Case Coordinator Remote Jobs in South Carolina (US)
This page tracks remote case coordinator openings that are location-eligible for South Carolina.
This page tracks remote case coordinator openings that are location-eligible for South Carolina.
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$20 - $60,000
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• Establish and maintain contact with hospital/facility case managers, social workers, nurses, discharge planners, and other clinical points of contact. • Obtain clinical updates, treatment plan information, anticipated length of stay, discharge planning status, and barriers to discharge. • Review available medical records and summarize relevant clinical information. • Document clinical updates, communication attempts, discharge information, pending items, and next steps in designated systems. • Communicate with prison medical teams when treatment plans, discharge needs, or care coordination questions require clarification. • Support communication related to transfers, direct admissions, facility acceptance, and physician-to-physician coordination when appropriate. • Collaborate with Correctional Account Coordinators, Account Managers, medical records teams, and other internal stakeholders to ensure accurate and timely case updates. • Maintain current case information in AXIS, Salesforce, SharePoint, spreadsheets, and other designated platforms. • Complete final documentation and case updates following discharge or transfer. • Prepare and send weekly case management reports to designated prison contacts. • Escalate clinical deterioration, unclear treatment plans, discharge barriers, communication gaps, or urgent concerns to management and appropriate stakeholders.
Operating on the belief that healthcare is broken, Oscar Health Insurance is on a mission to reinvent and humanize the industry by combining technology, design,
Role Description Hi, we're Oscar. We're hiring a Case Management RN to join our Clinical Concierge Team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role: - Educate members on improving health outcomes - Assist with transitions from care settings - Participate in process improvement and other pilot programs as they arise - Work with support teams to ensure care for our members You will report into the Case Management Supervisor. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote Pay Transparency: The base pay for this role is: $32.60 - $42.79 per hour. You are also eligible for employee benefits, monthly vacation accrual at a rate of 15 days per year. Responsibilities - Help coordinate care across a variety of settings (inpatient, outpatient, post acute, ER, home care) - Reach out to members undergoing difficult health challenges and develop care plans - Reach out to hospital case managers to assist with discharge planning - Communicate with members by phone or secure messaging to provide education on health conditions, new medications, and procedures - Compliance with all applicable laws and regulations - Other responsibilities as assigned Requirements - Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate unrestricted RN license - Obtain additional state licenses to meet our needs - 2+ years of clinical experience to include hospital, outpatient or community-based care management - 1+ years of experience in Care Coordination and Navigation Bonus Points - BSN - Working knowledge of Milliman Guidelines - CCM Certification - Behavioral Health experience Benefits - Medical, dental, and vision benefits - 11 paid holidays - Paid sick time - Paid parental leave - 401(k) plan participation - Life and disability insurance - Paid wellness time and reimbursements
Role Description Responsible for accurate, detailed, and thorough medical billing processes. Working in coordination with the team Lead, the Supervisor, and Management. The coordinator will work collaboratively with patients and office team members to ensure that billing practices are complete and accurate. The ideal candidate will be someone who has a strong desire to work individually while meeting the needs of a national organization. An important key requirement is the self-accountability to drive success in a virtual team environment. This position is a remote role with the ability to sit within any US locality. Key Responsibilities - Perform duties as assigned in a professional demeanor, which includes interacting with insurance plans, clinics, patients, and team members as needed. - Maintain current information on correct and lawful practices for billing payers. - Participate in the daily RCM processes, monitoring for accurate and timely completion of team duties. - Maintain up-to-date information on RCM process with National SOPs, processes, and policies. - Utilize all available job aids, websites, programs, and resources provided. - Support leadership with daily, weekly, monthly reporting needs as required. - Maintain department daily productivity goals in completing a set number of accounts while also meeting quality standards as determined by leadership. - Identify and communicate with Team Lead / Supervisor any issues including system access, payor behavior, account work-flow inconsistencies or any other RCM related opportunities. - Other duties as needed. Qualifications - High school diploma or GED equivalent required. - Minimum of two years of medical facility or medical office billing experience. - Ability to work both in a team environment and independently. - Experience utilizing Microsoft Office products including Outlook, Excel, and Teams. - Experience with automated billing systems preferred. - Knowledgeable of full revenue cycle processes, with insurance companies, Medicare, and Medicaid. - Strong attention to detail. - Demonstrates awareness, inclusivity, sensitivity, humility, and experience in working with individuals from diverse ethnic backgrounds, socioeconomic statuses, sexual orientations, gender identities, and other various aspects of culture. Physical Requirements The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. - While performing the duties of this job, the employee is regularly required to sit, stand, bend, talk, and hear. - The employee is frequently required to walk. - The employee must be able to lift and/or move objects up to 25 pounds. - Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. Benefits - Medical, dental, and vision insurance. - AD&D, short and long-term disability, and life insurance. - 401k retirement savings with employer match. - Paid parental leave. - Paid time off. - Holiday pay. - Employee Assistance Program.
