Top 38 Utilization review behavioral health Jobs in South Carolina

Behavioral Health Caseworker
Amerihealth Caritas —Columbia, SC
- Full-time
- Hybrid work
- Acute care
- Microsoft Word
- Microsoft Outlook
- Paid holidays
- Health insurance
4d
RN Case Manager PRN
HCA Healthcare Summerville Hospital —Summerville, SC
- PRN
- Surgery
- Mid-level
- Critical & Intensive Care
- Employee stock purchase plan
- Disability insurance
Quick Apply
Senior Medical Reviewer (Behavioral Health Focused)
BlueCross BlueShield of South Carolina —South Carolina
- Full-time
- Remote
- Nursing
- Microsoft Outlook
- RN License
- Health insurance
- Dental insurance
Director of Behavioral Health Services
Health Care Partners of South Carolina —Conway, SC
- $100,000 - $152,000 a year
- Full-time
- 5 years
- HIPAA
- Master's degree
- 403(b) matching
- Health savings account
Quick Apply
Clinical Utilization Review Specialist
South Carolina Youth Advocate Program —Columbia, SC
- Part-time
- Hybrid work
- LMFT
- Management
- Experience working with individuals with disabilities
Quick Apply
2h
Behavioral Therapist
Prisma Health —Greenville, SC
- PRN
- Experience working with individuals with disabilities
- Hospital
- LPC
- Health insurance
PRN Behavioral Therapist – Day Treatment Program
Prisma Health —Greenville, SC
- PRN
- Experience working with individuals with disabilities
- Hospital
- Computer literacy
- Health insurance
Care Manager II (Foster Care)
Amerihealth Caritas —Florence, SC
- Full-time
- Hybrid work
- Microsoft Word
- Nursing
- Microsoft Outlook
- Paid holidays
- Health insurance
Case Manager, Registered Nurse
CVS Health —South Carolina
- $54,095 - $155,538 a year
- Full-time
- Remote
- Spanish
- Nursing
- Addiction Medicine
- Health insurance
- Dental insurance
Admissions Counselor Acute (Full Time/Nights)
Rebound Behavioral Health —Lancaster, SC
- $26 - $30 an hour
- Full-time
- Acute care
- CPR Certification
- Nursing
1d
Care Manager II
Amerihealth Caritas —Columbia, SC
- Full-time
- Hybrid work
- Microsoft Word
- Nursing
- Microsoft Outlook
- Paid holidays
- Health insurance
Utilization Specialist
Rebound Behavioral Health —Lancaster, SC
- PRN
- CPR Certification
- Nursing
- RN License
14d
Behav Care Prog Therapist II FT, Day
Prisma Health —Columbia, SC
- Full-time
- LMFT
- Licensed Clinical Social Worker
- LPC
Mental Health Professional I / Multi-Dimensional Family Therapy (Rock Hill / Catawba)
State of South Carolina —York County, SC
- $51,039 - $59,622 a year
- Full-time
- Spanish
- Adults
- HIPAA
- Paid parental leave
- Paid holidays
Part-Time Clinical Therapist
SAFY —North Charleston, SC
- PRN
- Clean driving record
- LPC
- Mid-level
- Paid training
- Mileage reimbursement
Quick Apply
1d
Behav Care Prog Therapist II, Internal Medicine-Primary Care, FT, Days
Prisma Health —West Columbia, SC
- Full-time
- LMFT
- Internal Medicine
- Primary Care
Primary Therapist
Stabilize Health LLC —Port Royal, SC
- LMFT
- Addiction Medicine
- Licensed Clinical Social Worker
Quick Apply
Board Certified Behavior Analyst / BCBA
ICBD —Hilton Head Island, SC
- $95,000 - $120,000 a year
- Full-time
- Hybrid work
- Management
- Master's degree
- Driver's License
- Continuing education credits
- Mileage reimbursement
Quick Apply
Licensed Clinical Director/LPHA
Behavioral Health Agency —Columbia, SC
- From $55,000 a year
- Full-time
- Background check
- LMFT
- Doctoral degree
- Health insurance
- Dental insurance
Quick Apply
Case Manager - RN
Aiken Regional Medical Centers —Aiken, SC
- Full-time
- Acute care
- Nursing
- RN License
- Health insurance
- Dental insurance

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Behavioral Health Caseworker

Amerihealth Caritas -
Columbia, SC

Apply Now

Job Details

Full-time
4 days ago

Benefits

Paid holidays
Health insurance
401(k)
Tuition reimbursement
Paid time off

Qualifications

Record keeping
Driver's License
Bachelor's degree
Progress documentation
Managing patient records

Full Job Description

Role Overview:

Responsible for managing and coordinating care, services, and social determinants of health for Members with behavioral health conditions and acute, chronic, and medically complex needs. Serves as the primary point of contact for the care team that includes Members, physicians as well as community supports to guide members in achieving their optimal level of health. Utilizes strong assessment and communication skills, critical thinking, and clinical knowledge to identify issues, gaps in care, and barriers to care. The Behavioral Health Case Worker develops a plan of care through shared decision-making with the Member/caregiver and in collaboration with providers and other care team members to improve the Member’s health status and compliance with treatment plans and promote self-management.

