Join our dynamic team in Columbia, SC, where you will have the opportunity to make a significant impact on the health and well-being of our members. Enjoy the vibrant culture and welcoming community of Columbia while advancing your career in a supportive and innovative environment.

• Review and evaluate medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical expertise, administrative policies, and established clinical criteria to service requests or provide health management program interventions.


• Utilize clinical proficiency, claims knowledge/analysis, and comprehensive knowledge of healthcare continuum to assess, plan, implement, coordinate, monitor, and evaluate medical necessity, options, and services required to support members in managing their health, chronic illness, or acute illness.


• Provide active case management, assess service need...