Role Description An ECM Coordinator III supports department staff with administrative tasks related to a member’s medical condition(s), department case work, communication with internal and external stakeholders, and manage audits. This role will engage with members to offer support and resources related to their medical condition(s) through Allied Care. Essential Functions - Facilitate reviews, referrals, and outreach for referral-based proprietary strategies as well as engaging with members across Medical Management products. - Document all engagement accurately and concisely within the Microsoft Customer Relationship Management (CRM) system. - Manage escalated and time sensitive case management questions received from members, broker relationships, and internal and external Allied stakeholders. - Collaborate with strategic vendor partners to provide supportive services and support to members. - Lead and facilitate claims auditing in conjunction with ECM Coordinators. - Complete department auditing related to daily tasks to ensure accuracy and identify escalations. - Identify impactful scenarios through appropriate closing summaries in timely fashion. - Share impactful scenarios with the department’s leadership team to deliver to internal departments, such as Sales, Operations, and Executive leadership. - Identifying escalations for department leadership team, as appropriate. - Other duties as assigned. Qualifications - Bachelor’s Degree or equivalent work experience, required. - At least 3-5 years of administrative support experience required. - Focus on patient-provider engagement, needs assessments, coordination of care, and or patient treatment adherence within the healthcare or social service industry preferred. - Understanding of intermittent medical terminology such as CPT, HCPC, and diagnostic codes. - Understanding of basic benefit plan design terminology such as deductible, out-of-pocket, prescription drugs, physical medicine services, etc. - Strong verbal and written communication skills. - Strong analytical and problem-solving skills. Requirements - Accountability. - Communication. - Customer Service Orientation. - Functional/Technical Skills. - Quality Focus. - Time and Task Management. Physical Demands This is a standard desk role requiring extended sitting and computer work. Work Environment Remote. Benefits - Competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life and Disability Insurance. - Generous Paid Time Off. - Tuition Reimbursement. - EAP. - Technology Stipend.
Role Description Gainwell Technologies is seeking a Medicaid Case Management Supervisor to support day-to-day operational performance, lead team members, and drive process improvements across assigned business areas. This role is responsible for helping formulate operational strategies, improving team performance, securing compliance with policies and procedures, and ensuring resources are used effectively to meet business objectives. The Operations Supervisor will serve as a key leader for the team, providing guidance, coaching, and support while identifying opportunities to improve quality, efficiency, and customer service. This position requires strong people management skills, critical thinking, and the ability to anticipate operational challenges and implement practical solutions. - Supervise, train, mentor, and support employees to ensure operational goals and service expectations are met. - Help formulate and execute strategies that improve departmental performance and operational effectiveness. - Monitor day-to-day activities to ensure compliance with operational policies, procedures, and business requirements. - Identify opportunities to reduce operational costs while maintaining quality and service standards. - Procure, coordinate, and manage materials, tools, and resources needed to support team operations. - Track progress of administrative duties and ensure work is completed accurately and timely. - Promote best practices across all levels of the team to improve consistency, productivity, and service quality. - Build strong teams by encouraging collaboration, teamwork, accountability, and a positive workplace culture. - Anticipate potential issues that may impact successful outcomes and recommend creative, practical solutions. - Support employee engagement by providing clear direction, regular feedback, and ongoing coaching. - Partner with leadership and cross-functional teams to support business objectives and operational priorities. - Ensure customer service standards are met by identifying process gaps and implementing improvements. Qualifications - Paralegal or bachelor’s degree preferred. - At least one year of experience in a supervisory, team lead, or people leadership role. - Prior experience managing, mentoring, or overseeing team members in a professional work environment. - Experience working with, reading, or reviewing legal documents. - Medicaid experience required. - Ability to monitor team