Support Members during transitions of care through assessment, coordination of care, education of the discharge plan of care, referrals, and evaluation of the plan's effectiveness.
Review the medication list and help members coordinate pharmacy needs with a community pharmacist to ensure medication reconciliation is completed when any changes occur.
Evaluate, monitor, and update the care plan through regularly scheduled follow-up contacts based on the Member/caregiver's progress, needs, and preferences.
Establishes points of contact in order to collaborate with identified community, medical, and/or behavioral health teams.
Maintain timely, complete, and accurate documentation of Member interactions in ACFC electronic care management platforms where applicable.
Monitor appropriate utilization and coordinate services with other payer sources, make appropriate referrals, and identify and escalate quality of care issues.
Develop a working knowledge of ACFC electronic care management platforms, care management programs, policies, standard operating procedures, workflows, Member insurance products and benefits, community resources and programs, and applicable regulatory, state, and NCQA requirements.
May identify cases to be presented at care management rounds and follow up with providers on recommendations to achieve optimal outcomes for Members.
Support a positive workplace environment, collaborate, and share clinical knowledge and skills to support our culturally and demographically diverse Member population.
Conduct Face-to-face visits at the Member’s residence, provider’s office, hospitals, other acute locations, or community locations for education and/or assessment.

Work Arrangement: Remote; Field-Based

Regular travel required throughout assigned South Carolina service area and surrounding regions.
Candidates residing in or near Upstate (Spartanburg County), Midlands (Columbia area), Low Country (Charleston County), and PeeDee (Lee County, Dillon County) are strongly preferred.
Must have valid driver's license, reliable transportation and auto insurance.

Education/Experience:

Required Bachelor's Degree in related field (i.e., social work, health science, psychology, sociology, early childhood education, etc.). Masters prepared will be given preferred consideration.
2 years of proven professional experience working directly with SMI members (Serious Mental illnesses) aged six and up who may have one of the following conditions: Psychotic Disorders, Bipolar Disorders, Major Depression.
2 years of social services experience, engaging with clients (e.g., individuals, families, communities), routinely assessing their needs, connecting them to services, and monitoring their progress.
Proficiency using MS Office (Word, Excel, Outlook), internet applications, and electronic medical record and documentation programs. Electronic Case Management Platform (i.e. Jiva)
Strong documentation and record-keeping skills are required, emphasizing accuracy and adherence to established methods.
Proven professional expertise in assessing members' situations, developing care plans, and teaching self-management. in assessing member's situation, developing a care plan, and teaching self-management. Skilled in working one-on-one with members, effectively communicating preventative health and management philosophies, and presenting health education materials to both individuals and small groups.

Our Comprehensive Benefits Package:
Flexible work solutions include remote options, hybrid work schedules, competitive pay, paid time off, holidays and volunteer events, health insurance coverage for you and your dependents starting Day 1, 401(k) retirement savings plan, tuition reimbursement, and more.

Why Join Us: Your career starts now. We are looking for the next generation of healthcare leaders. At AmeriHealth Caritas, we are passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together, we can build healthier communities. If you are driven to make a difference, we want to hear from you.

About AmeriHealth Caritas
Headquartered in Newtown Square, Pennsylvania, AmeriHealth Caritas is a mission-driven organization with over 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. Our services include integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at http://www.amerihealthcaritas.com

Apply Now

Refine Your Search

utilization review behavioral health jobs in south carolina

Behavioral Health Caseworker

RN Case Manager PRN

Senior Medical Reviewer (Behavioral Health Focused)

Director of Behavioral Health Services

Clinical Utilization Review Specialist

Behavioral Therapist

PRN Behavioral Therapist – Day Treatment Program

Care Manager II (Foster Care)

Case Manager, Registered Nurse

Admissions Counselor Acute (Full Time/Nights)

Care Manager II

Utilization Specialist

Behav Care Prog Therapist II FT, Day

Mental Health Professional I / Multi-Dimensional Family Therapy (Rock Hill / Catawba)

Part-Time Clinical Therapist

Behav Care Prog Therapist II, Internal Medicine-Primary Care, FT, Days

Primary Therapist

Board Certified Behavior Analyst / BCBA

Licensed Clinical Director/LPHA

Case Manager - RN

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