- Lincoln Financial Group (Honolulu, HI)
- …Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management ... Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible for… more
- Humana (Honolulu, HI)
- …and ad hoc reports in Access and/or SQL + Graduate degree + Utilization Management Review Experience + Registered Nurse (RN) Credentials + Home Health, ... Durable Medical Equipment, and/or Skilled Nursing Facility Experience **Additional Information** **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week)… more
- Humana (Honolulu, HI)
- …**Preferred Qualifications** + Registered Nurse + Experience in Medicare Utilization Management + Project Management Professional (PMP) certification ... are addressed. They will work closely with established functions inside utilization management (Medical Director, clinician decision making teams, quality… more
- Veterans Affairs, Veterans Health Administration (Honolulu, HI)
- …by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Responsibilities Duties: The Caregiver Support Program ... track service activities including visits, referrals, caregiver demographics, equipment utilization and caregiver and Veterans satisfaction. Develops implements and… more
- Fresenius Medical Center (Honolulu, HI)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- Always Best Care Senior Services (Honolulu, HI)
- …or services (with complete cost/benefit analysis). Oversees all CQI and utilization review activities. Assists in agency evaluation activities. Participates ... personnel records, and company financial records, which may be discussed with all management staff. QUALIFICATIONS 1. A Registered Nurse licensed in the state… more
- Fresenius Medical Center (Honolulu, HI)
- …barriers to quality improvement. This includes promoting the adoption and utilization of Corporate Medical Advisory Board Recommended Algorithms and Standing Orders, ... standards, quality improvement tools and electronic applications. Performs desk review of facility Quality Assessment and Performance Improvement (QAPI)… more
- Cardinal Health (Honolulu, HI)
- …for physician leaders and physician board regarding all areas of practice management and operations. This leader has primary responsibility to manage and drive ... will be needed in the following areas: practice operations, revenue cycle management , patient growth and practice marketing, value-based care, payor relations, EHR,… more
- Hawaii Pacific Health (Aiea, HI)
- …(CDI) certification. Experience with InterQual, Milliman or other nationally recognized Utilization Management criteria. Experience with DRGs or inpatient ... to patients, physicians, and other outside facilities for treatment, payment, or review . HIS is the custodian and gatekeeper for privacy of the organization's… more