performance, create reports, track SLAs/BPIs, and support operational reporting needs. Requirements - Remote position open to candidates located anywhere in the U.S. - Must be willing to work an Eastern Standard Time (EST) schedule: Monday through Friday, 8:00 a.m. to 5:00 p.m. - Video cameras must be used during all interviews, as well as during the initial week of orientation. - To work effectively as a teleworker or hybrid positions with Gainwell, employees must have a broadband internet connection with a minimum speed of 24 Mbps download and 8 Mbps upload. Higher speeds are recommended for optimal performance. - The deadline to submit applications for this posting is August 3, 2026. Benefits - The pay range for this position is $50,600.00 - $72,300.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. - Generous, flexible vacation policy. - 401(k) employer match. - Comprehensive health benefits. - Educational assistance. - A variety of leadership and technical development academies to help build your skills and capabilities.
Role Description The ECM Nutritionist delivers member-centered nutrition support that reduces risk, improves outcomes, and removes barriers to accessing evidence-based lifestyle support. This role partners closely with case management, utilization management, pharmacy, behavioral health, and other internal partners to advance chronic disease prevention and management (e.g., diabetes, hypertension, obesity) through nutrition education, health literacy, benefits navigation, and digital care tools. The ideal candidate is an empathetic advocate who blends nutrition science with practical, culturally competent care strategies. Essential Functions - Provide nutrition education via phone and digital platforms for members with diabetes, prediabetes, hypertension, obesity, CKD, and CVD risk to enhance understanding of the relationship between diet, chronic conditions, and overall wellness. - Develop culturally appropriate meal plans and dietary recommendations tailored to members’ health conditions, preferences, and socioeconomic factors. - Collaborate with case managers, pharmacists, behavioral health clinicians, and other partners to align goals, reconcile care plans, and optimize medication/lifestyle synergy. - Refer members to available tools and resources to support lifestyle management. - Maintain accurate and timely documentation, including care goals, interventions, progress, follow-up, and referrals. - Other duties as assigned. Qualifications - Bachelor’s degree in health education, health promotion, food science, nutrition, or a related health program required. - Lifestyle Management and/or Wellness Coaching certifications strongly preferred. Requirements - 3-5 years’ experience working with individuals with chronic conditions and lifestyle-related comorbidities. - Demonstrated ability to create culturally sensitive nutrition plans and communicate effectively with diverse populations. Position Competencies - Accountability - Analytical Thinking - Collaboration - Communication - Customer Focus - Functional Expertise - Initiative Physical Demands This is a standard desk role requiring extended periods of sitting and computer work. Work Environment Remote Benefits - Medical, Dental, Vision, Life and Disability Insurance - Generous Paid Time Off - Tuition Reimbursement - EAP - Technology Stipend
South Carolina’s largest and oldest health insurance company
• Provides active care management, assesses service needs, develops and coordinates action plans in cooperation with members, monitors services and implements plans, to include member goals • Evaluates outcomes of plans, eligibility, level of benefits, place of service, length of stay, and medical necessity regarding requested services and benefit exceptions • Ensures accurate documentation of clinical information to support and determine medical necessity criteria and contract benefits • Provides telephonic support for members with chronic conditions, high-risk pregnancy or other at-risk conditions that consist of intensive assessment/evaluation of condition, at-risk education based on members’ identified needs, provides member-centered coaching utilizing motivational interviewing techniques in combination with reflective listening and readiness to change assessment to elicit behavior change and increase member program engagement • Participates in direct intervention/patient education with members and providers regarding health care delivery system, utilization on networks and benefit plans • May identify, initiate, and participate in on-site reviews • Serves as member advocate through continued communication and education • Promotes enrollment in care management programs and/or health and disease management programs • Provides appropriate communications (written, telephone) regarding requested services to both health care providers and members • Performs medical or behavioral review/authorization process • Ensures coverage for