Remote Jobs in South Carolina, United States

Claim Representative II is an intermediate-level role on the claim handler career path, responsible for handling moderate and difficult claims. The role exercises progressively more discretion in determining compensability and considers many factors when setting claim reserves, while negotiating and settling claims within given authority.

Elliott Davis is seeking a Sage Intacct Digital Business Systems Consulting Senior Manager to lead the Digital Business Systems Consulting Group. This leadership role helps clients evaluate and improve their business systems technology stack, covering people, daily processes, and technology, to uncover disconnects and design strategies that maximize current technology and correct process efficiencies.

R1 is the leading provider of technology-driven revenue cycle solutions that combine a global workforce of revenue cycle professionals with an advanced platform encompassing analytics, AI, intelligent automation, and workflow orchestration. As a Physician Advisor, you will help client facilities navigate compliant revenue by reviewing payor peer-to-peer cases daily, evaluating whether proper documentation supports the requested admission status, procedure, and care setting.

NIVA Health seeks a Wound Care Telemedicine Physician (Supervising) to deliver remote, insurance-based wound care to patients in South Carolina and North Carolina. The physician conducts telemedicine consultations, reviews photo-based wound assessments, directs advanced modalities and dressing strategies, and supervises Nurse Practitioners performing in-home visits.

The Director, Product Management - Health Data Interoperability at CVS Health defines and executes the product vision, strategy, and roadmap for healthcare data interoperability solutions. This leader manages a team of 4-5 Product Owners and drives innovation across data exchange platforms, interoperability services, APIs, and healthcare integration capabilities.

The Clinical Support Analyst role at CVS Health supports hiring, onboarding, access/system issue resolution, chargeback oversight, and Workday-related functions across the Clinical and Government Services Organizations. Day-to-day duties include maintaining staffing profiles for roughly 3,000 employees plus seasonal staff, ordering equipment and software, troubleshooting access issues, managing trouble tickets, and partnering with HR, Talent Acquisition, and IT to ensure seamless onboarding.

The Senior Data Analyst role within CVS Health's Quality Management team supports healthcare performance analytics for Dual Eligible Special Needs (D-SNP) populations, including Fully and Highly Integrated (FIDE and HIDE) groups. Day-to-day work involves independently leading complex analyses of Medicare Stars, pay-for-performance, provider incentive programs, member outreach campaigns, and performance reporting, while developing member-level targeting lists, dashboards, and scorecards.

CVS Health's Community Care Case Manager role serves the South Region, delivering collaborative assessment, care coordination, and advocacy to help members and families achieve quality, cost-effective health outcomes. As a Registered Nurse, you will manage catastrophic and chronically ill cases across the care continuum, liaising with members, providers, employers, and insurers, and conducting home, worksite, or office visits as needed.

CVS/Oak Street Health’s Decision Sciences team is hiring a Data Scientist to deliver data-driven solutions that optimize Oak Street Health’s care model and improve patient outcomes. Day-to-day, you will design and execute prospective study designs, ROI assessments, and clinical program evaluations; create statistical analysis plans with stakeholders; analyze large structured and unstructured datasets; and present findings to diverse audiences.

The Aftermarket Service Sales Manager at DeSHAZO executes the company’s service sales role, prospecting new customers, delivering total customer service throughout the order life cycle, and providing aftermarket support. Day-to-day work is roughly 80% pursuing new business and 20% office work, including account quotations, site visits, CRM logging, and credit/tax setup, across a territory covering South Carolina and Georgia and surrounding markets.

CVS Health is seeking a Pharmacist - Clinical Advisor to support Aetna as part of an account team in a client-facing managed care role. Day-to-day work includes serving as the clinical subject matter expert, analyzing drug utilization patterns and trends for PBM clients, delivering quarterly and annual clinical reporting with the account owner, and educating clients on CVS Health clinical programs and solutions to drive adoption and revenue.

WSP is seeking On-Call Emergency Managers – Preparedness to support its Federal Programs Team on an on-call, part-time basis. The role involves assisting clients and emergency management agencies nationwide with preparedness tasks including training, exercise, and planning across the emergency management cycle.

AC Disaster Consulting (ACDC) seeks Emergency Management Public Assistance Specialists at Mid and Senior levels to support disaster recovery for public and private clients. Specialists provide technical assistance through the recovery process, analyze project applications and inspection reports for FEMA compliance, manage grant lifecycles, and support emergency operations.

CrowdStrike's NGSIEM Agentic AI team is seeking a Senior Data Scientist to design, build, and deploy advanced AI systems that analyze and prioritize millions of security events per second. Day-to-day work includes leading architecture for large-scale retrieval, ranking, vector search, RAG, and anomaly detection; owning end-to-end ML pipelines; driving cross-functional AI initiatives; and mentoring junior scientists.

CrowdStrike's Product Security team seeks a Product Security Engineer, Vulnerability Intelligence to build and operate security tooling and automation across the Security Cloud. You will design and implement software and automation for security use cases such as software supply chain security, AI-powered vulnerability discovery, and multi-cloud platform visibility, while owning SRE excellence, CI/CD, and datastore operations for mission-critical security services.

The Branch Office Examiner, Compliance at Corebridge Financial's Legal team conducts approximately 75-125 comprehensive branch examinations per year to ensure compliance with industry rules, regulations, and firm policies. Day-to-day work includes generating and analyzing reports, performing pre-examination research, reviewing findings with branch management, drafting examination reports, and educating OSJ Managers, Financial Advisors, and support staff on regulatory requirements.

The South Carolina Department of Health and Human Services seeks a Program Integrity Operations Supervisor within the Operations and Managed Care Oversight (OMCO) unit in Richland County, SC. This in-office role provides mid-level operational leadership and coordination across all PI functions, including financial reconciliation, managed care oversight, enforcement workflows, audit documentation, data validation, and hearings support. The supervisor translates strategic direction into actionable

The Certified Coder role supports a busy multi-specialty practice in Myrtle Beach, SC, within the Float Pool. Day-to-day, the coder reviews clinical documentation, assigns CPT, HCPCS, and ICD-10 codes, enters charges and claims into the AthenaNet billing system, and communicates with physicians to ensure complete documentation.

Mobile Communications America (MCA) is seeking a DASaaS Program Manager to support its Data Division and In-Building Wireless Solutions, Network Services Team. The role leads end-to-end onboarding and deployment of approximately 150 existing Distributed Antenna System (DAS) sites and manages the new DAS-as-a-Service product offering, overseeing the full customer and site lifecycle from sales outreach through contract execution and operational handoff.

Qualfon is hiring Seasonal Customer Service Representatives to work 100% remotely from South Carolina, fielding inbound calls about customer benefits and claims. Day-to-day work includes responding to inbound and outbound inquiries, handling basic eligibility and benefits questions for dental providers, documenting encounters in a tracking system, and forwarding priority issues.