recent clinical experience, preferably in rehabilitation
URAC recognized Case Management certification (ACM, CCM, CDMS, CMAC, CMC, CRC, CRRN, COHN, COHN-S, RN-BC) required to be obtained within 3 years of hire if no nationally recognized certification is present at time of hire
Strong clinical background in orthopedics, neurology, or rehabilitation preferred
Strong cost containment background, such as utilization review or managed care helpful
Certification as a CIRS or CCM preferred

PAY RANGE:

CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.

For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.

Pay Range: $63,739 - $95,264

A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management (https://www.corvel.com/company/careers/)

In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.

ABOUT CORVEL:

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.

CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.

#LI-Remote

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.

Quick Apply

Refine Your Search

rn utilization manager jobs in columbia, sc

Telephonic Case Manager I - Columbia, SC

Medical Field Case Manager

Dialysis Clinical Manager Registered Nurse - RN

Registered Nurse (RN) - Utilization Management, PRN, Days

Registered Nurse (RN)-Hospital Case Manager, Full-Time, Days

Care Manager II

(RN) Senior Medical Reviewer (Remote in SC)

Hospice RN Case Manager

Registered Nurse (RN) - Navigator, Behavioral Care, PRN, Varied Shifts

Registered Nurse (RN)-Continuum of Care Mgr, Full-Time, Days

Hospice Assistant Nurse Manager (RN)-Registered Nurse, Midlands Inpatient, Full Time

RN Acute Care PRN days Facility Resource Pool Richland Hospital

Registered Nurse (RN)-Acute Care, Endoscopy, FT, Days

Assistant Nurse Manager (ANM) - Medical Oncology & Infusion, FT, Days

Registered Nurse (RN)-Acute Care, Perioperative Services, Columbia, SC

Assistant Nurse Manager, Vascular Access and Rapid Response, FT

Registered Nurse (RN)-Acute Care, Facility Resource Pool, PRN, Days

Registered Nurse (RN) - Acute Care, IICU, FT, Days

Registered Nurse (RN) - Acute Care, Orthopedic Spine, PT, Nights

Registered Nurse (RN)-Acute Care, Med Surg - Orthopedics, PT, Nights

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