appropriate services within benefit and medical necessity guidelines • Utilizes allocated resources to back up review determinations • Identifies and makes referrals to appropriate staff (Medical Director, Case Manager, Preventive Services, Subrogation, Quality of care Referrals, etc.) • Participates in data collection/input into system for clinical information flow and proper claims adjudication • Demonstrates compliance with all applicable legislation and guidelines for all regulatory bodies, which may include but is not limited to ERISA, NCQA, URAC, DOI (State), and DOL (Federal) • Maintains current knowledge of contracts and network status of all service providers and applies appropriately • Assists with claims information, discussion, and/or resolution and refers to appropriate internal support areas to ensure proper processing of authorized or unauthorized services
At Arriello, we provide Pharmacovigilance, Quality & Compliance, and Regulatory Affairs services to global pharmaceutical and life sciences companies, helping them meet regulatory requirements and protect patient safety. We are a growing business with a collaborative culture focused on high‑quality delivery, continuous improvement, and giving people the space to do their best work. Our values guide how we work: Inclusive – We value fairness, respect, and learning from one another. Dedicated – We deliver practical, client‑focused solutions. Innovative – We work together to find better ways forward. Passionate – We build strong relationships and care about the quality of what we do.
Role Description This is a remote position. As a Global Drug Safety Associate , you will support the delivery of high‑quality clinical and post‑marketing safety activities. You will work closely with senior Drug Safety colleagues to process safety cases, maintain documentation, and support compliance and operational tasks across multiple projects. Key Responsibilities - Support the processing of safety cases from clinical trial and post‑marketing sources, including AEs, SAEs, and SUSARs. - Assist with case receipt, triage, data entry, MedDRA and WHO Drug coding, follow‑up activities, and quality checks within safety databases. - Support expedited and local ICSR submissions under supervision. - Assist with reconciliation of safety data with clinical databases. - Support global and local literature monitoring activities. - Maintain and update Drug Safety documentation, trackers, and project files in line with internal procedures. - Provide administrative and operational support to the Global Drug Safety team, including mailbox monitoring and document management. - Support compliance monitoring, reporting activities, and internal process adherence. - Collaborate with cross‑functional teams and external partners as required. Qualifications - Bachelor’s degree in pharmaceutical sciences, life sciences, medicine, or a related field. - 1–3 years of experience in Drug Safety, Pharmacovigilance, or a medical environment, including case processing and regulatory submissions. - Experience in safety case processing within both clinical trial and post‑marketing settings is required. - Basic understanding of Drug Safety regulations and guidelines, including ICH, GVP, GCP, and CIOMS. - Experience or familiarity with safety databases is an advantage. - Fluent written and spoken English. - Strong attention to detail, organizational skills, and willingness to learn. - A collaborative team player with a positive and proactive attitude. Benefits - Work remotely while contributing to a global life sciences consultancy. - Lead quality operations that directly influence patient safety and regulatory compliance. - Collaborate in a multicultural, inclusive, and innovative environment. - Enjoy opportunities for career progression, professional development, and international exposure. - Flexible Work Options: Remote working flexibility to support your lifestyle. - Generous Time Off: Enjoy 5 weeks of holiday plus national holidays and 3 personal days to recharge. - Home Office Support: Get support to create a productive home office setup. - Bonuses: Benefit from an annual bonus program, spot bonuses, and employee-nominated recognition. Company Description At Arriello, we provide Pharmacovigilance, Quality & Compliance, and Regulatory Affairs services to global pharmaceutical and life sciences companies, helping them meet regulatory requirements and protect patient safety. We are a growing business with a collaborative culture focused on high‑quality delivery, continuous improvement, and giving people the space to do their best work. Our values guide how we work: - Inclusive – We value fairness, respect, and learning from one another. - Dedicated – We deliver practical, client‑focused solutions. - Innovative – We work together to find better ways forward. - Passionate – We build strong relationships and care about the quality of what we do.
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